The menopause is when a woman's period stops and she's no longer fertile. But when do you think this happens? 40s? 50s? No idea? Sometimes it can occur earlier than you'd think.

Today, Pink Parcel’s resident GP Dr Louise Newson, who runs a Menopause Clinic at Spire Parkway Hospital, tells us everything we NTK about early menopause.

Menopause and perimenopause, what's the difference?

The menopause and perimenopause refer to different phases of a woman's reproductive life. Menopause is when a woman no longer has periods, perimenopause is a transitional stage, explains Dr Newson.

She says: "A woman is menopausal when she's not had a period for one year. However, many women experience menopausal symptoms but still have periods. Periods may become lighter and less frequent or they may become heavier and more frequent. If a woman is still having periods, then she is perimenopausal and this phase can last for months or even years. Some women do not have any symptoms at all when they are still having their periods but other women have numerous symptoms that negatively interfere with the quality of their lives."

Dr Newson adds that often, the term menopausal is used generically rather than acknowledging perimenopause, which can cause confusion between the two distinct stages.

What are the symptoms?

Symptoms of the perimenopause are the same as the symptoms of the menopause – these can be numerous and the severity and duration will vary hugely between different women.

Dr Newson also explains that many women find that their symptoms can vary from month to month. She says that, "the main symptoms that people think about regarding the menopause are hot flushes and night sweats. However, there are other symptoms that can occur including mood swings, irritability, tiredness, poor concentration, memory problems, joint pains, worsening migraines and headaches, itchiness of the skin and reduced libido."

How is it officially diagnosed?

Diagnosis is usually made from the symptoms a woman is experiencing.

"Current guidelines state that if a woman is over 45 years and experiencing menopausal symptoms with some change in her periods then she does not need to have any blood tests. Women younger than 45 may sometimes have blood tests. This usually includes measuring an FSH level which is follicle-stimulating hormone. This level is raised in people who have low oestrogen levels," says Dr Newson.

When can the perimenopause stage occur?

Did you know that the average age of the perimenopause the UK is around 45? However, one in around 100 women under the age of 40 have premature ovarian insufficiency which means they will have an early menopause.

Dr Newson says, "this means that a significant number of women will experience perimenopausal symptoms when they are under the age of 40. There is no youngest age as menopause can affect women in their 20s and 30s."

How long are you usually perimenopausal for?

Again, the duration of perimenopause really does vary between women.

Dr Newson explains that some women will only have mild symptoms for a few months before their periods stop, whereas other women have more severe symptoms that can interfere with the quality of their life for many years before the end of their periods. She says: "Even when they become menopausal it is very common for women to experience symptoms for years and even decades.

What eases the transition?

The perimenopause can be an important stage in your life, to reflect and think about your lifestyle and wellbeing. "Eating a healthy, balanced diet and exercising regularly, can make a difference to how you feel when you're going through these hormonal changes. As can reducing alcohol intake and stopping smoking", says Dr Newson.

"As symptoms are due to low oestrogen levels, taking HRT which contains oestrogen can really improve symptoms. In addition, HRT is known to reduce future risk of heart disease, osteoporosis and diabetes which are all conditions that women are more likely to have after the menopause. The perimenopause does not have to be a negative experience," she adds.