5 common perimenopause myths

Still having regular periods? You might assume you’re not in perimenopause - and this is one of the most common myths I hear in clinic.

Perimenopause isn’t a moment in time, it’s a transitional phase, and it can start years before your periods stop. It’s not about one symptom, a specific age or a blood test result.

Let’s clear up some of the most common misconceptions.

Myth 1: You can't be in perimenopause if you still have a regular cycle

This is one of the biggest misunderstandings. While many women associate perimenopause with skipped or irregular periods, the hormonal shifts begin long before that happens.

Your oestrogen and progesterone levels start to fluctuate in your late 30s or early 40s, or sometimes even earlier. You might still bleed regularly, but other symptoms (like anxiety, sleep issues or heavy periods) are early signs that your hormones are changing.

Myth 2: Hot flushes are the first sign of perimenopause

Hot flushes get a lot of attention, but they’re not usually the first symptom.

More common early perimenopause symptoms include:

• Disturbed sleep

• Increased anxiety

• Breast tenderness

• Heavier or more painful periods

• Worsening PMS

Myth 3: You need blood tests to confirm you’re in perimenopause

This is a common assumption — but the reality is, blood tests aren’t very helpful during perimenopause.

Hormones like oestrogen and FSH can fluctuate dramatically during this phase. A single blood test offers a snapshot, not the full picture. That’s why many practitioners don’t rely on them to assess whether a woman is in perimenopause.

Blood tests are more helpful once a woman has gone 12 months without a period, to help confirm that menopause has occurred.

Instead, tuning into your symptoms, with the support of a qualified practitioner, is often the most accurate way to understand what’s really happening in your body.

Myth 4: There’s nothing you can do — you just have to suffer through it

This couldn’t be further from the truth. While perimenopause is a natural phase, it doesn’t mean you have to accept feeling unwell or just “get through it.”

Supportive strategies may include:

• Nutritional and herbal support to balance hormones, reduce inflammation, and support energy, mood and sleep

• Nervous system regulation through food, lifestyle and gentle stress reduction practices

• Targeted lifestyle changes that support hormone balance, stable blood sugar and metabolic health

For some women, it may also be appropriate to explore bioidentical hormone therapy. This should be discussed with a doctor who is experienced in hormonal health and can assess whether it is a suitable option based on your individual needs.

Myth 5: Perimenopause = Menopause

Perimenopause and menopause are related, but not the same.

• Perimenopause is the transition leading up to menopause — often lasting several years.

• Menopause is a point in time, defined as 12 months without a period.

Understanding this distinction helps women advocate for better care and recognise when support is needed - ideally well before menopause hits.