Despite the fact that perimenopause has been a fact of life since woman first walked the earth, there’s still a heap of confusion about it! One thing that I often explain to my clients who are in this stage of life is that there are 4 phases that you can experience.

Let’s take a closer look at the 4 phases of perimenopause and what to expect during each.

The 4 Phases Of Perimenopause

The overachiever precursor: Super-early perimenopause

Some of us like to be precocious with our hormonal shifts. Some women experience a kind of pre-perimenopause phase, particularly if their perimenopause journey is on the longer side.

So what does this look like?

  • Shorter cycles of 21-26 days
  • Heavier bleeds
  • Migraines
  • Increase in PMS symptoms
  • Sore breasts
  • Mood changes including irritation and being easily aggravated

Why does this happen? It comes down to that delicate hormone balance between progesterone and oestrogen. It could be that your progesterone is already depleted thanks to dieting, overexercising, stressing and being busy all the time (does that sound familiar??) But the lower progesterone makes even the gentle slopes you get at the beginning of the oestrogen rollercoaster feel massive. As a result, your perimenopause symptoms creep in before you really get started.

Phase 1: Early perimenopause

This is where most get an inkling that something is going on. The big hallmark here is that your period & cycle regularity goes out the window – some cycles are shorter, some are longer.

Other symptoms you can look forward to here (but not really) include:

So what’s the go? Again, we look to our hormonal shifts. Progesterone is slowly declining, and oestrogen fluctuations are growing. When oestrogen drops down, it goes lower than it ever did during your menstrual years. But these drops are followed by spikes, which causes additional problems!

Phase 2: Mid perimenopause

Now you’re really getting into the transition, and there’s a good chance you know you’re experiencing perimenopause if you didn’t already figure it out! We’re talking about:

  • Infrequent, unpredictable periods
  • Increased severity in hot flashes and night sweats
  • Vaginal dryness
  • Reduced libido

Some can also develop immune dysfunctions, food intolerances and gut issues such as reflux and bloating at this point. All of this is thanks to oestrogen fluctuations continuing, while your overall oestrogen production dwindles.

Phase 3: Late perimenopause

You’re in the final stretch, but now is the waiting phase where you count the days! What we are looking for is that magical 12 month gap from your last bleed, which means you move onto the final phase. But as you tick the calendar, you could experience:

  • Continued hot flashes, night sweats and vaginal dryness
  • Increased mood changes
  • Difficulty sleeping & insomnia
  • Brain fog
  • Reduced focus and mental clarity
  • Painful symptoms such as joint pain and stiffness

The reason symptoms really ramp up here is because we’re in the biggest dip in oestrogen production. So all of the symptoms that are linked to low oestrogen can escalate.

Phase 4: Menopause

Huzzah, you made it! Once you hit that 12 month mark from your last bleed, you’ve entered the crone era, aka menopause.

But that doesn’t mean all of your challenges will vanish magically. Some women do continue to experience certain symptoms. If this happens, make sure you seek support – this is your time, and the last thing you need is to struggle through it!

The special guest – weight gain!

Weight gain is incredibly common during perimenopause. But it’s a bit unpredictable – you can experience it during any of the phases I just covered. This is thanks to the oestrogen changes throwing off your insulin sensitivity.

It can also be caused by a high ratio of androgens (testosterone) compared to oestrogen and testosterone. Although testosterone drops off as well, it does so at a slower rate. And when your testosterone is higher than other sex hormones (relatively speaking) this feeds into insulin resistance.

Does this all sound like a nightmare?

While it’s true that a lot of women can suffer throughout the shifts of perimenopause – and let’s be honest, the suffering been downplayed and ignored for too long – it doesn’t have to be inevitable. There are ways that you can ease the transition without needing to reach for hormonal replacements like Mirena, the Pill or HRT.


If you are ready to feel calm, less stressed and able to put yourself first, book in for a free discovery call today. Together, we can explore how I can help you to support and nourish yourself – mind, body and spirit.