Irregular menstrual periods, hot flushes, changes in mood and sleep, as well as modifications in body composition: these are all symptoms of what is known as perimenopause.

At a time when attention to women’s health is greater than ever and the population of developed countries continues to age, it is essential for pharmaceutical companies to understand and effectively respond to the needs of a growing segment of the market: women in perimenopause.

Although perimenopause is a natural process, the challenges it poses can be complex to understand and manage. In this article, we will examine in detail what perimenopause is, but also the associated symptoms and the solutions to manage it effectively.

What is perimenopause?

Perimenopause, often confused with premenopause, is the period before menopause, which is when the last menstruation occurs and during which a woman’s body begins to deal with various fluctuations in hormone levels. A woman can be considered menopausal only after a whole year without menstrual cycles. In the pre-menopausal phase, there is a gradual decline in ovarian activity, with a progressive reduction in both the number and quality of follicles. Consequently, there is also a decrease in fertility.

In some situations, women can enter perimenopause early, in their late thirties, although perimenopause usually starts between 40 and 45 years and can be influenced by many factors, including lifestyle and family history. The early onset of perimenopause can often be linked to genetic factors, so in this sense it is useful for a woman to know when her mother began this transitional period, in order to obtain an approximate indication of the possible start of her own perimenopause.

Difference between premenopause and perimenopause

But how is premenopause different from perimenopause? While premenopause refers to a woman’s entire period of fertility before the onset of menopausal symptoms and lasts a few years, perimenopause is the transition phase within the menopausal process and includes the period of time preceding and following the end of the menstrual cycles. The term “peri” is actually a prefix that derives from ancient Greek and stands for “near”; in this case, therefore, it means “close to” the menopause.

Symptoms of perimenopause

During the initial phase, women may experience a variety of symptoms that differ greatly from person to person. As occurs for the age of perimenopause onset, symptoms can also be affected by factors such as lifestyle and genetics. Some of the most frequently observed symptomse are:

  • Irregular menstrual flow: periods can vary in intensity, from heavy to very light, or may be completely absent in some cases.
  • Hot flushes and night sweats: these are extremely common and can also be more intense as a result of genetic predisposition.
  • Insomnia: sleeping difficulties can result from night sweats and/or from other disorders related to this phase.
  • Vaginal dryness: the decrease in oestrogen levels contributes to vaginal dryness, which in turn can negatively affect libido, making sexual intercourse uncomfortable or painful.
  • Vulvovaginal atrophy: this is one of the most common symptoms and concerns the reduction of health and elasticity of the urogenital tissues, which are particularly reactive to oestrogens and variations in their levels.
  • Mood changes, depression, anxiety, irritability: the hormonal fluctuations typical of the perimenopause can cause mood changes and, in the more severe cases, lead to depression.
  • Cognitive difficulties and dizziness: concentration problems, forgetfulness, dizziness and balance issues may occur during this period.

These signals are the result of fluctuations in hormonal levels, particularly oestrogen and progesterone, that the body experiences during the transition from fertile to non-fertile age.

How to deal with perimenopause

Managing perimenopause requires a holistic approach that takes into account both physical and emotional aspects. A key component of this process is the adoption of a healthy lifestyle, including a balanced diet, regular exercise and stress management techniques.

In addition, it is important to discuss the different treatment options available with a physician. Although there are no drugs that can interrupt menopausal syndrome as a whole, the therapies available today mainly aim to mitigate the symptoms that affect women’s quality of life.

Among the treatments to manage menopausal disorders, hormone therapy is very effective and also allows to reduce the risk of osteoporosis. Hormone treatment options include:

  • Hormone replacement therapy (HRT): it involves the administration of oestrogens (ET) or a combination of oestrogens and progesterone/progestogens (EPT);
  • Selective oestrogen receptor modulators (SERMs): this strategy involves the use of drugs that can interact with oestrogen receptors, emulating the effect of the hormones naturally produced by the body.

As for natural alternatives, there are specific supplements for the well-being of menopausal women. Among gynaecological supplements, Afragil supports women during perimenopause and menopause, combining CalciumVitamin D3Vitamin C and Lycopene in a balanced formula. The product, developed by Cor.Con. International, is a chewable tablet containing  Solanum Lycopersicum and Haematococcus pluvialis, which protect cells from oxidative stress.


Although perimenopausal symptoms are very common in the female population, they can vary greatly in intensity and in their impact on the quality of life. From this comes the need to offer customised solutions that take into account the needs of every woman. This is why it is important for companies to include in their catalogues products such as gynaecological supplements, not only as a response to these minor and major symptoms, but as a real support for general well-being during a delicate transition period.

The growing awareness of perimenopause and the search for reliable and effective solutions to manage the symptoms of perimenopause represent a significant opportunity for the managers of pharmaceutical companies. Investing in targeted products is not only a strategic choice, but also a step towards recognising and supporting women’s health needs in this stage of their lives.