Wouldn’t that be great? It can be so confusing as our hormones start their journey from peri to full menopause to be able to say definitively ‘this is it’. Or even be able to say for sure that their symptoms were definitely menopause and not caused by something else.

Why is it helpful to know?

The most important reason of course is that if you know when perimenopause is starting then you will not leave it too late to have a family as your fertility declines as you approach that phase of life. In the West, women are having their children later due to their career, a need to work to support the family income or just not feeling that it is the right time.

We know statistically that many women are starting menopause earlier and earlier, though the average is around 51 it can occur in the 30’s and right up to the 60’s. Women who have had a hysterectomy, for example, undergo an immediate surgical menopause along with all the symptoms that go with it. In reality when we talk of going through menopause that is actually perimenopause as the strictly accurate meaning of menopause is defined as the end of the last menstrual period, as occurs after a hysterectomy.

In Western women, it occurs on average at 51 years. But there’s a wide range of normal extending from your 30s to 60 and it is so variable by individual that so far we are unable to predict it with any accuracy. It may have a genetic component that is currently being researched, but so far 1 in 20 women in the UK is likely to experience an early menopause.

What happens to start perimenopause?

The changes in our bodies start when the ovaries no longer respond to the controlling hormones released by the pituitary gland of the brain. As a result, the ovaries fail to release an egg each month and so do not produce oestrogen and progesterone.

It is the fall in the levels of these hormones in the bloodstream that gives rise to the symptoms of menopause. Although much is made of the fall in oestrogen levels, the decline in progesterone is even more important as although women continue to produce oestrogen in the fat cells and adrenals, we do not continue to produce progesterone and it is this imbalance that leads to symptoms of oestrogen dominance.