Perimenopause: what happens to your body, and what you can do.
Perimenopause usually begins in the mid to late 40s, earlier for some women. It typically lasts several years, sometimes much longer. We help you understand what is happening in your body and what can help.
The transition to menopause, not menopause itself.
Perimenopause is the transition to menopause, the period in which the ovaries gradually reduce their function. Oestrogen swings, rising and falling irregularly, progesterone declines, FSH rises. Menopause itself is confirmed in hindsight, once the last period was twelve months ago.
In Europe, the average age of menopause is 51. So perimenopause often begins in the mid-40s, and for some women in their early 40s. If your symptoms start before 40, have them checked by a doctor.
What becomes noticeable in perimenopause.
From hot flushes to brain fog, from sleep problems to weight gain. One symptom alone says little, the interplay is what matters.
The hormone biology behind it.
Oestrogen regulates far more than the cycle: sleep, mood, metabolism, bone health and the moisture of the mucous membranes. When oestrogen swings and falls, those effects show up throughout the body.
Oestrogen regulates sleep, mood, metabolism, bone and mucous membranes. When it swings and falls, it shows up throughout the body.
Progesterone often falls first, because ovulation is skipped more often. That can contribute to irregular or heavier bleeding.
FSH rises in response to falling oestrogen levels. A lab value that fluctuates widely and is not decisive on its own.
There are good weeks and bad weeks. A single lab value is rarely conclusive, the assessment needs symptoms and course over time.
Often missed: exhaustion, low mood and poor sleep are easily put down to burnout or depression first, and hormones only come up later. Sometimes the two are connected. An underactive thyroid can cause similar symptoms and is therefore assessed alongside.
What is medically possible in perimenopause, step by step.
It always starts with a medical consultation. What follows depends on your phase and your findings.
Intake questionnaire beforehand, then a 1:1 video consultation. Your physician works out whether your symptoms fit perimenopause or have another cause.
Oestradiol and FSH swing widely in this phase, a single value decides nothing. Lab values are used where they change the plan, and the thyroid is assessed alongside.
A dedicated video consultation: what connects, what is treatable and what is watched.
Closely guided during the setup phase, then on a quarterly rhythm. Dosage and tolerability are reviewed continuously.
Not every patient is suited to every therapy. Treatment decisions are made by your physician, not an algorithm.
To treatmentYour medical consultation
Your consultation brings clarity about your next medical step. Where medically indicated, targeted diagnostics complete the assessment. During treatment you are supported by a physician throughout.
Preparation in your patient area, a review by your physician before the appointment, 30 minutes by video with her, then your assessment and recommendation in writing.
Follow-up with your physician every month, for phases in which effect, tolerability or dosage need to be guided closely. You can stop at any time, and the current monthly period runs to its end.
Follow-up with your physician every three months, once your treatment is well established. You pay for three months in advance. You can cancel at any time, and the quarterly period you have already paid for runs to its end.
Where medically indicated: targeted diagnostics. Your physician discusses the scope and cost with you beforehand.
Your medical consultation
A fixed price for your consultation. Then you decide whether ongoing care makes sense.
Included in both
When your body changes, your next step should be clear.
In your medical consultation, your physician already knows your medical history and any existing results before you speak. You use the 30-minute video call to look ahead, and afterwards you receive your assessment and recommendation in writing.
- Between 38 and 65 years old
- Typical perimenopausal or menopausal symptoms
- Also with hormone therapy already underway
When your body changes, your next step should be clear.
In your medical consultation, your physician already knows your medical history and any existing results before you speak. You use the 30-minute video call to look ahead, and afterwards you receive your assessment and recommendation in writing.
Common questions about perimenopause.
The most common questions about perimenopause. Anything further you clarify directly with your physician.
All questions and answersWhen does perimenopause begin?
Perimenopause usually begins in the mid to late 40s, but it can start earlier. If your symptoms start before 40, have them checked by a doctor.
How long does perimenopause last?
Perimenopause typically lasts several years, about four on average, and much longer for some women. When it has ended only becomes clear in hindsight, once the last period was twelve months ago.
Is perimenopause the same as menopause?
No. Perimenopause is the transition, the phase of hormonal change. Menopause is confirmed in hindsight, once the last period was twelve months ago.
Can perimenopause be detected with a blood test?
Usually not. From around 45, your physician assesses perimenopause from your symptoms and your cycle, because hormone levels fluctuate too much. A blood test helps mainly in younger women or when another cause such as the thyroid is possible.
Does hormone therapy help with perimenopausal symptoms?
According to the guidelines, hormone therapy relieves hot flushes and night sweats effectively, and for many women sleep and mood improve too, often because the hot flushes ease. It is not suitable for every woman, though, and it is not free of risks. Whether it is right for you depends on your age, your medical history and your risks, and your physician assesses this.