Perimenopause is often the first time women begin to feel that “something isn’t quite right” — yet it is also one of the most misunderstood stages of hormonal change.

Perimenopause is the transitional phase leading up to menopause and can last anywhere from 2 to 10 years. During this time, ovarian hormone production becomes increasingly unpredictable. This hormonal fluctuation — rather than a simple decline — is what causes many of the physical and emotional symptoms women experience. Changes in menstrual cycles are often the earliest sign, with periods becoming irregular, lighter or heavier, closer together or further apart.

As hormone levels fluctuate, perimenopause can affect multiple systems in the body, including the brain, heart, bones, skin, and vaginal health. Symptoms may include fatigue, sleep disturbance, brain fog, low mood or anxiety, joint pain, reduced libido, vaginal dryness, and worsening premenstrual symptoms. Fertility also gradually declines during this time, even though pregnancy is still possible.

Many women are told to “wait it out” until their periods stop — but this is not necessary, nor helpful. Effective treatment can begin during perimenopause, and early management often leads to better symptom control and long-term health outcomes.

Dr Alba Pereira provides specialist, evidence-based perimenopause care, helping you understand what is happening in your body and how to manage it safely and effectively. She holds an Advanced Certificate from the British Menopause Society, ensuring that your care follows the latest clinical guidance.

Appointments are unhurried and focused on you. Dr Pereira will take time to understand your symptoms, health history, and priorities, and will discuss a personalised plan that may include lifestyle adjustments, psychological wellbeing, and treatment options such as Hormone Replacement Therapy (HRT) or appropriate non-hormonal alternatives. Blood tests may be used where clinically indicated to guide treatment safely.

The goal is not simply symptom relief, but helping you regain control, clarity, and confidence during this transitional phase — while protecting your future health.

With the right support, perimenopause does not have to be overwhelming. Thoughtful, early intervention can make a meaningful difference to how you feel now and in the years ahead.