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Symptom · Perimenopause

Weight gain

A few extra kilos, mostly around your middle, even though you’re eating and moving just as before: it’s one of the most common symptoms of perimenopause, and one of the most frustrating.

HOW COMMON
Around 6 in 10 women in perimenopause
TYPICAL PATTERN
Gradual, often 0.5–1 kg a year
OUTLOOK
Usually levels off after a few years

Why it happens

Lower oestrogen shifts where your body stores fat, from your hips to your middle. Testosterone also gradually declines, which makes it harder to keep muscle, so your metabolism slows: you burn fewer calories at rest, even if nothing else has changed.

What can add to it

  • Losing muscle with age and hormones.
  • Lack of sleep, which upsets your hunger hormones.
  • Ongoing stress, which encourages fat to settle around your middle.
  • An exercise routine that hasn’t kept up with your body’s changing needs.

Right now

  • Include enough protein at meals to keep cravings in check.
  • Take a short walk after meals.
  • Drink plenty of water: it’s easy to mistake thirst for hunger.

Every day

  • Add strength training to support your metabolism.
  • Keep up regular cardio, even if it’s gentle.
  • Prioritise sleep: it’s hugely underrated when it comes to weight.

Don’t recognise your body any more?

A doctor can help you understand what really makes a difference, and take it at your own pace, with no pressure.

General information only. It doesn’t replace advice from a doctor who knows your history.

Recognise several of these? That’s no coincidence.

Menopause isn’t just hot flushes. Symptoms can start years before your last period and affect your sleep, mood, energy, memory, weight and intimate health.

Tap a symptom to find out more.

Hot flushes

A wave of heat rising from your chest to your face, lasting one to five minutes. When oestrogen dips, your brain’s thermostat becomes oversensitive, so even a tiny change in temperature can set one off.

Sleep problems

Out like a light one night, wide awake at 3am the next. Progesterone used to help you switch off, and there’s less of it now. Add night sweats from shifting oestrogen, and deep sleep is often the first thing to go.

Brain fog

Words on the tip of your tongue, reading the same line twice, losing your thread mid-sentence. Oestrogen helps fuel your brain, so when it swings, your focus does too. And less progesterone means poorer sleep, which makes the fog thicker.

Anxiety

An email, a meeting, running ten minutes late, and suddenly your stress is through the roof. Progesterone has a natural calming effect, and oestrogen helps keep serotonin steady. When both are in flux, everything feels heavier than it used to.

Joint pain

Knees that creak when you stand up, stiff hands first thing in the morning. Oestrogen helps keep inflammation in check, so when levels dip, joints can feel stiff and sore. Lower testosterone also makes it harder to keep the muscle that supports them.

Irregular periods

One cycle short, the next one long, then a month with nothing at all. You ovulate less often, so you make less progesterone, while oestrogen swings up and down. Periods can get heavier too. It’s often the very first sign of perimenopause.

Palpitations

Your heart suddenly races or pounds while you’re doing nothing at all. Shifting oestrogen affects the nerves that control your heart rhythm. Unsettling in the moment, rarely serious, but always worth mentioning to your doctor.

Mood swings

Laughing one minute, in tears the next, or ready to tell everyone where to go. Oestrogen and progesterone are rising and falling faster than before, and both affect the brain chemicals that keep your mood steady.

Low libido

Desire takes longer to show up, or sometimes doesn’t show up at all. Testosterone, which fuels desire, gradually declines, and lower oestrogen can make arousal slower and sex less comfortable. It’s common, it’s not ‘all in your head’, and it can be treated.

Vaginal dryness

Dryness, and sometimes a little discomfort day to day. Oestrogen keeps vaginal tissue naturally moist, so lower levels mean less moisture. It’s very common, and still far too rarely talked about.

Night sweats

Waking up soaked in the middle of the night, changing the sheets, then lying awake. It’s a hot flush triggered by shifting oestrogen, just at night. And with less calming progesterone, getting back to sleep is harder.

Painful sex

Discomfort, or real pain, during or after sex. Lower oestrogen makes vaginal tissue thinner and more delicate, so something that never used to hurt suddenly can. You don’t have to put up with it.

Dry skin

Skin that feels tight, marks more easily and has lost some of its bounce. Oestrogen helps your skin make collagen, and you can lose up to 30% of it in the first five years after menopause.

Fatigue

A tiredness that won’t shift, even after a good night’s sleep. Less progesterone means lighter, more broken sleep, and swings in oestrogen bring night sweats and low mood. You feel it from the moment you wake up.

Hair loss

More hair in your brush, a parting that looks wider than before. Oestrogen and progesterone both help keep hair growing. With less of them, androgens (hormones like testosterone) have more effect, and hair grows back finer.