Perimenopause, is the natural transition period women go through before the menopause. It is a natural step in a woman's body towards permanent infertility. The average age of menopause in the UK is around 52 but perimenopause can start at different ages. Some women notice changes in their early 40s, and occasionally in their mid 30s. This is due to female hormone changes, mainly oestrogen, rising and falling unevenly. Here, London-based GP Deyo Famuboni reveals the 10 signs you could be experiencing perimenopause.

Ali Maffucci, 28, from New York, lost 11 kg, (24 lbs) in three months by replacing pasta, rice, and bread with spiralized vegetables (she is pictured, left and right, before and after her weight loss). She went from a size 12/14 to a size 8/10 (pictured centre). Before changing her diet she said she felt tired and lethargic, but now she feels happier and more energized than ever. She said: 'My focus during the days is so much stronger now too. Without that old laziness anymore I get so much more done now.'

Alison, 43, from Gloucestershire was left with an imploded breast that looked 'like a croissant' (bottom left) after she succumbed to a severe infection following breast augmentation surgery six years ago. Since the botched operation, she has had 12 further surgeries, none of which have managed to fix the damage. Now she has appeared on reality show Extreme Beauty Disasters in the hope surgeon Vik Vijh (top right) will be able to fix the mess.

Bettie Jo, from Houston, Texas, tipped the scales at 47 stone (660lbs) but found it difficult to lose weight without the support of her husband Josh, she reveals on tonight's My 600lb Life on TLC. The 24-year-old (right) was housebound and unable to tend to her own needs and lived off a diet of fried chicken. Bettie Jo, who now weighs 35st 8lbs (500lbs) thanks to surgery, reveals on the show that Josh (pictured with her left) had become her 'caretaker' - helping her go to the toilet and into the shower, and putting powder between her rolls of flesh afterwards to stop her skin from chafing.

Kerrie Armitage, 28, from Leeds, suffers from the ultra-rare condition aquagenic urticaria - an allergy to water. She was diagnosed two years ago after her skin erupted in agonising blisters (right) when she got caught in a rain storm. Now the 28-year-old has had to stop kissing her husband Peter (inset) - because the saliva on his lips can trigger a painful flare-up. She said: 'Because his lips are wet, the saliva can make me react. He's got to make sure his lips are dry before he gave me a kiss. It's not every time - I can do the same thing time and time again and not react, but then I'll do it once more and get a flare-up.' Her condition has become so bad that her hugging her children can trigger an episode, as their body heat makes her sweat - and she has trained herself not to cry.

Shaun Appleby's heartbroken mother Satish said her son's lifestyle should be a warning to others. The teenager, from North Tyneside, died aged just 18 after years of gorging on junk food and sitting at his computer for up to 10 hours a day. Over the years his weight peaked at nearly 20st. But five years later, just as he began to shed the weight, he was found dead in his bed. A coroner recorded Shaun's death as being due to sudden adult death, noting he was also obese. Research has shown that excess weight increases the risk of sudden cardiac death, as does type 2 diabetes, which is related to obesity. Today his heartbroken mother said: 'My message is for children to get out more, meet other kids, get more fresh air and get off their computers. It's not healthy to be on a computer for hours and hours every day. If this saves one child then Shaun's death is not wasted. No parent should be going through what I am.'

Yamini Karanam, 26, has dubbed the tumour, circled inset, her 'evil twin sister', adding 'she's been torturing me for the past 26 years'. She underwent surgery at the Skullbase Institute in Los Angeles to remove a mass, initially diagnosed as a pineal brain tumour. But Dr Hrayr Shahinian, the expert operating on Miss Karanam, discovered the growth was in fact an embryonic twin, complete with bone, hair and teeth. Known by its medical name, a brain teratoma, the tumours are very rare. Indeed, Dr Shahinian, who has removed around 7,000 brain tumours has seen just two teratomas in his career.

A series of images showing the heartbreak, brutality and horror of the Ebola virus as it tore through West African communities (pictured left) has taken the top prize at the world's largest international photography competition. The Sony World Photography Award winners were announced at a gala in London last night, where dozens of stunning photographs showcased people, communities and landscapes from around the world. Pictured top right is a pyrograph on Mount Kenya, while bottom right is a group of children playing football in one of the most dangerous neighbourhoods in Argentina.

Tiny Teddy Houlston (pictured left with his mother) was alive for less than two hours before he died on April 22 last year. His parents Jess Evans, 28, and Mike Houlston, 30, from Cardiff, were told during the pregnancy that he suffered from rare brain condition anencephaly - which stops the brain and spine developing properly - but were determined that his life would not be wasted. Despite their heartbreak over the loss of their son, the couple allowed medics to carry out pioneering surgery on their baby so he could go on to save the of an adult man, 233 miles away in Leeds, who was suffering from renal failure. They managed to spend a few precious hours with Teddy before his death, during which he was reunited with his twin Noah outside the womb (right). The parents, who were childhood sweethearts, said that their son 'lived and died a hero'. Teddy's twin Noah is now a healthy one-year-old living at home with his parents and his sister Billie, three (pictured together inset). The family have shared Teddy's story in the hope people will donate to the charity, 2 Wish Upon A Star, which aims to improve bereavement services for parents who lose babies or young children.

Rajpal Singh, 34, from Bathinda in India's western state of Punjab, went to many different medical centres complaining of a stomach ache, but doctors were baffled as to the cause. Finally, an X-ray revealed a mass of foreign objects in his stomach (the scan is pictured top right, and some of the coins he swallowed, bottom right). Mr Singh had sunk into a depression and began eating metal objects including coins, iron nails, magnets, nuts and bolts and screws. Doctors carried out a nine-hour operation to remove the metal from his stomach (left is an image revealing the objects, taken from a camera put down his throat into his stomach), but he will still need another procedure as they couldn't get it all out in one go.

Chris Rowe, from Gloucester, was repeatedly told by doctors he was suffering a simple virus. He has since been diagnosed with an aggressive lung cancer that has spread to his liver and bones. The 31-year-old has been told his cancer is inoperable and has undergone gruelling rounds of chemotherapy in a bid to prolong his life so he can create memories with his young family. His wife, Kate, 28, is currently pregnant and due to give birth in June - they also have a three-year-old daughter called Sophia. He hopes that by sharing his story that others look out for the symptoms of lung cancer.

Samantha Rawcliffe, 40, from Morecambe, pictured left and top right with her husband Philip, was diagnosed with functional neurological disorder following the accident. It has left her confined to her home, and reliant on 32 drugs a day bottom right. She has since had to give up her job as a teaching assistant, and can no longer drive. She struggles to walk further than eight metres, and relies on a mobility scooter to get around. The 40-year-old spends most of her time confined to her home, and has to take 32 tablets each day to prevent choking fits and tremors. She said: 'I used to be the life and soul of the party and I've never been a miserable person but there is so much that I can't do and it's hard to take.'

Kate Thomas, 24, of Sunderland, was told that her son Miles' flat head syndrome was cosmetic, and there was no treatment available on the NHS (she is pictured with her son, left, and he is pictured, right and inset). Worried, she visited a private clinic, who said the condition could cause blindness and facial disfigurements. So she decided to raise the £2,000 needed for a special helmet that would change the shape of Miles' head. She set up a GoFundMe page and hosted raffles in her local pub, raising the money in just a day. Miles will be fitted with a helmet later this month, and Mrs Thomas is delighted. She said: 'I'm delighted that he is finally getting his treatment and would again like to thank everyone who donated.I am stunned by everyone's generosity and can't believe that people would be so kind.'

WARNING: GRAPHIC CONTENT. Sally Lutkin, 49, of Kingston upon Hull, East Yorkshire, decided to have a rose surrounded by her grandchildren's names tattooed on her leg, as a personal reminder of her loved ones (she is pictured, left). But her leg became red and swelled up, and she was in so much pain she couldn't walk. She was rushed to hospital where she underwent emergency surgery to stop the infection spreading to the bone. Instead of a lovely design, she was left with a gruesome black hole in the middle of her leg (right) and still has a scar 18 months later (inset). She has vowed never to have another tattoo again. She said: 'I'd had tattoos before but I'll never have one again. No one is laying their hands on me ever again after this.'

Hattie Gladwell, 19, from West Sussex, was fitted with a stoma and bag to collect her body's waste, after undergoing major surgery for ulcerative colitis. Now she blogs about her experiences of living with the medical bag (pictured right), posting selfies (left) and sharing the challenges she's faced since surgery. The blogger has even opened up about being intimate with her boyfriend (inset), who has helped rebuild her confidence.

Ali Gordon, 26, and Lydia Millen, 27, from Milton Keynes, have been dating for two years after meeting via Instagram. Ali has been the driving force behind the overhaul, helping Lydia to ditch her bad lifestyle habits. Lydia, 27, explained: 'I was so unhealthy [before I met Ali]. I smoked up to 20 cigarettes a day, binge drank at weekends and my diet was just awful I didn't have a clue and was majorly under eating. I saw that Ali looked at his body a completely different way than I did and I almost felt a little jealous, I wanted to look at mine that way. So he started schooling me on training, nutrition and I fell in love with the lifestyle. I've now been smoke free for two years and I can't remember the last time I had a drink.'

Tony Orrell, 56, from Feltham, Middlesex, reached 38 stone (left) by living off takeaways. After developing diabetes, Tony joined Slimming World and took up dancing - losing 21st in three years (right). At size XXXXXXXXL, Tony had to buy his clothes from specialist retailers online and was scared to sit on normal chairs. He vowed to shed the pounds alongside his wife Debbie, also 56, after he hit 38 stone and she tipped the scales at 18 stone.

Five-year-old Jacob Lemay of Massachusetts was born a girl. After he insisted that he be treated as a boy since the age of two, his parents Joe and Mimi decided to let him transition. Now they hope to change the perception of transgender people.

The 49-year-old cancer patient revealed how a large tumour underneath her left breast, pictured left, 'dissolved away', right, after a pioneering new drugs therapy. Doctors at the Memorial Sloan-Kettering Cancer Center in New York have hailed their patient's recovery 'one of the most astonishing responses', ever seen. Scientists at the hospital have conducted a trial, treating patients diagnosed with advanced melanoma with a new type of treatment. They combined a standard drug already used, ipilimumab, with another, nivolumab. 'This is one of the most astonishing responses I have seen,' said medical oncologist Paul Chapman. 'It reminds us of the potential power of the immune system if we can remove the "brakes" that keep it from attacking cancer cells.'

Eloise Parry, from Shrewsbury, 'burned up from the inside' after swallowing the highly-toxic substance known as Dinitrophenol or DNP. Her mother Fiona, 51, has now issued a stark warning about buying diet pills online. She said that her daughter never intended to take her own life, she just didn't understand the danger of taking an overdose of the slimming tablets.