Welcome to the Menopause Hub

Quick read

What is menopause vs perimenopause?

Menopause is defined as the permanent cessation of menstruation resulting from the loss of ovarian follicular activity, which leads to a significant decline in the production of oestrogen and progesterone.

Perimenopause is the transitional phase leading up to menopause, marked by fluctuations in hormone levels and changes in menstrual cycles due to the gradual decline in ovarian function. During this time, women may experience irregular periods and varying symptoms as ovarian follicular activity decreases and the production of oestrogen and progesterone becomes erratic.

As ovarian reserve depletes, the hypothalamic-pituitary-ovarian axis undergoes dysregulation, leading to anovulatory cycles and fluctuating hormonal levels during the perimenopausal transition. At the point of menopause, however, hormones stay permanently low, and the rollercoaster of perimenopause calms down.

30-40s

is often the starting age when women experience perimenopause symptoms.

51

is the average age of menopause, but it can occur earlier or later.

12 

consecutive months without a menstrual period, signals the start of menopause.

Younger vs older woman

Compare healthy vs unhealthy indicators

Younger women

  • The ovaries produce and release eggs, as well as the hormones oestrogen and progesterone.
  • Uterine lining changes according to hormone level.
  • Periods are regular.
  • Vaginal walls are thick, lubricated and elastic.

Older women

  • The ovaries stop making the hormone oestrogen and progesterone.
  • Ovulation does not occur.
  • Uterine lining stays thin.
  • Periods do not occur.
  • Vaginal walls become thinner, drier and less elastic.

Stages of Menopause

Menopause is complex and it affects every women differently. While there are more than 20 common signs of menopause, there are over 100 official signs associated with perimenopause, menopause and postmenopause.

Many women believe the menopause is something that affects them in the mid-late 40s, but hormonal changes marking the beginning of the menopause can start years before. In fact, it is not uncommon for these changes to start in your late 30s or a decade before your actual menopause.

Perimenopause

A transitional period that usually begins 4-10 years before menopause.

Menopause

Menopause lasts for one day - the day you have been 12 consecutive months without a period.

Postmenopause

Postmenopause is the next day after menopause and beyond.

Surgical-induced menopause

Surgical-induced menopause, also known as medically induced menopause, occurs when a woman's ovaries are surgically removed or when their function is intentionally halted.

Ostrogen level by age

Ovarian failure The ovaries gradually stop releasing eggs and producing oestrogen and progesterone. This typically begins in the late thirties or early forties, with a rapid decline in hormone production in the years leading up to menopause.

Endocrine changes As ovarian function declines, there is an increase in follicle-stimulating hormone (FSH) and luteinising hormone (LH) levels due to decreased negative feedback from oestrogen. FSH levels often exceed 40 IU/L during menopause.

Oestrogen deficiency The hallmark of menopause is hypoestrogenism, resulting in multiple systemic effects that are responsible for both short-term and long-term symptoms and health risks.

Key differences between perimenopause and post menopause

Perimenopause
Postmenopause
Hormone activity
Hormone levels fluctuate
Hormone levels remain consistently low
Menstrual cycles
Irregular cycle
Cessation of menstruation
Fertility
Pregnancy is still possible
Pregnancy is not possible
Duration
Transition up until the cessation of menstruation
Permanent state after cessation of menstruation
Hormone activity
Perimenopause Hormone levels fluctuate
Postmenopause Hormone levels remain consistently low
Menstrual cycles
Perimenopause Irregular cycle
Postmenopause Cessation of menstruation
Fertility
Perimenopause Pregnancy is still possible
Postmenopause Pregnancy is not possible
Duration
Perimenopause Transition up until the cessation of menstruation
Postmenopause Permanent state after cessation of menstruation

Symptoms of perimenopause and menopause

While some women will sail through menopause with no signs at all. The majority of women will experience a variety of signs, and the impact of these on physical and mental health can be devastating on lives, relationships and jobs.

Vasomotor symptoms

Vasomotor symptoms

Hot flushes and night sweats often begin during perimenopause and can be very intense due to hormonal fluctuations. 75% of women have experienced this.*

Mood and cognitive symptoms

Mood and cognitive symptoms

Mood swings and cognitive changes are common during perimenopause, often linked to fluctuating hormone levels.

Bone health issues

Bone health issues

The risk of osteoporosis and bone fractures increases in menopause due to sustained low oestrogen levels.

Vaginal and urinary symptoms

Vaginal and urinary symptoms

Vaginal atrophy, dryness, and painful intercourse become more persistent due to the sustained low oestrogen levels. Increased risk of UTIs, urgency, and incontinence become more common.

Cardiovascular risk

Cardiovascular risk

The risk of cardiovascular disease (CVD) can start to rise during perimenopause due to the gradual loss of oestrogen’s protective effects on the heart and blood vessels.

Weight gain and metabolic changes

Weight gain and metabolic changes

Continued weight gain, particularly in the midsection, and an increased risk of metabolic syndrome are typical of menopause.

How food impacts the Menopause

Our diet is the foundation of our health and wellbeing and it is even more important when going through menopause. What we eat and avoid can have a significant impact on menopause signs. In a menopause survey of 1,526 women, 82% had made changes to their diet to help with symptoms of menopause, and 66% found these changes effective.* Discover the best foods to reach for and avoid during menopause to manage signs.

Foods to reach for

Foods to avoid

Learn more

PeriMenoFriend®

Award-winning supplement. Our nutritionists have formulated PeriMenoFriend® with every ingredient doing a job.

Perimenopause is different from menopause. Hormones are fluctuating unpredictably and your body needs nutrient support through the transition. PeriMenoFriend® is formulated with this in mind.

PeriMenoFriend® 95% find it effective*
  • Hormone balance, mood and mental performance
  • Reduced tiredness and fatigue
  • Phytoestrogens from seven plants
  • Brain function, skin, hair and nails
  • Ingredients backed by over 300 studies

22 ingredients formulated by nutritionists for perimenopause. 

Learn more

MenoFriend®

A formula that understands what menopause requires.

MenoFriend® combines six botanicals at evidence-based doses with a vitamin and mineral base for energy, hormone regulation, mental performance and bone health. Red clover, sage, wild yam, maca, hops and mung beans are plant sources of isoflavones. Sage is rich in polyphenols. Wild yam provides diosgenin. Maca is grown at 4,000 metres in the Peruvian Andes and used there for centuries.

MenoFriend® 89% find it effective*
  • Energy and mood
  • Hormone regulation and mental performance
  • Non-soy phytoestrogens from six botanicals
  • With maca root, red clover & sage

19 active ingredients with non-soy phytoestrogens from six botanicals, plus vitamins and minerals designed for menopause.

Learn more

The evidence behind DRV+

Women's Health

How menopause reshapes gut health

Our survey of 1,526 women shows that gut health deteriorates for most women during menopause - usually beginning in perimenopause.

1,526 respondents January 2024 Cross-sectional customer survey
67% report worse gut health
73% experience bloating
79% feel a psychosocial impact
Study Findings

We surveyed 1,526 women across the menopausal transition on gut symptoms, their timing, frequency and downstream impact.

What we found:

66.8% reported noticeably worse gut health since menopausal symptoms began - typically starting in peri-menopause (58%). Bloating led (73%), experienced daily or near-daily by 77% of those affected. 79% reported a psychosocial consequence. Among gut-targeted supplements assessed, Gut Works® rated strongest (78.4% positive).

What This Means

It starts earlier than expected

58% first noticed gut changes in peri-menopause.

Often before menopause is formally established.

Persistent, not occasional

77% of bloating sufferers experience it daily or near-daily.

With a mean of 3.4 gut symptoms per woman affected.

Diet alone isn't enough

Only 11% found dietary change 'very effective'; Gut Works® led supplements at 78.4%.

Targeted support outperformed diet for most women

Read the abstract
Women's Health

A non-hormonal menopause option with a clear duration-response

MenoFriend® is a non-hormonal nutritional supplement for the menopausal transition. This individual-level analysis reports effectiveness, symptom relief and a direct comparison with HRT in the same population.

978 respondents (735 established users) January 2024 Cross-sectional customer survey
89% established users rate it effective
83% all users rate it effective
69% HRT comparator
Study Findings

Individual-level cross-tabulation of 978 MenoFriend® users (735 established, 2+ months), with HRT (n=574) as a same-population comparator.

The results?

82.6% of all users and 88.7% of established users rated MenoFriend® effective, versus 68.5% for HRT, with a far lower dissatisfaction rate (17.4% vs 31.5%). A clear duration-response was seen (64.2% at under two months rising to 95.8% at 1-2 years). MenoFriend® outperformed HRT specifically for brain fog (35.0% vs 26.8%).

What This Means

Favourable vs HRT in this population

88.7% (established) vs 68.5% for HRT; nearly half the dissatisfaction rate.

Note: ~25% of users also used HRT concurrently.

Clear duration-response

Combined-positive rose from 64.2% to 95.8% across duration bands.

Adequate exposure (3+ months) is key to assessing benefit.

Distinct cognitive edge

Brain-fog relief 35.0% vs 26.8% for HRT.

Alongside hot flushes/night sweats (44.8%) and mood (42.4%).

Read the abstract

Free menopause resources

Practitioner papers, supplement considerations and client handouts to read online or download as PDF.

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Menopause survey: Menopause survey: Based on a UK survey conducted by DRV+ of 1500 women, nationally representative, during February 2024. All customer survey findings reflect our own efforts and have not been influenced or verified by any external organisations or third-party entities.