Perimenopause Symptoms You Might Not Realize You're Experiencing
“You’re perimenopausal,” my doctor told me during my routine pap smear a little over a year ago. I remember thinking to myself: That’s impossible, I’m only 41 years old, it must be something else.
But as soon as I started listing off all of the physical and emotional changes that seemed to have taken over my body since the last time I saw her, things quickly started adding up.
Headaches, night sweats, weight gain (specifically in the midsection) and increased anxiety and depression had become a normal part of my life.
As I watched my doctor nod her head with each symptom I rattled off, I quickly realized that at age 41, my body was starting to prepare for the transition into menopause.
And while I finally had some answers to the physical and emotional ailments that had been puzzling me for the last year, she also informed me that my body might take another 10-plus years to actually reach menopause.
What is perimenopause?
Perimenopause means "around menopause," and refers to the time during which your body makes the natural transition to menopause, marking the end of the reproductive years.
Many of the changes you experience during perimenopause are a result of decreasing estrogen, which along with progesterone rises and falls as you make your way to menopause.
Women start perimenopause at various ages and stages in their lives. Some may start experiencing symptoms as early as mid-30s, while others begin noticing changes in their 40s.
What are the symptoms?
The symptoms that women most often experience on their journey to menopause include: irregular periods, hot flashes and sleep problems, mood changes, vaginal and bladder problems, decreasing fertility, breast tenderness, changes in sexual function, loss of bone and changing cholesterol levels.
Women who have experienced perimenopause also report a higher-than-normal number on the scale as they face unexplained weight gain.
As hormone levels shift to support us during our post-reproductive years, those few extra pounds tend to creep up without prior notice. The weight gain is often linked to fluctuating estrogen levels, which can make maintaining balance in your body difficult.
And if the hot flashes, weight gain, mood swings and sexual dysfunctions were not enough to deal with, many women also report short-term memory impairment or lack of focus. This “fuzzy thinking” or "brain fog" that seems to take over at a moments notice can also be linked to the hormonal fluctuations leading up to menopause.
How long does it last?
The average length of perimenopause is four years, but women can experience anything from a few months to 10 years of symptoms. Perimenopause ends when a woman has gone 12 months without having her period.
Reducing the symptoms
There's a lot you can do — from diet and lifestyle changes to medications — to reduce your symptoms dramatically.
Doctors have found that systemic estrogen therapy, which includes low-dose birth control pills, skin patches, gel or cream, can help manage the discomfort that comes with night sweats and hot flashes. For women experiencing vaginal dryness, estrogen can also be applied directly to the vagina by using a vaginal tablet, ring or cream.
Some women also experience relief from hot flashes and reduced mood disorder symptoms by taking an antidepressant or a selective serotonin uptake inhibitor.
Other methods of symptom reduction include smoking cessation; reducing your intake of caffeine, sugar, and alcohol; and getting adequate exercise and sleep.
Many women who experience milder symptoms are able to manage any discomfort with just a few dietary and health changes they make on their own. But if you find that you are unable to get relief on your own, it may be time to visit your doctor to talk about options that are individualized to your own needs.
A version of this article was originally published in January 2017.