What women often notice
- Irregular or changing periods
- Hot flushes and night sweats
- Sleep disturbance and fatigue
- Anxiety, irritability or low mood
- Brain fog and poor concentration
- Central weight change and joint aches
Perimenopause
The decade before menopause is a real physiological transition
Perimenopause typically starts in the 40s (sometimes earlier) and lasts around four to eight years. Hormone levels fluctuate. How you feel can sit a long way from “how you look on paper”. Face-to-face at The Richmond House Clinic, Penarth, and video consultations for the UK, Isle of Man and Gibraltar.
Common symptoms and common pitfalls
What the consultation holds
- Not dressing symptoms up as “just ageing”
- Sleep treated as a foundation, not an extra
- Resistance training over “eat less, more cardio”
- Blood sugar volatility and stress physiology
- Looking for overlap: thyroid, iron, sleep apnoea
- HRT discussed where it belongs, not assumed
Lifestyle medicine sits beside medical treatment
Some women do well with lifestyle interventions alone. Others benefit from hormonal or non-hormonal therapies. The aim is not to “biohack hormones”. It is to reduce symptom burden, protect cardiometabolic and bone health, and write a plan that matches your risk profile and values.
A longer guide covers the main pitfalls and the questions patients usually bring to clinic.
Journal notes
Practical notes on PCOS & perimenopause
Occasional writing from clinic: cycle health, midlife change, and lifestyle medicine. No daily emails.