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What Is Perimenopause? Understanding the Transitional Time Before Menopause

Life is full of transitions that affect us mentally, emotionally and physically. For women, menopause is a transition that marks the end of their reproductive years. But the reality is that menopause is preceded by a three to five year transition known as perimenopause

Perimenopause, or “around menopause”, is the time in a woman’s life when her ovaries begin to produce less estrogen, and her body prepares to enter the state of menopause. “A woman may begin to notice some changes in her body and menstrual cycle as a result of fluctuating hormone levels,” said Dr. Kiarra King, MD, FACOG, a board certified obstetrician and gynecologist. 

These changes are natural and normal, but with these changes can come a lot of questions and concerns about what to expect. So, we broke it down.

What is perimenopause?

Perimenopause is the transitional period of time leading up to menopause. Dr. King said it can begin when a woman is in her mid-forties and continue until actual menopause occurs. In the United States, the average age of menopause is 51.

Many of these changes during this time are a result of decreasing estrogen, which along with progesterone rises and falls as you make your way to menopause.

The age in which women enter perimenopause varies with some women entering at as early as their late 30’s, while others may begin to notice changes in their mid-40’s.

What is the difference between perimenopause and menopause?

Perimenopause and menopause are not interchangeable, but they do have very similar symptoms that might make it hard to distinguish between the two. In short, perimenopause occurs before menopause and carries the common symptoms of irregular periods, hot flashes and decreasing fertility.

How long does perimenopause last?

On average symptoms may last six months to two years,” said Dr. King. “But some data shows symptoms can last for four and even up to 10 years.” 

It’s impossible to predict how long it will take your body to leave the perimenopause state and enter menopause, but perimenopause ends when a woman has gone 12 months without having her period.

What are the symptoms?

Symptoms can vary — and some women might not experience any until the end of the perimenopause state. But the most common symptoms include: irregular periods, hot flashes, night sweats, vaginal dryness or increased UTIs, mood changes, unexpected weight gain, changes in sleep patterns, bone loss and changing cholesterol levels. 

As the body’s hormone levels shift to support the post-reproductive years, some women have reported experiencing “brain fog” or short-term memory impairment. 

How to help or reduce the symptoms?

Perimenopause can markedly impact the quality of life for some women, while others may barely notice the transition, said Dr. King. Making small lifestyle modifications to help alleviate some discomfort is the best step to reduce symptoms. Dr. King recommends the following:

  • Dress in layers, that way in the event of a hot flash you can easily remove clothing to help alleviate symptoms. 
  • Keep a personal fan nearby at work or home.
  • Keep your surroundings cool.
  • Minimize triggers, for some warm drinks, spicy foods, alcoholic beverages, stress and warm weather can trigger or amplify hot flashes. 
  • Regular exercise may decrease the intensity of hot flashes 
  • Use a personal lubricant in the event of vaginal dryness
  • Try to maintain a regular sleep schedule. 
  • See your physician if you’re unsure about what you are experiencing. In some cases hormone replacement therapy may be indicated to help ameliorate symptoms.  

For many women, perimenopause symptoms are manageable and treatable, but if you find that you’re unable to get relief on your own, consult with your doctor and talk about a plan that is personalized to your needs. 

“One thing I always want to emphasize, when discussing perimenopause and menopause, is that they are not disease states,” said Dr. King. “They occur due to normal physiologic changes that all women will experience.”

Before you go, check out some of our favorite quotes to inspire positive and healthy attitudes about bodies and food: 


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