What is happening hormonally
Perimenopause is the transition period during which oestrogen and progesterone levels fluctuate and decline. Menopause is the point 12 months after the last period. Symptoms result from hormonal fluctuations — which is why they are often most intense during perimenopause rather than post-menopause. The average age of menopause in the UK is 51; perimenopause typically begins 4–10 years earlier.
HRT: what NICE now says
NICE guidelines updated in 2015 and 2023 state that HRT is the most effective treatment for menopausal symptoms and that the risks for most healthy women under 60 are small relative to the benefits. The previous scare about breast cancer risk was based on older combined HRT formulations; current body-identical HRT (transdermal oestrogen with micronised progesterone) carries a different risk profile. Every woman should discuss options with her GP or a menopause specialist. Use our free perimenopause symptom tracker to document symptoms before appointments.
Lifestyle changes that help
Regular aerobic exercise reduces hot flush frequency and severity. Weight-bearing exercise protects against bone density loss. Reducing alcohol and caffeine reduces hot flush triggers. Phytoestrogens (soy, flaxseed, chickpeas) may have mild oestrogenic effects. Sleep hygiene (our free sleep checklist) is critical — night sweats disrupt sleep, and sleep disruption amplifies every other symptom.
Our picks compared
| Pick | Product | Best for | |
|---|---|---|---|
| Top pick | A4 heavyweight matte card | Track symptoms | Check price → |
| Book | Menopausing Davina McCall menopause HRT guide | Menopause guide | Check price → |
| Pillow spray | Sleep pillow spray menopause night sweats cool | Sleep support | Check price → |
| App | Balance menopause app Dr Louise Newson free | Menopause app | Check price → |
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