In a study published in Nature that surveyed symptom patterns across 4,400 US women aged 30 and older, the women’s health experts at Flo Health found that many women in their thirties are unknowingly experiencing perimenopause symptoms and not seeking support or treatment to manage them.

In fact, of the women they spoke to, over 90% of women have never received education about menopause in school, and more than 60% feel uninformed about what to expect. 

Additionally, a significant proportion of women in their 30s reported experiencing ‘moderate to severe’ symptoms that are common during perimenopause and menopause, as measured by the Menopause Rating Scale (MRS). 

This included 55% of women aged 30-35 who self-reported symptoms that met the MRS criteria for moderate or severe perimenopause symptoms, and 64% of women aged 36-40 met the criteria.

This study is unique in its focus on early perimenopause symptoms and how they progress, addressing a significant gap in current research.  According to a distressing report from Harvard Medical School, less than 1% of published medical studies focus on menopause, contributing to gaps in scientific understanding, and further suggesting that perimenopause is likely even more neglected in research. 

We still have a very long way to go when it comes to understanding and addressing women’s health issues, as even periods are still stigmatised.

To learn more about perimenopause and how we can prepare for it, HuffPost UK spoke with Anna Klepchukova, Chief Medical Officer of Flo Health.

How to prepare mentally and physically for menopause

According to the Flo study, psychological symptoms, such as anxiety, depressive mood, and irritability, were highest in women aged 41-45, and lowest in those 56 and over.

This is a daunting prospect, especially if — like 30% of UK adults — you already experience mental health difficulties.

We asked Klepchukova if there are any steps we can take to prepare ourselves.

She explains: “Absolutely. There are things that women can do to help them prepare. But it’s important to say that every woman’s experience of perimenopause will be unique. So there isn’t a one-size-fits-all method. There is evidence that focusing on their overall well-being and health can help women prepare for this time.

“Specifically, establishing and maintaining a healthy lifestyle, which includes good, balanced nutrition, regular physical activity, and stress management strategies, can support a woman’s body through the changes that happen during perimenopause.”

This seems simple enough, but what about the mental impacts? Surely they can be a little more complex.

Well, Klepchukova believes that there is a way that we can help ourselves: “It can help to accept that this phase of life can come with unexpected changes and symptoms, and being open to learning more about how your own body’s needs evolve can be helpful, too.

“What I want women to know is that it’s important to listen to their bodies and that they have the right to ask for support when they need it — whether that’s from a healthcare professional, their loved ones, or other trusted resources.”

How can we reduce our anxiety around perimenopause?

I don’t know about you, but as a 35-year-old woman, I am a bit anxious about this impending change in my body. However, Klepchukova assures that being well-informed will help overcome this dread.

“Anxiety is common during perimenopause,” she explains,  “with up to 50% of women aged 40–55 experiencing symptoms like tension, nervousness, and irritability.”

The health expert went on to say: “Hormonal fluctuations play a key role—oestrogen helps regulate neurotransmitters like serotonin and dopamine, so changes can directly impact mood.

“But life stressors, such as balancing work, caregiving, and family, can also contribute, while symptoms like hot flashes, night sweats, and brain fog can create a snowball effect, making anxiety worse.”

There are ways to help yourself such as prioritising rest, exercising, sleeping well and breathing techniques can help to reduce the anxious symptoms. 

However, she adds: “Don’t forget that treatments are available for your symptoms. Hormone therapy (HRT) can ease anxiety for those already considering it for other symptoms. Doctors may also recommend cognitive behavioural therapy (CBT) and anxiety-specific medication.”

How can we open up the conversation about perimenopause and menopause with our loved ones?

Of course, more needs to be done to raise awareness of these changes and the symptoms that they can bring but if we hope to break down stigma, we need to normalise speaking to our loved ones about it, especially if we need extra support.

Klepchukova says: “Many women hesitate to discuss perimenopause due to societal stigma and cultural taboos. To normalise the conversation, it helps to be clear and direct—saying, “I want to talk to you about my perimenopause journey” can be a good starting point.”

She also suggests sharing reputable resources, such as those from Flo Health to explain what you’re going through. In the UK, there is also a non-profit called Menopause Support which can guide you and loved ones.

Klepchukova adds: “Involving friends, family, and partners can help them grasp what you’re going through and can also encourage them to support you. Sometimes it can help to be very specific and say, “I’m feeling low—can we come up with ways you can help me?”

“Support groups or counselling can also provide a safe space for discussion. This can reduce feelings of isolation and strengthen your support network. If you’re finding that things are challenging, it doesn’t have to be in silence — opening up allows others to understand and help.”

Help and support:

• Mind, open Monday to Friday, 9am-6pm on 0300 123 3393.
• Samaritans offers a listening service which is open 24 hours a day, on 116 123 (UK and ROI - this number is FREE to call and will not appear on your phone bill).
• CALM (the Campaign Against Living Miserably) offer a helpline open 5pm-midnight, 365 days a year, on 0800 58 58 58, and a webchat service.
• The Mix is a free support service for people under 25. Call 0808 808 4994 or email help@themix.org.uk
• Rethink Mental Illness offers practical help through its advice line which can be reached on 0808 801 0525 (Monday to Friday 10am-4pm). More info can be found on rethink.org.