Perimenopause is the time, usually in your 40s, when your periods become irregular before they stop altogether. Hormone levels change, and with them sleep, mood, weight and energy. It is a natural stage, not an illness, and there is a lot you can do to feel strong through it, alongside your doctor’s advice.
What is perimenopause?
The NHS puts it simply: perimenopause is when your periods become irregular, and menopause is when they stop altogether. You have reached menopause when you have not had a period for 12 months (and are not using hormonal contraception). WHO calls the years of change the menopausal transition, which ends one year after your final period.
Most women reach menopause between 45 and 55, but it can happen earlier. If your periods stop or you have symptoms before 45, see your doctor: early menopause has its own causes and care.
Signs of perimenopause
Symptoms vary a lot from woman to woman. The NHS lists:
- Period changes: periods that come more or less often, or bleeding that gets heavier or lighter.
- Mood and mind: mood swings, low mood or depression, and problems with memory or concentration (“brain fog”).
- Hot flushes and night sweats, and trouble sleeping.
- Body changes: weight gain, joint pain, muscle aches, headaches, palpitations, dry skin and hair loss.
- Intimate and bladder changes: vaginal dryness, urine infections and leaking urine, and lower libido.
The NHS says symptoms usually last 7 to 9 years, sometimes longer, and can change over time. Keeping a simple diary of your periods, sleep and symptoms for two or three months helps you and your doctor see the pattern.
Why your weight and shape change in your 40s
Weight gain is one of the symptoms the NHS lists, and many women notice it settling around the middle. It rarely has one cause. Broken sleep leaves you tired and craving quick energy; mood swings and stress make comfort eating more likely; joint aches make you move less; and muscle, which keeps your body strong and active, slowly declines with age unless you use it. Our guide to metabolism after 35 explains why muscle matters more than your “metabolism”.
Crash diets make this worse, because they strip away muscle along with fat. What works is steady: strength training, regular movement, protein at every meal and better sleep.
What helps: a perimenopause plan you can do at home
Strength training, twice a week or more
The NHS recommends regular exercise with a focus on strength and weight-bearing work to protect your bones, and WHO advises muscle-strengthening activities on at least two days a week. At home that can be chair squats, wall push-ups, lunges, and rows or presses with water bottles. WHO notes that loss of bone density at menopause is a significant contributor to osteoporosis and fractures, so this matters for the next 30 years, not just your waistline.
Move most days
Aim for at least 150 minutes of moderate activity a week: brisk walking, dancing or low-impact cardio. The NHS also recommends regular exercise and relaxing activities for mood.
Cool the hot flushes
- Wear light, layered cotton clothes and keep your bedroom cool at night, with a fan if you can.
- A cool shower or a cold drink can help when a flush comes.
- Notice your triggers. The NHS lists spicy food, caffeine, hot drinks, smoking and alcohol. For many of us that means watching the third cup of hot chai and very spicy dinners.
Protect your sleep
Keep regular sleep times and rest as much as you can. A wind-down hour without your phone, and no tea or coffee late in the day, make a real difference. Our stress guide has a 15-minute daily reset.
Eat for your bones and energy
The NHS recommends a healthy, balanced diet with plenty of fruit, vegetables and calcium. In an Indian kitchen: milk, dahi and paneer, ragi, green leafy sabzi, dal and chana, with sensible portions of roti and rice. Protein at every meal helps protect muscle.
Don’t smoke, and go easy on alcohol
The NHS notes that smoking can make menopause symptoms worse.
Contraception: you can still get pregnant
Irregular periods don’t mean you can’t conceive. The NHS advises using contraception until 2 years after your last period if you are under 50, or 1 year if you are over 50, and notes that HRT is not a contraceptive. Talk to your doctor about the right option.
When to see your doctor
- Your symptoms are affecting your daily life, sleep, work or relationships. There are hormonal (HRT) and non-hormonal treatments, and your doctor can help you weigh them up.
- You have menopause symptoms or your periods stop before 45.
- Your periods become much heavier or more frequent, or you bleed between periods or after sex.
- You have palpitations.
- Any bleeding after 12 months without a period, even once and even if it is light. The NHS says to see a doctor about this.
How FunDa helps women in their 40s and 50s
The Superwoman Club is designed for women in their 30s, 40s and 50s. You get strength training for bones and joints, the Superwoman Lifestyle step for sleep, stress and hormone-friendly routines, nutrition built around your own kitchen, and live sessions with Dr. Jyoti every week, with women who are going through the same changes. The one-year plan gives you time for the habits to hold through every season. We coach fitness and lifestyle; we don’t diagnose or treat medical conditions, so keep your doctor involved, and results vary. For life after your periods stop, read our menopause fitness guide.
Sources
- NHS. What are menopause and perimenopause? (reviewed 19 May 2026).
- NHS. Menopause and perimenopause: symptoms (reviewed 19 May 2026).
- NHS. Things you can do to help menopause and perimenopause symptoms (reviewed 19 May 2026).
- NHS. Menopause and perimenopause: treatment.
- NHS. Common questions about continuous combined HRT (contraception during perimenopause).
- World Health Organization. Menopause, fact sheet (16 October 2024).
- Bull FC et al. World Health Organization 2020 guidelines on physical activity and sedentary behaviour. Br J Sports Med. 2020.
