Perimenopause, Menopause & HRT

Everything you need to know, from the first signs to finding what works for you.

For those experiencing symptoms of perimenopause, menopause, or other hormonal changes, you'll know it is not a sudden realisation. It is a slow process of joining the dots together and trying to work out what is causing the changes.

From my own experience, I had hot flushes in my mid 40s but they were fairly mild and I did not think I was old enough to be perimenopausal. I continued with them as a mild inconvenience, but soon I was also suffering from terrible insomnia, brain fog, temperamental moods, and weight gain.

I thought for a long time the issue was insomnia and if I treated that, I would solve all the other problems. It was only when my brain fog became particularly bad that I reached out to my GP. It was the fear of early onset Alzheimer's that finally pushed me to act. With all the other symptoms, I just did not join the dots.

I was not asked to carry out a blood test. It was a phone call, on my way home from London on a busy train, praying the reception did not cut out as we went through tunnels. I started on a treatment of patches containing oestrogen and progesterone. An oestrogen only patch for the first 14 days, followed by a combined oestrogen and progesterone patch for the next 14 days.

These worked okay but caused aches and pains which made my insomnia worse. Determined to figure this out on my own, I stopped the patches, armed myself with magnesium spray and a strict bedtime routine, and saw very little progress.

After a few months off the patches, I went back and asked for an alternative. By this time the weight gain was almost out of control. I was stuck in a cycle of feeling bad, snacking in front of the TV, sleeping badly, and seeing no way out. My GP issued oestrogen gel and progesterone capsules, which I have been using for over a year, and they have been life changing. Spurred on by Davina McCall, I requested testosterone from my GP to try and get my energy back. After a year of waiting to speak to a consultant, I was finally issued testosterone gel.

I share all this because this combination of HRT has enabled me to get out of the rut and find the strength to not only cope in this stage of life but to thrive. I am stronger and fitter than I was in any previous decade of my life.

HRT is not for everyone, and there are some women who can manage their symptoms using other tools. But for me, it has been the help I needed. I really hope this guide helps even just one woman who is struggling to find her mojo, get back on her feet, and feel stronger and ready to take on the world.

At TribElle, we know first hand the struggle to find reliable information or to speak to someone who will listen and help join the dots together, rather than treat symptoms in isolation. This guide is here to give you information on perimenopause, menopause, and HRT options, along with lifestyle advice to work in combination with or without HRT.

Other Hormones That Play a Role

Why hormones fluctuate: The hormonal changes during perimenopause are not a steady decline but a turbulent rollercoaster of up-and-down shifts. The symptoms women experience often depend on whether their oestrogen levels are spiking or dipping at any given time. This is a normal and natural part of the transition leading up to menopause.

🚨 When to See a Doctor

While these symptoms are a normal part of the perimenopause transition, do consult a healthcare provider if you experience:

Hormones After Menopause

Hormone Replacement Therapy (HRT)

HRT is a treatment used to alleviate symptoms of perimenopause and menopause by replacing the hormones the ovaries produce less of as you age. It is considered a safe and effective treatment for most women.

✅ What HRT Can Help With

Two Main Types of HRT

⚠️ Important Considerations

Breast cancer risk: Combined HRT may slightly increase the risk, which increases with duration of use. The risk is lower with oestrogen-only HRT.

Individualised treatment: The choice of HRT type and dosage should be made in consultation with a healthcare professional, considering your symptoms, medical history, and risk profile.

Stopping HRT: Should be done gradually under medical supervision to minimise the return of symptoms.

💡 Consider Professional Support & Alternatives

Non-hormonal medications: Discuss options with the TribElle Clinical Team. Certain antidepressants or other medications may be prescribed by your GP if HRT is not suitable for you.

Herbal supplements: Approach with caution. While some women report benefits from remedies like black cohosh or St John's Wort, scientific evidence is mixed and they can have side effects or interact with other medications.

Other therapies: Acupuncture is one option that some studies suggest can improve hot flashes and quality of life.

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