9 best gentle interventions for perimenopause

Estimated to affect around 13 million women in the UK at any given time,¹ perimenopausal symptoms can sometimes begin more than a decade before your periods stop, causing an array of feelings ranging from confusion to concern.²

While your doctor can recommend hormone replacement therapy (HRT) or non-hormone solutions to help combat these symptoms, perimenopause doesn’t typically require treatment unless its symptoms are causing you particular discomfort or distress. 

Therefore, you might be wondering if any interventions can help make a difference. In this article, we discuss exactly that, including nine evidence-backed strategies that could make managing your symptoms a lot easier.

Perimenopause describes the transitional stage before menopause. It’s the time when your menstrual cycles gradually become more irregular before stopping altogether, spelling the end of your reproductive years.³

Every woman experiences perimenopause differently and at varying ages. Perimenopause typically takes place between the ages of 45 and 56 years, lasting up to seven years.^2,4 However, the transition to menopause can take up to 14 years for some people and even start in your 30s.

During perimenopause, you may notice several symptoms that affect your physical and mental health. These symptoms arise from the subtle (and not-so-subtle) changes that take place in your body, such as hormonal changes.

Together, the hormones oestrogen and progesterone are responsible for ovulation and menstruation.^5,6 In preparation for menopause, your oestrogen levels begin to decrease, causing a hormonal imbalance. These fluctuations then lead to several changes: your menstrual cycles shorten or lengthen, your ovaries produce fewer eggs, and menopausal-related symptoms, such as hot flushes, vaginal dryness and difficulty sleeping, begin.⁴ 

When your periods stop for 12 consecutive months, this signals the end of perimenopause, meaning that you’ve officially reached menopause.⁴

Throughout perimenopause, you may experience various symptoms. Some of the most common include:^7,8

• irregular periods
• hot flushes 
• mood changes
• vaginal and bladder issues
• decreased libido
• night sweats

However, there are a whole host of other symptoms you may experience. So take a look at our dedicated guide to the signs and symptoms of perimenopause to learn more. 

We also recommend seeking medical advice if you find that your symptoms get in the way of performing everyday activities, you have any concerns about your menstrual cycle or think that you might be experiencing menopausal symptoms earlier than expected.⁹

Perimenopause is a natural process that most women will experience at some point. While it's not a medical condition that requires treatment, it can cause various physical and emotional symptoms.

By working with your GP, they’ll be able to review your symptoms and create a treatment plan that lessens the impact on your daily activities.

However, in addition to medical treatment, interventions, such as exercising, eating well and taking care of your mental wellbeing, can also relieve some of the symptoms of perimenopause.

Here are nine more things that may help manage your perimenopause symptoms:

The hormonal changes that take place during perimenopause can affect bone density as your oestrogen levels drop⁷– and that’s where strength training comes in. 

While it may be common knowledge that this kind of exercise builds muscles, multiple studies show that strength training or resistance exercise can also be important for maintaining musculoskeletal health — especially as we age.¹³

Meditation is well known for having various positive impacts on our health, whether it’s reducing stress levels, decreasing anxiety, improving attention, or increasing compassion.^14–17 The list goes on. But did you know meditation might also help with perimenopause symptoms? 

Small studies indicate that meditation may improve the vasomotor symptoms of perimenopause, such as hot flushes, and improve your ability to cope with and alleviate other menopause-related symptoms.^18,19 

The clothes we wear can also impact our health – especially during perimenopause. 

Wearing more natural fabrics, such as bamboo, cotton and linen, can be helpful when experiencing hot flushes or sweating. These materials are often more breathable and naturally moisture-wicking — which helps sweat evaporate more quickly during a hot flush.

Consider using licensed herbal products and food supplements to potentially combat your perimenopause symptoms. Some of the key ingredients to look out for in these products include:²³ 

• black cohosh
  
• red clover
  
• soya isoflavones 
• sage leaf 
• ginkgo biloba
  
• St. John’s Wort
  
• korean Ginseng
  
• evening primrose oil
  
• fish oil
  

For more information on how these supplements could help you, read our article on eight of the best perimenopause supplements.

However, it’s important to keep in mind that the science behind how these herbal products work and whether they’re actually effective is scarce and solid clinical evidence is lacking. Some small and emerging studies have found there to be potential benefits in some of these ingredients, but further research is needed.^24,25,26

As always, if you’re considering taking any of these supplements, speak to your GP before trying them out. Some of these may interact with other medications or may not be suitable for you, which is why it’s important to check this with your doctor.

Increasing your intake of fruit and vegetables, and limiting how many ultra-processed foods you eat, may help with some symptoms of perimenopause. 

For example, a large 2012 study found that women who eat more vegetables, fibre, fruit, and soy products experienced symptoms like hot flashes and night sweats (known as vasomotor symptoms) less frequently during perimenopause.²⁹

Vaginal dryness is common during all stages of the menopause. This can cause itching, discomfort during sex and the urge to urinate more than usual.³⁰

Natural lubricants are available to ease the discomfort of vaginal dryness, with some of the best options being water-based. These water-based lubricants are also safe to use with any condoms and won’t damage them.

During perimenopause, hormones start to fluctuate, causing irregular periods and several menopause-related symptoms, such as hot flushes, mood swings and difficulty sleeping.

However, several natural perimenopause interventions exist which might help reduce your symptoms. These include: 

• performing regular exercise 
• strength training 
• meditating 
• aromatherapy massage
• wearing natural fabrics 
• taking suitable food supplements 
• managing your blood sugar level
• eating a healthy diet
• using a natural water-based lubricant

For further information on perimenopause, check out our menopause support hub. Here, you’ll be able to seek guidance from our menopause-trained advisors and qualified menopause nurses. 

The advice in this article is for information only and should not replace medical care. Please check with your GP or healthcare professional before trying any treatments or remedies.