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Researchers call for better support for women during perimenopause
Most of the women surveyed described numerous ways they needed support in managing their periods during perimenopause
Women going through perimenopause need better education and support about how their periods might change towards the end of their reproductive life, a new study led by UCL researchers has concluded.
The research, published in Post Reproductive Health, highlighted how, as women approach the menopause, their periods may become unpredictable, heavy and cause worse premenstrual symptoms, including mood swings, breast tenderness and headaches.
The team of researchers from the UCL EGA Institute of Women’s Health and Centre for Reproductive Health, University of Edinburgh, interviewed 31 perimenopausal women aged between 40 and 55.
They found that almost all of the women spoke of having unpredictable periods that accompanied the perimenopause, including changes in cycle length and period duration. This was the case even if their periods had been regular throughout the rest of their lives.
The researchers said most women stated that due to constant and unpredictable changes during perimenopause, it was challenging to commit to plans, in case they coincided with a period that would leave them unable to cope either emotionally or physically.
Additionally, many participants talked about the increased heaviness of their periods during the perimenopause which, they said, often resulted in them being caught off-guard or having low iron levels.
Premenstrual symptoms were also described as being more intense and lasting much longer than before. This ranged from new feelings of anxiety, to uncontrollable mood swings and longer periods of premenstrual syndrome (PMS).
Senior author, Professor Joyce Harper from the UCL EGA Institute for Women’s Health, said: “We need to be sure that perimenopausal women understand how their periods might change at this time in their lives and that we need to be supporting perimenopausal women as their periods become unpredictable, heavy, or have worse premenstrual symptoms.
“All of these factors can affect the working life and mental wellbeing of women going through the perimenopause.”
All of the women involved in the research described numerous ways they needed support in managing their periods. Suggestions included extra support in the workplace, such as working from home to reduce anxiety around unpredictable periods, greater sympathy from managers and colleagues, as well as mandatory managerial training and better education in schools.
Many of the participants also desired emotional support as they navigated mood swings and other bodily changes, particularly from their husbands, children and friends.
While the women said that having friends or mothers that they could confide in was comforting, many also desired additional help from support groups where they could meet people with similar experiences.
Experts at UCL, including Professor Harper, have recently announced plans for the UK’s first menopause education and support programme.
The project aims to provide education and support for women across the UK experiencing menopause to help them gain a greater understanding of what is happening to their bodies.
Professor Harper said: “This study offers valuable insight into the impact of periods on the wellbeing of perimenopausal women.
“Most negative menstrual experiences stem from a lack of education about what is and isn’t normal and when to seek medical care. Early, inclusive, and comprehensive menstrual education is vital for everyone, alongside specialised women’s health training for healthcare professionals.
“Empowering women with knowledge aids self-advocacy and informed treatment choices. We have conducted a similar study in schools with 49 15-year-old girls and they felt they needed more education and support around menstruation.”
She added: “Accessible support is essential for each woman’s perimenopause journey. We hope to make this possible for more women through our plans for the UK’s first menopause education programme.”
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Calla Lily Clinical Care has partnered with Merck to support the intravaginal drug delivery platform Callavid in an effort to improve how vaginal medicines are given.
The collaboration will continue development of Callavid, described as a leak-resistant device that addresses challenges with self-administered vaginal therapies.
Callavid uses a small, tampon-shaped device with an integrated absorbent liner. It is inserted, remains in place during drug absorption, then is removed.
The platform is intended for use with medicines in fertility treatment, oncology and hormone therapy. Administration via the vaginal route can prompt patient anxiety about positioning, dosing accuracy and leakage.
The partnership is the first industry collaboration for the Callavid technology, which was developed by Calla Lily Clinical Care.
Thang Vo-Ta, co-founder and chief executive of Calla Lily Clinical Care, said: “This collaboration with Merck marks an important milestone in the development of Callavid, our novel vaginal drug delivery platform.
“Merck’s scientific heritage and forward-looking approach to innovation make them an ideal partner as we work to address long-standing unmet needs in women’s health.
“By improving how vaginal therapeutics are delivered and experienced, Callavid has the potential to enhance both patient outcomes and quality of life.
“We see this collaboration as a meaningful step towards translating our technology into real-world clinical and patient impact.”
Calla Lily Clinical Care is seeking to develop what it describes as the world’s first drug-device combination product to prevent threatened miscarriage and for IVF luteal phase support, the phase after ovulation when the body produces progesterone to support early pregnancy.
The device is also being developed to deliver therapeutics for oncology, menopause, infectious diseases and live biotherapeutics to reduce repeated antibiotic use.
Dr Lara Zibners, co-founder and chairman of Calla Lily Clinical Care, said: “Our initial engagement with Merck through the Merck Innovation Challenge in October 2024 was an important moment of alignment around the need for more patient-centric innovation in women’s health.
“As both a clinician and a patient, I have seen how profoundly drug delivery can shape treatment experience.
“This collaboration builds on that early dialogue and reflects a shared interest in rigorously exploring new approaches that may improve how therapies are delivered and experienced by patients.”
Submitting your research project for Femtech World Awards recognition can feel daunting.
What makes one project stand out from another?
After reviewing successful submissions from previous years, we’ve identified the key elements that transform good research into award-winning work.
Innovation That Solves Real Problems
Judges aren’t just looking for novelty – they’re looking for innovation that addresses genuine gaps in women’s health.
The best submissions clearly articulate a specific problem and demonstrate how their research offers a fresh approach to solving it.
Ask yourself: Does your research tackle an underserved area? Are you approaching a known problem from a new angle?
The most compelling projects often focus on issues that have been overlooked, understudied or inadequately addressed by existing solutions.
Whether you’re investigating menopause in the workplace, developing better diagnostic tools for endometriosis, or exploring mental health interventions for new mothers, clarity about the problem you’re solving is essential.
Rigorous Methodology
Strong research stands on solid foundations. Judges carefully evaluate your methodology to ensure your findings are credible and reproducible.
This doesn’t mean your research needs to be complete – early-stage projects are welcome – but you should demonstrate thoughtful research design.
Include details about your sample size, data collection methods, controls, and analytical approaches.
If you’re conducting qualitative research, explain how you’re ensuring validity. If you’re building a technological solution, describe your testing protocols.
Transparency about limitations shows intellectual honesty and strengthens rather than weakens your submission.
Measurable Impact Potential
The research projects that win hearts and awards are those with clear pathways to real-world impact.
Judges want to see beyond the research itself to understand how your work will improve women’s lives.
Consider questions like: Who will benefit from this research? How many people could be affected? What would successful implementation look like?
Whether your impact is clinical, social, economic, or policy-related, be specific.
Instead of saying “this will help women,” try “this diagnostic tool could reduce endometriosis diagnosis time from 7-10 years to under 2 years for an estimated 200 million women worldwide.”
Inclusivity and Diversity Considerations
Award-winning FemTech research recognises that women are not a monolith.
Judges increasingly value projects that consider diversity across age, race, ethnicity, socioeconomic status, disability, and geographic location.
Have you thought about how your research applies across different populations? Are you inadvertently excluding certain groups?
The strongest submissions acknowledge these considerations and, where possible, design research to be inclusive or clearly define the specific population being served.
Clear Communication
Even groundbreaking research won’t win if judges can’t understand it. The ability to communicate complex ideas clearly is crucial.
Avoid unnecessary jargon, define technical terms, and structure your submission logically.
Think of your submission as telling a story: Here’s the problem, here’s why it matters, here’s what we did, here’s what we found, and here’s why it matters for the future.
Feasibility and Sustainability
Judges appreciate ambitious research, but they also value realistic plans.
Show that you’ve thought about practical considerations: Do you have the resources to complete this work? Is your timeline reasonable?
For projects seeking commercialisation, is there a viable path to market?
Demonstrating that you’ve considered challenges and have strategies to overcome them shows maturity and increases confidence in your project’s success.
Your Passion Matters
Finally, don’t underestimate the power of genuine passion.
The researchers who win aren’t just technically proficient – they deeply care about their work and its potential to create change.
Let that commitment shine through in your submission.
Ready to submit? Find out more about the awards and enter for free here.
Transdermal HRT best protects bone density in women with functional hypothalamic amenorrhoea, a condition that stops periods, a review of trials has found.
The meta-analysis pooled randomised clinical trials involving 692 participants and found transdermal hormone replacement therapy and teriparatide increased bone mineral density by between 2 and 13 per cent.
Functional hypothalamic amenorrhoea can follow anorexia or intense exercise. Bone mineral density measures bone strength and the amount of mineral in bone.
Around half of women with the condition have low bone mineral density, compared with about 1 per cent of healthy women, and their fracture risk is up to seven times higher.
The research was conducted by scientists at Imperial College London and Imperial College Healthcare NHS Trust.
Professor Alexander Comninos, senior author of the study and consultant endocrinologist at the trust, said: “Bone density is lost very rapidly in FHA and so addressing bone health early is very important to reduce the lifelong risk of fractures.
“Our study provides much needed comparisons of all the available treatments from all available studies.
“Clearly the best treatment is to restore normal menstrual cycles and therefore oestrogen levels through various psychological, nutritional or exercise interventions – but that is not always possible.
“The foundation for bone health is good calcium and vitamin D intake (through diet and/or supplements) but we have additional treatments that are more effective.”
When FHA is diagnosed, clinicians first try to restore periods through lifestyle measures, including psychological and dietary support, but these can fail. Guidelines then recommend giving oestrogen, though the best form was unclear.
The team reviewed all prior randomised trials comparing therapies, including oral and transdermal oestrogen, and also assessed teriparatide, a prescription bone-building drug used for severe osteoporosis.
They found no significant benefit for oral contraceptive pills or oral hormone therapy.
A recent UK audit reported that about a quarter of women with anorexia-related FHA are prescribed the oral contraceptive pill for bone loss; the study suggests using transdermal therapy instead.
Comninos said: “Our goal is simple: to help women receive the right treatment sooner and to protect their bone health in the long-term.
“We hope this study provides clinicians with better evidence to choose transdermal oestrogen when prescribing oestrogen and so inform future practice guidelines.
“Right now, millions of women with FHA may not be receiving the best treatments for their bone health.”
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