Perimenopause is the time leading up to menopause, when a woman starts to experience bodily changes related to menopause, and extends to the year after menopause. (Menopause is the day a woman has not had a period for 12 months in a row.)

During perimenopause, the ovaries produce less of the female hormones (estrogen and progesterone) the woman begins to lose the ability to become pregnant.

This change is a natural part of aging that usually starts when women reach 45-55 years old. Some women start perimenopause as early as their 30's.

The age at which perimenopause starts and time it takes to reach menopause varies from woman to women.

Signs and symptoms of perimenopause

Many of the symptoms experienced during menopause may be related to getting older, but some are due to the approach of menopause. Menopause-related symptoms that may arise during perimenopause include:

  • Changes to the menstrual cycle. Periods may become shorter or longer, lighter or heavier, or with more or less time in between periods.
  • Hot flashes. This is the sensation of a sudden rush of heat in the face and upper body.
  • Night sweats. These are hot flashes while sleeping that may be followed by a chill.
  • Trouble sleeping through the night
  • Vaginal dryness
  • Mood changes, feeling irritable or less at ease, possibly due to lack of sleep.
  • Trouble focusing, feeling mixed-up or confused
  • Hair loss or thinning of hair on the head and the growth of more hair on the face.

When you visit your doctor, take along a diary about what’s happening with your period. For a few months before your visit, record when your period starts and stops each day, and indicate whether it is light of heavy. Also note any other symptoms you have.

Treatment for perimenopausal symptoms?

Some women take oral contraceptives (birth control pills) to ease perimenopausal symptoms even if they don't need birth control. These hormone treatments of combined estrogen and progestin can help keep your periods regular plus ease all the symptoms listed above. Talk with your doctor to see if this option is for you. If you are over 35, you should not take birth control pills if you smoke or have a history of blood clots.

If a woman still seeks treatment for menopausal symptoms after reaching menopause, she should switch from birth control pills to hormone replacement therapy (HRT). HRT contains much lower doses of hormones and reduces the risk of side effects.

Lifestyle changes for perimenopause

Maintaining a healthy lifestyle can help alleviate some perimenopausal symptoms and support a woman's overall health.

  • Eat Healthy. A healthy diet is more important now than before because your risks of osteoporosis (extreme bone loss) and heart disease go up at this stage of life. Eat lots of whole-grain foods, vegetables, and fruits. Add calcium-rich foods (milk, cheese, yogurt) or take a calcium supplement to obtain your recommended daily intake. Get adequate vitamin D from sunshine or a supplement. Avoid alcohol or caffeine, which also can trigger hot flashes in some women.
  • Get Moving. Regular exercise helps keep your weight down, helps you sleep better, makes your bones stronger, and boosts your mood. Try to get at least 30 minutes of exercise most days of the week, but let your doctor recommend what’s best for you.
  • Find healthy ways to cope with stress. Try meditation or yoga--both can help you relax, as well as handle your symptoms more easily. 

Can a woman get pregnant while in perimenopause?

Yes. A woman can become pregnant even if she has missed several periods in a row.

Talk to your doctor about your birth control options during perimenopause.

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Last updated: 1/8/2019