Understanding Perimenopause & Menopause
If you’re noticing changes in your body and aren’t sure what they mean, we can help you navigate this transition with clarity and care.
Perimenopause and menopause are natural transitions that mark a new season of life, but for many women, they arrive with more intensity than expected. Hormonal shifts can influence everything from sleep and mood to pelvic health, strength, and daily energy levels. Here at Ivoryrose, we specialise in supporting women through every chapter of their lives and this season, is no exception.
Perimenopause and menopause are deeply individual experiences, shaped by hormonal changes that can begin years before your final period. For many women, early symptoms are subtle, gradual and easily mistaken for stress, parenting fatigue or the ongoing mental load of daily life.
Perimenopause is not a single moment but a transition — a phase where hormones fluctuate well before menstruation ends, creating physical, cognitive and emotional changes that can feel confusing or unexpected. Our focus at Ivoryrose is to help you understand these shifts, recognise what’s normal and feel supported throughout this chapter.
Menopause vs Perimenopause: What’s the Difference?
Perimenopause is the transitional phase leading up to menopause. It can begin earlier or later than expected and presents differently for every woman. There’s no single marker that signals its start, hormonal fluctuations happen quietly in the background, often long before symptoms become obvious.
Because these changes can resemble everyday stress or exhaustion, many women don’t realise they’re in perimenopause until symptoms become more persistent.
Like so many women’s health issues, there are many misconceptions around this topic, many clients are surprised to learn that:
Menopause is one point in time
You are considered in menopause once you have gone 12 months without a period. After this, you enter post-menopause.
Perimenopause is the lead-up.
Whilst the common belief is that hormonal fluctuations for the most part begin in the 40s, they can in fact start earlier or later. This transition can last anywhere from 4 to 10 years, and many women will continue to menstruate, sometimes regularly, while experiencing the earliest signs of change.
Common Symptoms & Experiences
Every woman’s experience is unique, but many notice:
Hot flushes or night sweats
Mood changes, anxiety or irritability
Irregular or changing periods
Brain fog or difficulty concentrating
Shifts in pelvic floor strength
Bladder urgency or leakage
Vaginal dryness or discomfort
Decreased libido
Joint aches or stiffness
Sleep disruption or increased fatigue
Changes in body composition
These symptoms are common — but not something you need to push through on your own.
Perimenopause can be difficult to recognise because symptoms often come and go, periods may remain regular, and hormone levels fluctuate daily — making blood tests unreliable.
Early signs commonly overlap with stress, sleep disruption or emotional load, and many women assume they’re “too young” to be experiencing hormonal change. For women balancing work, school-aged children and sometimes ageing parents, it’s easy to attribute these shifts to life’s demands rather than perimenopause, even when they’re significantly affecting daily wellbeing.
How Physiotherapy Can Help
Women’s health physiotherapy offers evidence-based support to help you understand your body, manage symptoms and feel more grounded, confident and capable throughout this transition. Our physiotherapists can support you with:
Pelvic floor assessment and targeted strengthening
Bladder and bowel management
Exercise programming to support energy, bone density and muscle mass
Strategies to rebuild or maintain strength during hormonal change
Support for joint stiffness, pain or discomfort
Management of sexual health changes and pelvic discomfort
Education on what’s normal, and what can be improved
Lifestyle guidance to support sleep, stress and overall wellbeing
This isn’t about adding more to your plate. It’s about giving your body the right support at the right time.