06-07-2025
Everything You Need to Know About Perimenopause
Perimenopause deserves our full attention. Once considered a taboo topic, this transitional life stage is finally taking centre stage in women's health conversations, blending clinical science with emotional intelligence. From hormone diagnostics and HRT to mindset shifts and sleep rituals, this is your definitive guide to navigating perimenopause with clarity, confidence, and care.
What is perimenopause, really?
"Perimenopause is the transition period leading up to menopause, typically beginning four to ten years beforehand," explains Dr Alla Zaentc, Functional Medicine & Longevity Specialist at AEON Clinic, Atlantis The Royal, Dubai. It's a time of fluctuating estrogen and progesterone levels, which send ripples through virtually every system in the body: reproductive, metabolic, neurological, and emotional.
While menopause is diagnosed retrospectively after 12 consecutive months without a period, perimenopause is often harder to define. "Symptoms can be subtle at first, irregular periods, brain fog, mood swings, even heart palpitations," says Dr. Zaentc. "But they're all signals from the body that change is underway."
The hidden signals
Beyond hot flashes and night sweats, many symptoms of perimenopause fly under the radar. Think joint aches, sudden anxiety, thinning hair, or migraines that now feel different. "One of the earliest signs is disrupted sleep," notes hormone health coach Laure Sejean. "Waking between one and three am can signal liver overload. Later in the night? That might be cortisol surges."
Other overlooked clues include reduced libido, trouble concentrating, and unexplained weight gain, especially around the midsection. "Women often tell me, 'I haven't changed anything, but my body feels completely different,'" Sejean shares. It's not in your head. It's in your hormones.
Hormones in flux
During perimenopause, estrogen and progesterone don't simply decline. They spike and crash erratically. "This hormonal rollercoaster affects everything from serotonin levels and metabolic rate to bone density and cardiovascular health," says Dr. Zaentc.
High follicle-stimulating hormone (FSH) and low anti-Müllerian hormone (AMH) are key markers, but perimenopause remains largely a clinical diagnosis, best understood through symptoms, not just labs. "Women need to be heard, not just tested," Dr. Zaentc stresses.
Medical meets holistic: two paths to support
At AEON Clinic, treatment begins with a full-body, lifestyle-led evaluation, incorporating sleep, nutrition, stress, and fitness. Hormone Replacement Therapy (HRT) is considered when symptoms are severe, and a woman is within 10 years of menopause onset. "When used appropriately, HRT can improve quality of life and prevent long-term health risks like osteoporosis," says Dr. Zaentc.
