What is perimenopause?

Perimenopause is the transitional time around menopause. Menopause is when a woman’s periods stop. It’s marked by changes in the menstrual cycle, along with other physical and emotional symptoms. This time can last  2 to10 years. During this time, your body:

  • Releases eggs less regularly
  • Produces less estrogen and other hormones
  • Becomes less fertile
  • Has shorter and more irregular menstrual cycles

What causes perimenopause?

Perimenopause is a natural process caused when your ovaries gradually stop working. Ovulation may become erratic and then stop. The menstrual cycle length and flow may become irregular before your final period.

Symptoms are caused by the changing levels of hormones in the body. When estrogen is higher, you may have symptoms like you might have with PMS. When estrogen is low, you may have hot flashes or night sweats. These hormone changes may be mixed with normal cycles.

What are the symptoms of perimenopause?

No two women will experience perimenopause in the same way. These are the most common symptoms:

  • Mood changes
  • Changes in sexual desire
  • Trouble concentrating
  • Headaches
  • Night sweats
  • Hot flashes
  • Vaginal dryness
  • Trouble with sleep
  • Joint and muscle aches
  • Heavy sweating
  • Having to pee often
  • PMS-like symptoms

The symptoms of perimenopause may look like other conditions. Always consult your health care provider for a diagnosis.

How is perimenopause diagnosed?

Sometimes it’s hard  to tell if you are having symptoms of perimenopause. Your symptoms, medical history, age, and a physical exam may help your health care provider with the diagnosis. You may also have blood tests to measure your hormone levels.

How is perimenopause treated?

Perimenopause does not need to be treated unless symptoms are bothersome. Treatments may include:

  • Hormone therapy using estrogen or estrogen and progestins to level out hormone levels
  • Antidepressants to stabilize moods

Your health care provider may suggest other lifestyle changes:

  • Eat a healthy diet with fruits and vegetables and whole grains.
  • Get at least 1,000-1,200 mg of calcium each day through your diet or supplements.
  • Exercise regularly.
  • Find what triggers your hot flashes (for example, alcohol, coffee or tea) by keeping a record.

Discuss the use of other treatments in relieving  symptoms with your health care provider.

You may hear about herbal supplements that claim to help manage hot flashes. It’s important to remember that the FDA does not regulate these supplements. They are not tested like traditional medications to prove their effectiveness and safety.

Talk to your health care provider before using any herbal supplements.


Key points

  • Perimenopause is the time around menopause when your ovaries gradually stop working.
  • This is a natural process that causes physical and emotional symptoms.
  • It does not require treatment, but treatment can help lessen symptoms.
  • Treatment includes hormones, antidepressants, and lifestyle changes.

Next steps

Tips to help you get the most from a visit to your health care provider:

  • Before your visit, write down questions you want answered.
  • Bring someone with you to help you ask questions and remember what your provider tells you.
  • At the visit, write down the names of new medicines, treatments, or tests, and any new instructions your provider gives you.
  • If you have a follow-up appointment, write down the date, time, and purpose for that visit.
  • Know how you can contact your provider if you have questions.

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