You’ve likely heard the term menopause before. But what about perimenopause?
While most of us are familiar with the idea of menopause, understanding of perimenopause is less common. Perimenopause means “around menopause”, and is used to describe the transition period between the onset of your first symptoms and the onset of menopause (which is technically marked by 12 consecutive months without a period). A healthcare provider would say that you’re “in perimenopause” when your cycles are irregular (i.e. varying by 7 days from your baseline; for example, a cycle of 33 days followed by a 26-day cycle), when you skip cycles altogether, or if you are having symptoms such as hot flashes. Knowing what’s happening in your body and why it’s happening is powerful. When you have this information, you’re able to be proactive and preventive, and if you need support along the way, you know how to access it.
Before we get into preparing for menopause, let’s talk a bit about some perimenopause specifics.
When, how, and why?
Perimenopause can be unpredictable. Periods change dramatically — they can become heavier and more frequent, or lighter and intermittent. It’s generally a confusing time that catches many people by surprise.
Perimenopause is often broken down into two general phases:
- Early perimenopause, when periods can still be regular
- Late perimenopause, marked by skipped and/or irregular periods
The full transition through menopause takes 8-10 years. And while most of us will start in our mid-40s, some may begin years earlier.
The takeaway? There’s no such thing as a one-size-fits-all experience.
Perimenopause symptoms: what to expect
Some of the telltale signs of perimenopause — hot flashes, night sweats, and mood swings — actually begin to subside once you reach menopause.
Below are common symptoms that signal the beginning of perimenopause, all of which can be traced back to changing hormone levels— although not everyone will experience any or all of these symptoms.
- Emotional and physical changes (e.g., weight gain, breast tenderness, low libido, depression/anxiety, mood swings, difficulty concentrating, vaginal dryness)
- Hot flashes and night sweats, which may cause sleep disturbances (also known as vasomotor symptoms)
- Irregular periods: This is an umbrella term that can include short or skipped menstrual cycles and heavy bleeding (often one of the earliest symptoms)
This might sound overwhelming, but there are lots of ways to mitigate these symptoms. First, we’ll explain a bit more about them.
Are the symptoms constant for the entire duration of menopause?
It depends. Some symptoms come and go and others are more constant. What you can expect, however, is for symptoms to peak about 1-2 years before the onset of menopause. This happens because of an accelerated drop in estrogen.
How long will these symptoms last?
Typically, five years— but remember, the perimenopausal experience isn’t the same for everyone. Some people may only experience a change in their period when nearing menopause, while others will experience it for upwards of 10 years.
Are these symptoms always due to perimenopause?
Not always, no. There are several common conditions, including thyroid abnormalities and even medication side effects that can cause similar symptoms, so be sure to check in regularly with your healthcare provider.
Is there a test for perimenopause?
Not really. Healthcare providers may order tests to check your hormone levels and thyroid function, but these tests are imperfect at best, since hormones fluctuate during perimenopause.
The low-down on hormones during perimenopause: What’s really happening?
Hormonal fluctuations are to blame for the symptoms listed above, but let’s break it down further.
In your 20s and 30s (i.e. during premenopausal cycles), hormones enjoy a predictable ebb and flow. During perimenopause, hormone levels go up and down with less of a pattern. The two key female hormones, estrogen and progesterone, go through a lot of changes.
The levels of progesterone decrease first, followed by estrogen, which goes up and down unpredictably. Other hormones also change. Testosterone slowly decreases. There are also changes to FSH (follicle-stimulating hormone) and LH (luteinizing hormone). Before menopause, FSH and LH work together to produce a period. FSH causes eggs to grow and mature in the ovaries and LH helps the eggs release. During perimenopause, FSH levels also go up and down significantly.
After menopause, or during the postmenopause period, hormones are low but steady.Interested in learning more about treatments? Tap here.
