Perimenopause: how to prepare for a smoother transition

The good news about perimenopause is that, although it can't be avoided, it can be navigated in a far more informed way, and that changes the experience a lot.

Talk to your gynaecologist sooner than you think you need to

You don't have to wait until symptoms are intense or your cycle has disappeared completely. Keeping a record of your menstrual changes and symptoms, even mild ones, gives you valuable information for that conversation, and allows your doctor to rule out other causes and guide any intervention better.

The pillars that are up to you

• Sleep: look after your sleep hygiene from now on, before night sweats make it harder.
• Regular physical activity: it benefits mood, sleep and metabolic health all at once.
• Mediterranean-style eating: it is the pattern with the most consistent evidence for cardiometabolic, bone and muscle health at this stage.
• Support networks: talking to other women going through the same thing reduces the sense of isolation, which is very common in this quiet phase.

What the evidence says

• The most recent European clinical guidelines, such as the European Society of Endocrinology guideline (2025), specifically address the assessment and management of perimenopause, not only of established menopause. Recognising symptoms early allows a more proactive rather than reactive approach.
• Among lifestyle interventions, regular physical exercise has the strongest evidence in women over 40, and the International Menopause Society 2026 White Paper also supports looking after sleep and managing stress.
• A 2026 review concludes that Mediterranean-type eating patterns show the most consistent evidence for cardiometabolic, bone and muscle health during the menopausal transition, although their effect on hot flushes is modest.
• Around 25% of women experience menopausal symptoms severe enough to be debilitating, according to the European Society of Endocrinology guideline. You are not the only one if you are finding it hard.

Conclusion

Perimenopause is not an illness you have to "get through" in silence, but a real biological transition with a measurable impact on body and mood. Naming it, understanding it and preparing with quality information is the difference between going through it blind or doing so with the right tools.

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