How Do I Know if I’m Perimenopausal?

How Do I Know if I’m Perimenopausal?

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How Do I Know If I’m Perimenopausal?

Most of us grow up aware that menopause will happen at some point in midlife, but how many of us know about perimenopause and when that begins? With so many different symptoms and no clear timeline to follow, a lot of women are asking the question: How do I know if I’m perimenopausal?


What is perimenopause?

There are 3 main stages to the natural menopause journey: perimenopause, menopause, and post-menopause. Perimenopause covers the months and years leading up to menopause when your hormones are fluctuating and causing all kinds of physical and mental symptoms.

On average, women move into perimenopause in their late 30s / early-mid 40s.  However, with premature menopause and Primary Ovarian Insufficiency fertility levels decline, and the menstrual cycle stops before the age of 40.

There are ethnic differences in how women experience perimenopause and menopause. Research shows that Black, Latina, and Asian women may begin perimenopause earlier than white women and may have a longer transition phase.

Periods continue during perimenopause, although it might not be a regular cycle and it may be longer, shorter, lighter, or heavier than before. And if your menopause journey is surgically or medically induced, you may not experience the perimenopause phase at all – you may jump straight to menopause.

Menopause is that point in time when your periods have stopped. The average age for women to reach menopause in the US is 51, though women of color often experience it earlier than this.

Menopause means ‘end of periods’ and is defined as that day on the calendar when you haven’t had a period for 12 months (or 2 years if you’re under 40). At this point you can say you’ve done it; you’ve gone through menopause!

The post-menopause phase is everything after this point – i.e., the rest of your life after your menstrual cycle has stopped. You may find a few symptoms lingering on, but these should settle down as your body adjusts to producing much lower levels of sex hormones.


What are the symptoms of perimenopause?

According to the Menopause Invisibility report by Gen-M, there are at least 48 different symptoms associated with perimenopause and menopause. There are the common ones that you’ve probably heard about, like hot flashes, anxiety, night sweats, weight gain, and brain fog, but there are plenty that are less well-known, including:

  • Altered sense of smell and taste
  • Acid reflux and bloating
  • Vulvovaginal dryness and pain
  • Itchy ears
  • Burning mouth and tongue
  • Dizziness
  • Cold flushes
  • Thinning hair
  • Pins and needles in your hands, feet, arms, or legs
  • Insomnia
  • Palpitations

If you’re in your late 30s or early-mid 40s and you’re starting to notice some of these symptoms – whether your periods are changing or not – you could be in perimenopause.

The reason for such a crazy range of symptoms is because estrogen and progesterone act in lots of areas of the body. From bones and nerves to the heart and digestive tract, our sex hormones do way more than just run the menstrual cycle.

Take the brain for example. A lot of women notice increasing anxiety and difficulty sleeping in their late 30s / early 40s. Their monthly cycle is the same and menopause may be ten or twenty years away yet, so they don’t make the link between these symptoms and their hormones.

But the brain is one of the first places to be affected by changing estrogen and progesterone levels. Progesterone has a calming effect on the nervous system and estrogen influences our sleep/wake cycle. So, when these hormones start to fluctuate during perimenopause, we can experience difficulty sleeping, mood swings, and frequent anxiety.


Can perimenopause symptoms be something else?

There is a crossover between some perimenopause symptoms and other health conditions. It’s always worth speaking to your healthcare provider if you are concerned about what’s going on, especially if you have a family history of health issues.

Health conditions to consider include:

  • Thyroid function can be affected by perimenopause and may cause similar symptoms. Weight gain, constipation, low energy, and brain fog are all signs of low thyroid function (underactive thyroid) while anxiety, racing thoughts, weight loss, diarrhea, and palpitations are classic signs of overactive thyroid.


  • Pregnancy! It may be the last thing on your mind at this point in life, but until you’ve reached menopause there is still a chance you can fall pregnant.


  • Over-exercising: a high-intensity training regime can cause periods to stop.


  • Sleep apnoea: night time waking can be due to hormone changes but can also be caused by sleep apnoea, a serious sleep condition. Left unchecked, sleep apnea can increase the risk of Type II Diabetes, heart disease, and high blood pressure.


  • Depression: mood swings and low mood are common during perimenopause but if symptoms persist or get worse, speak to your healthcare provider about support.


  • Arthritis: joint pains are common in midlife, but persistent pain and swelling may be a sign of osteoarthritis or rheumatoid arthritis.


  • Cancers: persistent fatigue, night sweats, and itchy skin can be signs of lymphoma, a type of cancer.


How can I manage perimenopause symptoms?

Diet and lifestyle changes are a great place to start. Food and drink, movement, relaxation, and sleep all provide the foundations for a healthy well-being and can go a long way toward easing perimenopause symptoms.

And, if you then decide to try Hormone Replacement Therapy (HRT) or herbal alternatives for hormone balance, your body will be in a better place to respond to them.

Try these five top tips for managing perimenopause symptoms:

  1. Minimise caffeine: this can be hard to stomach when you rely on a coffee fix, but caffeine is a major trigger for symptoms of anxiety, gastrointestinal problems, insomnia, and fatigue. Tolerance to caffeine can change over time and you may not be able to handle it as well as you used to. Try gradually replacing coffee, tea, and caffeinated sports drinks with water and herbal alternatives and see what a difference it makes.


  1. Nourish your gut: there’s a group of microbes in the gut called the estrobolome that processes deactivated estrogen. When the estrobolome is out of kilter, it produces too much of an enzyme that reactivates estrogen, sending it back into circulation. More estrogen might sound like a good thing but it’s not, and this recycled estrogen can worsen hormone imbalances. To keep your estrobolome in check, include fermented foods like sauerkraut, kimchi, natural yogurt, and kefir, and eat fiber-rich fruits, vegetables, and whole grains.


  1. Eat a rainbow of fruits and vegetables every day: the colorful compounds in fruits and vegetables help manage inflammation and hormone balance. Aim to include as many different colors as you can in each meal.


  1. Include plenty of good quality protein in every meal and snack: We start to lose more muscle mass after menopause, and this affects metabolism and bone health. Make space for at least ¼ plateful of protein-rich foods with each meal. Eggs, good-quality meat, fish, shellfish, beans, pulses, nuts, and seeds are all good sources. Collagen powder can help top up protein levels – vegetarians and vegans can use pea, hemp, or soy protein.


  1. Include phytoestrogen foods each day: chickpeas, tofu, tempeh, miso, alfalfa sprouts, and ground flaxseeds are all rich in plant-based estrogen compounds called phytoestrogens. These compounds help balance out fluctuating estrogen levels during perimenopause and can ease troublesome symptoms.


Perimenopause is a unique journey for each of us, and symptoms can change as we get nearer to menopause. Making diet and lifestyle changes is a good place to start, alongside finding a supportive healthcare practitioner to discuss any concerns.

Natural Nutrition for Perimenopause - What to eat to feel good and stay sane book cover by Sally Duffin Perimenopause Nutritionist

Discover even more nutrition and lifestyle tips for managing perimenopause and menopause in “Natural Nutrition for Perimenopause – What to eat to feel good and stay sane”.

Available on Amazon or direct from YPD Books, this friendly guidebook covers everything from what perimenopause is and how to spot the signs of change to essential nutrients, supplements, toxins, and lifestyle support.

“Reading this book has helped me understand how my diet and lifestyle can support my body through perimenopause.  And it’s written beautifully too.”   Amazon Reviewer

bones, skin, an

Meet the Practitioner – Kerry Taylor, Menopause Coach

Meet the Practitioner – Kerry Taylor, Menopause Coach

Today I’m talking to Kerry Taylor, Menopause Coach.

Kerry works with large organisations and private 1-1 clients to offer support on all aspects of the menopause transition.

Based in a beautiful part of the world – south west France – Kerry has a global reach with her online business.

Kerry Taylor, Menopause Coach

SD Hi Kerry, thank you for joining me today. Can you start by sharing a little about your background and how you came to be a Menopause Coach?

KT Hi Sally, of course. So, I qualified as a nurse originally, 18/19 years ago. Then about 10-12 years ago I worked on a joint project between the NHS and Department for Work and Pensions (DWP) helping people with long term health conditions to get back into work. 

After that project ended, I began to work freelance in workplace health and occupational health with people who had long-term mental health conditions. 

I worked with lots of different organisations and employment sectors and noticed a lot of referrals from women in their 40s and 50s.  These women were suddenly experiencing symptoms like anxiety, depression, loss of concentration, poor memory – to the point where they thought they might have dementia.

None of this was being picked up as menopause, and this really piqued my interest. I thought there’s a lot of this going on and there’s not a lot of support being given. 

What these women needed was a lot of practical advice on how they can manage their symptoms, how they can maintain their attendance at work. So, I did additional training with the British Menopause Society and transitioned into doing menopause coaching.

Two women at work, chatting

Fantastic, it sounds like each stepping stone of your career has led you to this point!  Who do you currently work with?

KT I work with a large organisation on their occupational health, and with women in 1-1 sessions.  I ran a session with a client’s husband recently.  Their relationship was really struggling, and she wanted him to hear from someone else about what’s going on for her and how he can help.  He found it really helpful and has become a lot more understanding and empathetic, even to the point of knowing when to walk away and give her some space!

SD Getting the partner onboard is so important, isn’t it.  Often the husband or partner is struggling because the woman is so overwhelmed and can’t communicate what she needs.  Once they know what’s happening, they feel more able to offer support.

What is the situation like in France regarding public perception of menopause and how it is managed by healthcare professionals?

KT France is slightly lagging behind in terms of accessing up to date research on HRT (hormone replacement therapy). But the main difference is that if you visit a doctor here, they will do a full raft of investigations right away because they recognize that early intervention prevents problems further down the line. 

They are big on complementary therapies and natural remedies here.  If I go to my doctor and say I’m experiencing brain fog and other symptoms and I think it’s menopause she will immediately send me for a mammogram, a smear test, and a gynaecologist referral.  And that will all be done within 2-3 weeks.

But the gynaecologist will first say they are going to prescribe herbal remedies and skin creams and so on before thinking about synthetic medications like HRT.  Which is fine, but in some cases, HRT is the best approach and yet you must go through everything else first to get there.

SD Wow, this is such a contrast to the UK system.  Women here are struggling to get a telephone appointment with a GP and if you do manage to get one, the treatment approach is usually HRT or nothing! Even once you have a HRT prescription, there’s no guarantee the pharmacy will have any!

SD Can you explain a bit about what sort of workplace support is available to women, and how they can access it?

KT Sure.  So, this obviously varies between organisations and what resources they have available, but generally speaking employers are keen to offer support. 

I always start by advising women to look through the company policies on staff wellbeing and read them through the lens of menopause.  For example, it’s easy to think that a policy on stress management doesn’t apply to menopause but stress makes menopausal symptoms worse. 

Once you’ve identified some relevant policies approach your manager and start the conversation about getting help and support. 

The kind of support companies offer varies but it might include:

  • A specific menopause policy
  • Stress management and/or staff wellbeing policy
  • Employee Assistance Programme that might cover counselling, CBT (Cognitive Behavioural Therapy), or seeing a physiotherapist
Woman talking on the phone

Hot flushes are one of the most disturbing symptoms for women.  In terms of specific practical support, women can ask to be seated near a window and have a desk fan if it’s an office situation and have access to cold drinking water facilities.

Uniforms can be problematic for hot flushes.  If the uniform is provided ask about size and fabric options.  Some women find the maternity size most comfortable because of its loose fit and often lighter fabric.  This is really helpful when bloating is a problem too.  If there isn’t a maternity option, ask about having the uniform in 2 different sizes.

Working from home may be an option for some women. This can help with managing symptoms of brain fog and anxiety.  It removes all the distraction and demands of an office.

SD Fantastic advice there, thank you.  Lots of practical tips for women to try.

Finally, if you could share one golden nugget of advice for women experiencing perimenopause and menopause, what would it be?

KT When I see women who are overwhelmed and being hard on themselves about how they are struggling to cope I always say, “what would you say to your best friend if they’d just come to you and told you all this?” 9 times out of 10 they come back with a much kinder response!

It’s so important to be kind to yourself, to recognize the need for help and don’t assume you can power through on your own.  If it all feels like too much, do a brain dump of all your symptoms and worries on paper and then work out the main barriers and challenges.  Break them down into manageable chunks and go from there.

SD Small steps, that’s the best way forward.  Thank you so much Kerry, it has been a joy speaking with you.

Find out more about Kerry’s work and connect with her at:

Instagram @kerrytaylormenopausecoach

Facebook Kerry Taylor Menopause Coach

Kerry Taylor, Menopause Coach
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Order your copy today!


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“Reading this book has helped me understand how my diet (and lifestyle) can support my body through perimenopause. And it’s written beautifully too.” – Amazon reviewer


Natural Nutrition for Managing Endometriosis

Natural Nutrition for Managing Endometriosis

Endometriosis - can good nutrition help?

As part of Endometriosis Awareness Month I’ve been sharing nutrition tips (see below) and a Facebook Live that focus on simple steps to support hormone balance.

Endometriosis affects over 1.5 million women and girls in the UK alone, and many women suffer for years before receiving a clear diagnosis.

The condition is caused by cells that normally live in the womb growing in other parts of the body.  They can grow on the bowel, the ovaries, even in lungs, eyes and the brain.

Because these cells are womb cells, they respond to the hormonal changes of a woman’s menstrual cycle.  They grow larger during the second half of the cycle and even bleed during menstruation.

These changes can cause a wide range of symptoms including painful heavy periods, pain during sex, bowel problems, depression, exhaustion, and infertility.

In the video I explore these tips in more depth and answer some common questions about periods and endometriosis.

If you’d like to know more feel free to comment below or hop over to the Facebook Group at and join in the conversations there!