What is perimenopause?

Perimenopause refers to the years leading up to menopause. But despite being just as important as the milestones that precede and follow it, perimenopause rarely gets the attention it deserves. 

A survey by The Society for Women’s Health Research found that only 30% of women discuss menopause with their closest friends—a stark contrast to the openness around puberty or pregnancy. 

This extends to the workplace as well. This survey by the US National Institute of Health found that while 93% of respondents said menopause symptoms affected their work, 38% couldn’t adjust their schedules to cope as they felt uncomfortable discussing their struggles with their colleagues. 

You might notice it in small ways at first: you wake up in the middle of the night, first feeling chilly, then flushed with heat. You may notice a weight gain, even though your diet hasn’t changed. Your hair might start to thin. Your period becomes irregular—sometimes heavy, sometimes skipping a month entirely. 

Some months, oestrogen levels surge and your energy levels rise, mood stabilises, and skin appears more hydrated and plump. Other months, they plummet, which may leave you feeling exhausted, irritable and wondering why your body suddenly feels unfamiliar. 

This unpredictability and variability are defining factors for women going through perimenopause. While some women experience severe symptoms, others go through perimenopause with little disruption. 

If you want a more comprehensive explanation of the symptoms, please read this article written by our senior resident physician, Dr Lau Pik Onn. 

Perimenopause isn’t just about managing the symptoms as they arise—it’s about preparing for the long-term health shifts that follow. Once menopause officially begins (marked by 12 consecutive months without a period), women face an increased risk of osteoporosis, cardiovascular disease, and mental health problems like depression due to declining oestrogen levels. 

Bone health 

Oestrogen plays a key role in maintaining bone density. When oestrogen levels drop, bones weaken, which increases the risk of osteoporosis and fractures. Regular bone density screenings and lifestyle changes, such as weight-bearing exercises, a calcium-rich diet and vitamin D supplements can help mitigate this risk before it becomes an issue in the future. 

Heart health 

Oestrogen also protects the heart, keeping arteries flexible and reducing inflammation. As levels decline, the risk of heart disease and stroke rises. That’s why postmenopausal women should be proactive about screening for cardiovascular risk factors, including cholesterol levels and blood pressure. 

Mental health and cognitive function 

Perimenopause and early post-menopause are associated with an increased risk of depression and other mental health concerns.  

This happens because during the menopausal transition, the level of oestrogen, which has neuroprotective properties, drops. As a result, the brain undergoes structural changes that increase the risk of neurological diseases, amyloid plaque buildup (linked to Alzheimer’s disease) and loss of brain volume. These brain-related shifts can contribute to symptoms such as poor concentration, fatigue, and insomnia, which may overlap with depression and anxiety. 

Oestrogen also regulates serotonin and dopamine, the brain chemicals that keep your mood balanced. When oestrogen levels change and drop, these chemicals can also decrease, leading to mood swings, increased stress, and trouble with focus and memory. 

Recognising these changes early allows women to take steps to protect their mental and overall health during perimenopause and beyond. 

There are ways to help navigate perimenopause. Prioritising your health during this transition can make all the difference in how you feel—both now and in the years to come.  

Targeted nutrition can play a significant role in managing perimenopause symptoms. The Icon Women’s Health (Advanced Formula) supplement is designed to support your body through this transition, providing essential vitamins and nutrients for perimenopausal and postmenopausal women. 

But menopause is just one of many health concerns that women face as we age. Staying proactive and paying attention to changes in our body is crucial. Routine tests like mammograms for breast cancer, pap smears for cervical cancer, and bone density screenings for osteoporosis are essential for early detection and better health outcomes. 

Prioritise your wellbeing today and take charge of your health for a stronger, healthier future.