11 December 2025
A Flash of Wisdom: Navigating the Hormone Rollercoaster.
A practical guide to pre-menopause, perimenopause, menopause, and post-menopause, with reminders on symptoms, screening, and long-term health.
If you are wondering why you are simultaneously sweating in a snowstorm and forgetting your best friend’s name, you may already be on the hormone rollercoaster.
The transition can be understood in seasons, from pre-menopause through perimenopause, menopause, and post-menopause.
Season 0: pre-menopause
Pre-menopause covers the reproductive years before perimenopause. For most women this means regular periods and no classic menopausal symptoms.
Behind the scenes, egg reserve gradually declines, especially moving into the late 30s and early 40s. Fertility also begins to decline from the mid-30s.
This is a foundation-building phase. Bone health, adequate calcium and vitamin D, weight-bearing exercise, sleep, stress management, and healthy eating all matter.
If you are under 40 and your cycle is consistently irregular, seek medical advice. Irregular periods can be linked to stress, diet changes, thyroid issues, polycystic ovary syndrome, fibroids, or endometriosis.
Season 1: perimenopause
Perimenopause is the transition leading up to menopause. It often starts in the 40s and can last several years.
Oestrogen and progesterone levels fluctuate. Cycles may become shorter or longer, periods may become heavier or less predictable, and symptoms can include mood changes, night sweats, insomnia, brain fog, anxiety, and reduced emotional tolerance.
Useful steps include prioritising sleep, exercising regularly, stopping smoking, reducing alcohol, and speaking to a clinician if symptoms affect daily life.
Season 2: menopause
Menopause is a point in time, reached after 12 consecutive months without a period if over 50, or 24 months if under 50. It means the ovaries have stopped ovulating.
Season 3: post-menopause
Post-menopause is the time after menopause. Oestrogen and progesterone levels are consistently lower, which can bring long-term considerations around bone health, cardiovascular risk, and genitourinary symptoms.
Weight-bearing exercise, bone density assessment where appropriate, cholesterol screening, and routine NHS screening all become important.
Midlife hormonal change can be disruptive, but you are not broken and you are not alone. Information, support, and appropriate clinical care can make a real difference.
If you require advice about symptoms, book an appointment. You can also explore our health checks.
