Perimenopause Care
Perimenopause Care
When something feels “not quite right”
Specialist, doctor-led care for women navigating perimenopause and the years leading up to menopause.
You may not have missed a period. You may not think of yourself as “menopausal.”
But something has shifted.
Perimenopause can begin years before your final period. Hormone levels fluctuate in ways that are subtle, unpredictable and often difficult to recognise at first.
Our BMS-registered specialist doctors provide careful assessment and personalised treatment, helping you understand what is happening and feel more like you again.
BMS accredited doctors, available online
Personalised medication delivered
A support team to help coordinate your care
Spread the cost of your care with Klarna
BMS accredited doctors, available online
Personalised medication delivered
A support team to help coordinate your care
Spread the cost of your care with Klarna
When something feels “not quite right”
Perimenopause is the stage before menopause when hormone levels begin to change and fluctuate.
Perimenopause can affect how you feel physically, mentally and emotionally - often in ways that are unexpected, changeable, or hard to explain. Many women might feel something is "not quite right" long before menopause, all while struggling to get clear answers.
Consulting one of the UK’s leading perimenopause doctors can provide clarity and personalised support during this transition.
Perimenopause is the transition phase leading up to menopause. During this time, the ovaries gradually produce less oestrogen and progesterone, but not smoothly or predictably.
Hormone levels can fluctuate dramatically, which is why symptoms often vary from month to month.
Perimenopause typically lasts several years and ends when menopause begins (defined as 12 consecutive months without a period).
A perimenopause/menopause specialist can help distinguish normal hormonal changes from other underlying conditions, ensuring early intervention when needed.
Although closely related, perimenopause and menopause are distinct stages.
- Perimenopause refers to the time when hormone levels are fluctuating and symptoms are present, but periods have not stopped completely.
- Menopause is reached after 12 consecutive months without a menstrual period (provided there is no other cause for the absence of bleeding, such as pregnancy, hormonal contraception, or hormone replacement therapy).
Fluctuating hormone levels in perimenopause often contribute to many of the symptoms experienced, which is why many women to seek menopause support during this time.
There is no single age at which perimenopause begins.
Many women notice changes in their early to mid-40s, but symptoms can start earlier or later. Genetics, overall health and medical history can all influence timing.
Some women experience perimenopause before the age of 40. This may indicate premature ovarian insufficiency and should be assessed by a clinician with specialist expertise in perimenopause and early menopause.
Oestrogen receptors are found throughout the body, which is why perimenopause can affect many different systems. Symptoms vary widely between women and may change over time. Common symptoms include:
- Irregular periods
- Hot flushes and night sweats
- Sleep disruption
- Anxiety or low mood
- Brain fog or difficulty concentrating
- Palpitations
- Joint and muscle pain
- Headaches
- Vaginal dryness
- Urinary symptoms
- Reduced libido
- Changes in weight or body composition
Not everyone experiences all symptoms, and some may be subtle at first, particularly in early perimenopause.
Early perimenopause
Periods may still be regular, but hormonal changes are beginning. Symptoms can include changes in cycle length, heavier or lighter bleeding, mood changes or sleep problems. Early recognition by clinicians experienced in perimenopause can help prevent symptoms escalating over time.
Late perimenopause
Late perimenopause is usually marked by more noticeable cycle disruption, such as skipped periods or long gaps between cycles. Symptoms may feel more intense or harder to manage during this stage.
Perimenopause is often under-recognised, particularly in its early stages. Symptoms may be attributed to stress, mental health conditions or ageing rather than hormonal change.
Specialist perimenopause doctors focus exclusively on menopause and hormonal health, allowing for:
- Earlier recognition of symptoms
- Longer consultations
- Careful adjustment of treatment over time
- Expertise in complex or early cases
Women may benefit from specialist care if symptoms are affecting daily life, if previous treatment has not helped, or if symptoms begin earlier than expected.
How our care works
- 1
Specialist consultation (45 min)
A menopause specialist doctor takes time to explore your symptoms, hormonal stage, medical history, and any existing concerns
- 2
Personalised plan
You will receive a personalised care plan based on your symptoms, medical history, and priorities. This may include hormone treatment where appropriate, alongside practical lifestyle and wellbeing support
- 3
Ongoing review and support
Medication management, blood tests if needed, and continuity of care for as long as you need
Is specialist perimenopausal support right for me?
You may benefit from specialist perimenopause support if these feel true for you:
Treatment options for perimenopause
Perimenopause is a natural life stage, but treatment can help manage symptoms and protect long-term health.
Hormone replacement therapy is the most effective treatment for many perimenopausal symptoms. This usually includes oestrogen and, if you have a womb, progesterone. Some women may also benefit from testosterone.
At Menopause Care, our BMS (British Menopause Society) registered specialists prescribe regulated, body-identical hormone therapies in line with national guidance. Your treatment is individualised and reviewed regularly, as hormone needs often change during perimenopause.
Some women benefit from additional support alongside or instead of hormone therapy. This may include:
- Cognitive behavioural therapy (CBT)
- Lifestyle and nutritional support
- Vaginal oestrogen
- Psychological support
This whole-person approach reflects the reality that a single hormone rarely drives symptoms.
Our Approach
Every person’s experience of perimenopause is different. Our role is to help you understand how hormonal changes may be affecting your body and mind, and explore safe and evidence-based treatment options. Your care is led by specialist clinicians experienced in perimenopause and women’s health. We take a thoughtful, supportive, and non-judgmental approach, combining medical expertise with care that is tailored to you.
Regular follow-up and ongoing support
Our Founder, Dr Naomi Potter, on how we’re here to help
“I had met so many patients who felt confused about their symptoms, anxious without clear guidance, and left without a diagnosis or information about menopause. With Menopause Care, I wanted to change that, offering the support, knowledge, and compassion women deserve to feel their best through midlife.”
Everything you want to know
Perimenopause is usually diagnosed based on symptoms rather than a single test.
For most women over the age of 45, hormone blood tests are not required. However, blood tests may be recommended in certain situations, including:
- Symptoms occurring under the age of 40
- Unclear diagnosis between the ages of 40 and 45
- To exclude other conditions such as thyroid disorders or anaemia
A specialist perimenopause assessment considers your complete medical history and symptoms, so many women can benefit from seeing a clinician with advanced menopause training who are registered with the British Menopause Society.
Perimenopause is the transition phase leading up to menopause, when hormones fluctuate and symptoms can begin. Menopause is confirmed once you have had no periods for 12 months. Symptoms can occur in both stages, and treatment can be appropriate in either.
Perimenopause often begins before periods stop. You may notice changes in your cycle, sleep, mood, energy, or how you feel day to day. Some people experience hot flushes or night sweats, while others mainly notice anxiety, low mood, brain fog, or irritability. A clinician experienced in perimenopause can help assess your symptoms in context and rule out other causes.
Early perimenopause is one of the most overlooked stages. If you feel different, but you are being told everything looks “normal”, specialist support can help you get clarity and avoid months or years of unnecessary uncertainty.
Yes. Many people are in early perimenopause while still having regular periods. Symptoms can start years before cycles become irregular, which is why early perimenopause is often missed.
Not always. For many people, perimenopause is diagnosed based on symptoms and medical history. Blood tests can sometimes be helpful, especially if symptoms are unclear or there are other possible causes. Your clinician will recommend tests only if appropriate.
A new patient menopause specialist consultation is £295 for 45 minutes. Follow-up options are £225 for 30 minutes.
Absolutely. Specialists for early perimenopause symptoms can provide timely support before symptoms escalate, whilst ruling out other causes, ensuring personalised and effective management.
Yes, our doctors at Menopause Care are British Menopause Society (BMS) registered menopause specialists and are listed on the BMS Specialist Register.
No. You can self-refer for a private appointment. Clinic letters can be shared with your GP if you wish.
Yes. Online consultations provide access to experienced perimenopause clinicians across the UK, with the same clinical standards as in-person appointments.
Your clinician will take a full medical history, discuss your symptoms in detail, and assess your individual risk factors. You will receive a personalised treatment plan and clear next steps, including options for lifestyle support, non-hormonal treatment, and hormone therapy where appropriate.
For many people, HRT is a safe and effective option. Safety depends on your medical history, symptoms, and individual risk factors. Your clinician will discuss whether HRT is appropriate for you, and explain benefits and risks in plain language.
Yes. Mood symptoms are common in perimenopause, and they can overlap with or worsen existing anxiety or depression. Your clinician will take this into account and help you explore options that support both mental and physical wellbeing.
That is completely fine. Many people want clarity first. The first appointment is designed to give you a clear clinical assessment and a personalised plan, even if you decide not to start treatment straight away.
Specialist input can be especially valuable if you have migraines, high blood pressure, a family history of breast cancer, or other health considerations. Your clinician will take a careful, personalised approach and discuss options that fit your situation.
This is common. Symptoms may persist if the dose, type, or balance of hormones is not quite right. A specialist review can help assess what is happening and adjust your plan safely.
Yes. Menopause Care can provide prescriptions directly through our in-house pharmacy, ensuring you receive your treatment safely, conveniently, and without delay. Our clinicians review your treatment regularly and tailor it to your individual needs, so you can feel confident that your care is both personalised and seamless.
Menopause Care has clinics across the UK, including locations in London (Mayfair, Barnes, and Wimbledon), as well as Manchester, Sheffield, and Glasgow.