What perimenopause means
In perimenopause, periods change and eventually stop because hormone levels fall. Menopause usually affects women between 45 and 55, but it can come earlier. Symptoms usually last seven to nine years, sometimes longer, and change during this time.
Signs you might not connect straight away
Besides changing periods and hot flushes, the NHS lists among others:
- sleep problems and night sweats
- mood swings, low mood, problems with memory and concentration
- vaginal dryness, burning, more frequent urinary tract infections
- palpitations, joint and muscle pain, headaches
- reduced interest in sex
- thinning hair and skin changes
According to the European Society of Endocrinology's 2025 guideline, about one in four women has debilitating symptoms.
Contraception is still relevant
It is still possible to get pregnant during perimenopause. The NHS advises continuing contraception: from 50, until one year after the last period; between 40 and 49, until two years after.
For Rhythmus this also means: as cycles become more irregular, the phase calculation becomes less accurate. The calculated ovulation is not a method of contraception in any case.
What can help
The Lancet's 2024 series on menopause argues for not treating this time merely as a list of symptoms, but for supporting women through it with knowledge and a say in decisions. The European guideline describes treatment options with and without hormones in detail; which one fits is a medical decision.