From perimenopause to menopause: understanding what is happening
Periods that change, lighter sleep, hot flushes, mood swings. These signs can begin years before menopause, often without the connection being made. This first module helps you put words to them, and keep track of what is happening for you.
A wellbeing course that does not replace medical advice. For any treatment, speak to your doctor, gynaecologist or midwife.
What you will do in this module
Understand the stages
Perimenopause, menopause, afterwards: what these words mean, and when you move from one to the next.
Recognise your signs
List what you are experiencing, including things that are not always linked to hormones.
Start your journal
One minute a day to track flushes, sleep, mood and periods. Useful for you, and for your next appointment.
Not a switch, a transition
Menopause is the permanent end of periods. It can only be confirmed afterwards, after 12 months without a period. Before that, there is a transition period: perimenopause, also known as the menopausal transition. It generally lasts 2 to 4 years, according to the Assurance maladie, and begins on average around the age of 47, according to the MGP.
According to Inserm: progesterone production falls first, then oestrogen production becomes irregular before dropping.
What many women do not link to hormones
Every woman experiences this period in her own way: some have almost nothing, others have several signs at once. Here are the most common, as described by Inserm and the Menopause Society.
In the body
In sleep, mood and the mind
A hot flush generally lasts from 1 to 5 minutes, according to the Menopause Society.
What your cycle can tell you
Choose a stage to see how periods are spread over six months. These are the reference points of the international STRAW+10 classification, adopted by the Menopause Society. They are reference points, not a diagnosis.
Why it is worth paying attention early
of hot flushes on average when they begin in perimenopause, compared with 3.4 years when they begin afterwards.
of bone loss for about 3 years, starting about one year before the final period.
You are not the only one
“I felt very alone. […] There was no one to talk to, there was no information.”
“It can last 10 or 12 years.”
“No one prepared me for this.”
Nadia, 44
For a few months now, Nadia has been waking at around 3 in the morning, drenched. Her periods come sometimes after 23 days, sometimes after 34. At work, she struggles to find her words in meetings, and it worries her. She thought she was simply overworked.
By filling in her journal for three weeks, she notices a link: the restless nights mostly come back in the days before her period. She takes the printed page to her doctor. The appointment is shorter and more focused, and she leaves with concrete next steps.
What changed for her: understanding that it was “not all in her head”.
Contraception: still necessary
During perimenopause, ovulation becomes irregular but remains possible, and so does pregnancy. The Assurance maladie recommends continuing contraception until the menopause is confirmed.
Hormonal contraception can also mask certain signs by regulating bleeding, as the Cleveland Clinic points out. Talk to your doctor or midwife to find out when to stop it.
When to seek advice without delay
According to the Mayo Clinic, seek medical advice if you have:
- very heavy periods;
- periods that last more than 7 days;
- bleeding between periods;
- periods that regularly come less than 21 days apart;
- any bleeding after 12 months without periods.
If your mood collapses or you have dark thoughts, call 3114, free of charge and available at any time. In an emergency, call 15.
Your journal, one minute a day
Note down how you feel each day. After two or three weeks, patterns begin to emerge. You can print the summary for your appointment.
Your last 14 days
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Taking stock with Lumina
Keep a sheet of paper and a pen nearby. Lumina's voice guides you one question at a time, leaving you time to write between each one.
Hello, and welcome. I am Lumina. Over the next eight minutes, we are going to take stock together of what you are experiencing at the moment. Keep a sheet of paper and a pen nearby, or open your journal. If you do not have them to hand, pause the audio while you fetch them.
Settle comfortably into a seated position, with both feet on the floor. Let your shoulders gently drop. If you wish, close your eyes. Otherwise, simply rest your gaze on a point in front of you.
Notice your breathing, without trying to change it. The air coming in. The air going out. There is nothing you need to achieve. Just be here, with yourself.
Here is the first question. Over the past few months, have you noticed any changes in your body? Perhaps hot flushes. Night sweats. Lighter sleep. A new kind of tiredness. Stiffer joints. Or drier skin.
Open your eyes if you had closed them, and write down everything that comes to mind. Even things that seem unrelated. You can sort through them later. I will give you a minute.
Take your time. About thirty more seconds.
Very good. If you have not finished, you can pause and come back whenever you like.
Second question: your cycle. If you still have periods, what have they been like for the past few months? Closer together, further apart, heavier, or on the contrary lighter? Write down the date of your last period, if you know it. If you have not had a period for more than a year, simply note that down. And if you use hormonal contraception, note that too: it regulates periods and can mask certain signs.
I will give you a little more time to write.
Third question: your mood and your mind. Over the past few weeks, have you felt more irritable than usual? More anxious? Have you had moments of brain fog, words that will not come, lapses of memory? Give your average mood for the week a score from zero to ten. Zero, very difficult. Ten, very good.
Take your time.
Now read through your list again. Circle the sign that bothers you most today. Just one. This is the one you will track first in your journal, every day, for the eight weeks.
One important point. If, while making this list, you noted very heavy periods, periods lasting more than seven days, bleeding between periods, or bleeding after a year without periods, talk to your doctor or your midwife. It is not necessarily serious, but it is worth getting an opinion. And if you are having dark thoughts, do not wait: call 3114. It is free and available at any time.
To finish, complete this sentence on your sheet: "In eight weeks, I would like…". Perhaps to sleep better. Perhaps to understand what is happening in your body. Perhaps simply to feel like yourself again. Write what is true for you.
What you have just done matters. Many women go through this period without knowing what is happening to them. You are beginning to put words to it. Starting this evening, take a minute to fill in your journal: your hot flushes, your sleep, your mood, and your periods if you still have them. Within a week, you will already see some patterns emerging.
What we understand, we go through differently. Until very soon.
Four questions to take stock
The complete Serene Menopause programme
Each week includes a part dedicated to perimenopause, an audio practice, examples and an exercise.
- From perimenopause to menopauseThis module, free
- Hot flushes: the approach inspired by CBTA plan for before, during and after, and more helpful thoughts
- Cooling hypnosisThree guided 20-minute sessions
- Getting your sleep backTechniques inspired by CBT for insomnia
- Muscles and bonesA strengthening programme at home
- The menopause plateProtein, calcium, vitamin D
- Pelvic floor and intimacyGuided exercises, intimate comfort, life as a couple
- Mood, confidence and workEasing irritability, talking about it with those around you
"It is not things that disturb people, but the judgements they make about things."
Epictetus, Handbook, 5, quoted by Philosophie magazine
Serene Menopause, the complete course, is now open
The 8 weeks, the three cooling hypnosis sessions, sleep, muscles, the plate and intimacy. Immediate, lifetime access, at your own pace. And keep up your journal every day: it accompanies you throughout the course.
Would you also like broader wellbeing support right now? Discover L'Équilibre Total
"What we understand, we go through differently." — Lumina
Sources
- Assurance maladie, Perimenopause: symptoms and contraception — ameli.fr
- Inserm, Menopause report — inserm.fr
- MGP, Perimenopause — mgp.fr
- The Menopause Society, Perimenopause — menopause.org
- Mayo Clinic, Perimenopause: symptoms and causes — mayoclinic.org
- Cleveland Clinic, Birth control during perimenopause — clevelandclinic.org
- Duration of hot flushes, SWAN study — pmc.ncbi.nlm.nih.gov/articles/PMC6082400
- Signs up to 10 years before the final period — pmc.ncbi.nlm.nih.gov/articles/PMC11745533
- STRAW+10, classification of the stages of reproductive life — pmc.ncbi.nlm.nih.gov/articles/PMC3580996
- SWAN Fact Sheets 2023 (bone loss) — swanstudy.org