Perimenopause: why you’re not alone

According to the Nuffield Health group, 13 million women in the UK are currently perimenopausal or postmenopausal, yet most of us don’t know - or don’t give it any thought - until we are in the thick fog of it. In a bid to get a head start on the impending decade, Scarlet Spy gets stuck into menstrual coach Maisie Hill’s new book: Peri menopause power. Here’s what she’s learned so far …

Maisie Hill Perimenopause power.

What is the difference between perimenopause and menopause? 

According to Hill, the menopause is actually just one day (who knew?) marking 12 months since your last period, after which you’re postmenopausal - with all the effects that come with it.

Perimenopause is everything that comes beforehand, essentially the years leading up to your periods stopping. During this time, although you will still have periods, they are likely to be more irregular - more frequent or further apart, or an unpredictable mix of them both - and you’ll also be experiencing some menopausal symptoms. 

The menopause – when periods actually stop – is usually experienced between the ages of 45 – 55, with the average age 51. Interestingly this varies depending on which country you live in. 

Perimenopausal symptoms include (and are not limited to): 

  • Increased PMS
  • Unpredictable periods – more or less frequent, heavier, lighter, shorter, longer
  • Anger
  • Fatigue
  • Headaches and migraines 
  • Brain fog 
  • Breast tenderness
  • Hot flushes
  • Night sweats 
  • Sleep disturbances 
  • Anxiety, depression and panic attacks
  • Vaginal dryness 
  • Reduced or increased sex drive 
  • Bladder changes 

And I can expect this when?  

Perimenopause typically kicks off sometime in your 40s, but some symptoms *can* start as early as your 30s. In the book Hill explains, even if it does happen in your late 40s, there are things you can do now to influence later on, rather than just waiting until you’re really struggling. Hill herself (pictured below) was about to turn 40 when she wrote the book and explained how she wanted to arm herself with as much knowledge as possible as she ‘tiptoes into the menopause.’

Maisie Hill author and menstrual coach

The Autumn phase of life 

Knowledge is power as we step into this new ‘autumn phase of life’ – as Hill so eloquently puts it. In fact, Hill believes the perimenopause is a wonderful opportunity to ‘radically change how you think and feel about yourself and your life.’ 

Hall also noticed an association between attitude to menopause and experience of symptoms, with a negative attitude increasing the frequency and severity of symptoms.

The gender health gap

It’s not always easy to stay positive though… a recent report from the British Heart Foundation found that even advanced healthcare systems like the NHS, routinely side-line women’s health issues – and menopause doesn’t escape this. 

In the last three years there’s been a 37 per cent increase in online searching for information on the menopause, yet Hill found there is insufficient research into the impact of hormonal changes in pre- and post-menopausal women, not to mention the global supply shortage of hormone replacement therapy (HRT). 

In her book Hill writes: ‘If the tables were turned and men were the ones who were wide awake drenched in sweat at 1am; if their cognitive function changed and their penises shrivelled up, how much money do you reckon would be coughed up to help them?’ Quite. 

So, what can I do now to help myself? 

Yoga at Chewton Glen

Lots, actually – Hill’s book goes into great depths on how to navigate your hormones on the journey to menopause, including the whole Hormone Replacement Therapy (HRT) debate. But there are some simple things you can implement now that will help you feel more hopeful and empowered on your journey to menopause. 

Set boundaries 

According to Hill, working on your boundaries is key, ‘there is a common thread in all my work and that’s the impact of habitual people-pleasing and an inability to give and uphold boundaries.’  An absence of which can cause anxiety, depression and exhaustion – which are also common complaints during the perimenopause. Hill observes that when our boundaries become foggy - and we make a habit of saying yes to things we’d really like to say no to – we lose a sense of who we are and what makes us happy.

Book a facial 

Whatley Manor, Aquarias Spa Gaiayoga facial

During perimenopause changing oestrogen levels can affect the skin and decease collagen levels. Try facial acupuncture or a treatment using gua sha (jade or rose quartz) to stimulate collagen and improve the appearance of wrinkles. We love the Gaiayoga Lifting Facial at Aquarias Spa, Whatley Manor, which uses a combination of advanced lifting face massage technique and lymphatic drainage to increase muscle tone and volume. The Jade Gua Sha stones relieve tension, reduce puffiness and improve circulation. They are also said to harmonise and balance the heart chakra – aiding both emotional and physical ailments and giving the feeling of wellbeing.

Create a sleep ritual

We all know sleep is a precious commodity but Hill explains, ‘once we arrive in the perimenopausal zone, sleep becomes even more elusive due to changing hormones and life stressors.’ Shockingly, during this time and the postmenopausal years, 53% of us will be having sleep issues. A single night of sleep deprivation can double cortisol production the next morning, as well as decreasing insulin sensitivity by 40 per cent. 

There are lots of simple things you can start to implement, such as cutting back on the booze, ensuring you’re in bed by 10pm each night and keeping your room cool and well ventilated - create a sleep ritual that work for you. 

Embrace the cold shower 

Ice bucket

According to Hill, ‘an out-of-whack stress response is one thing that’s guaranteed to cock up your experience of the menopause (apart from the patriarchy)’. By stimulating your vagus nerve, you slow you heart rate and move out of fight or flight mode – a place you’ll often find yourself in during the perimenopause. The more TLC you give your vagus nerve, the more relaxed you’ll feel and able to connect with yourself and others. To improve vagal tone, Hill suggests deep breathing, laughing, yoga, humming and embracing the Wim Hof method and showering with cold water.

But avoid the thermal suite… 

Hot flushes are one of the most common symptoms of the permenopause - throw in a hot spa and everything goes to hell in a hand basket. Savant Spy says: ‘If you want to stay cool, pick a spa like Pennyhill ParkGalgorm or Thermae Bath Spa that has an ice room, or grotto. Or choose a spa with an outdoor hydro-pool, a spa garden or outdoor facilities; perhaps now you will enjoy a bucket shower, plunge pool or ice fountain.’

Lift weights

Building bone density by doing resistance and weights-bearing exercises is hugely important, says Hill. The key is to go for a ‘high load and low repetitions at least three times a week’. Already in your 40s? It’s never too late to start: the trusty kettlebell could help protect against things like osteoporosis.


OTO CBD Power drops

The buzz word in wellness, CBD, can help with depression, anxiety and insomnia – making it an ally of the perimenopause. Helen Cain, Head of Spa at the luxurious OTO says: “CBD (Cannabidiol) is a molecule found in hemp plants that matches one naturally produced by our own bodies in the endocannabinoid system (ECS). The ECS helps keep the body in balance - or, to use the technical term, homeostasis. It helps regulate sleep, mood and pain amongst other things; by communicating to neurone transmitters, cells and hormones to regulate back to their happy equilibrium.”

Limit or quit alcohol

You may not want to hear it but alcohol increases body temperature (hello hot flushes and night sweats) and raises your resting heart rate (hello hot flushes and palpitations). It also disrupts your production of melatonin and screws up your circadian rhythm, says Hill. If you’re not ready to jack it all in, opt for a low alcohol wine from Wild Life Botanicals


Maisie Hill’s book Perimenopause Power: Navigating your hormones on the journey to menopause (Bloomsbury, £14.99) is available now


Spa Likes

"Beautiful interiors, luxurious swimming pools, being pampered, long massages, quality food."

Spa Dislikes

"Noisy echoes, overlooking facilities, thin walls in treatment rooms, cramped spa layout."