What are Pre & Peri Menopause?

Pre-menopause refers to the whole period preceding menopause, which can last for 10 years or even more. During this time most women will still have periods (irregular and regular) and is still considered to be in her reproductive years. There is often no noticeable change, despite underlying hormone changes. 

Peri-menopause refers to the time when the effects of hormonal changes  become evident, but before true menopause. The term is used to refer to the transition phase when hormone production has drastically fallen but before production stops completely. It is a time when the levels of reproductive hormones become more variable and the effects of these fluctuations can be significant. 

When will this happen?

Women may begin to experience symptoms of pre-menopause, or maybe even peri-menopause, as early as the age of 35.   Most women don’t become aware of the transition until they reach their mid to late forties. Often the timing of this phase is similar to the time when a woman’s mother went through the same transition. However, the length of time and severity of menopause-related symptoms for any individual woman cannot be predicted, and every menopause is unique. Genetic and environmental factors are important factors in determining when a woman may enter menopause.

What are the symptoms?

Common symptoms during this phase of hormonal fluctuation can include:

Irregular periods

Periods that are heavier or lighter than usual



Mood swings


Anger and irritability


Heart palpitations

Memory loss

Hot flushes

Night Sweats

Dysfunctional uterine bleeding


Weight gain


Fluid retention

Breast tenderness

Aches and painful joints

Frequent headaches

Urinary incontinence

Vaginal dryness

Dry skin

Low libido 

How is it treated?

As a woman moves through each phase of menopause, hormone levels can fluctuate significantly. However, vital hormones, such as estrogen, progesterone and testosterone remain important for bones, vaginal and urethral health, skin, brain function as well as cardiovascular health. It is therefore important to effectively balance and replenish these hormones in order to maintain a woman’s health, energy, mood and brain function.

At Fulcrum. we conduct a thorough medical history combined with appropriate testing thus enabling us to identify when symptoms began as well as the severity of hormonal imbalance.  We can then develop an individualized treatment plan.

One size does not fit all!  As every woman is unique, so are her hormones. Every woman has her ‘own’ menopause and thus every hormone replacement therapy is specifically designed for her.