Perimenopause is a natural shift that occurs in a woman’s life, marking the start of the reproductive years’ decline. It can be a puzzling time because perimenopause is often accompanied by a smorgasbord of physical and emotional changes. Understanding the signs and symptoms of perimenopause is key to living this transition with awareness and, hopefully, some semblance of support and sanity. In this blog post, we will parse the early signs of perimenopause, attempt to understand why they happen, and discuss how to cope with them in a way that doesn’t fully unravel you. Because perimenopause is unruly enough as it is.
What is Perimenopause?
The phase often called the menopausal transition—known more formally as perimenopause—most commonly happens to women in their 40s. However, for some, it can start in the late 30s. Women experience this phase for anywhere from a few months to several years, leading to menopause, which is defined as the time when a woman has not had a menstrual period for 12 consecutive months.
Undergoing the perimenopausal transition, if we can refer to it as such, does not happen without hormonal fluctuations—primarily with estrogen and progesterone—that occur over some predetermined (or not) timeline. Again, if we can generalize, most would say (as we have already said) that this phase most commonly happens in a woman’s 40s.
Common Perimenopause Symptoms
Perimenopause Symptoms
- Irregular Periods
One of the earliest and most typical signs of perimenopause is the change in the menstrual cycle. During this time, women may experience a variety of developments that alter their usual monthly rhythm. These developments might take the form of variations in not just the usual cycle but also flow and frequency. And while some women might have flows that make it hard to tell exactly when their period has begun, others might find themselves with several as well as significant skips in their cycle. In general, though, these changes can seem quite pronounced and are usually accompanied by a few other physical signs. But why is perimenopause happening, and what’s the deal with the hormones? - Hot Flashes and Night Sweats
Sudden sensations of warmth that can encompass the entire body, frequently with a heaping helping of sweat and redness, are called hot flashes. The related symptom of night sweats can cause a woman to wake from a sound sleep. Both these uncomfortable companions of the perimenopause can be managed by a number of strategies. - Mood Swings
Perimenopause can bring about a lot of changes for women, and it’s not just physical. Under the influence of changing hormone levels, women can experience significant emotional fluctuations.
“It’s very common for women to describe their mood as being more variable during this time,” says Mary Jane Minkin, MD, clinical professor of obstetrics and gynecology at Yale University. “Some might say they’re feeling a lot more anger or irritability or just not getting along with people. Indeed, mood swings can be part of the perimenopause spectrum.
- Sleep Disturbances
Countless women going through perimenopause share stories about sleep troubles exacerbated by hormonal and other physical changes of this life stage. Insomnia—the inability to fall asleep or stay asleep—seems to be fairly common, as do other forms of disrupted sleep. The reasons for this are probably complex, but they’re likely tied to the kinds of issues with which a lot of perimenopausal women are already contending—like increased anxiety and brain fog, as well as some added physical discomfort. - Vaginal Dryness
A decline in estrogen can lead to reduced moisture in the vagina. This can result in discomfort during sexual activity and may affect sexual health. Women experiencing this issue have at least three potential solutions. They may rely on lubricants and/or moisturizers during sexual activity. Some women may also turn to hormone therapy for relief. - Decreased Libido
A woman’s sexual desire can be influenced by hormones. For some women, the transition to menopause coincides with a noticeable dip in libido. This drop can obviously be a source of concern, and we always recommend that women talk openly with their partners about the lack of desire. In many cases, working through the problem together can lead to new levels of intimacy. - Weight Gain
Numerous women encounter weight growth while in perimenopause, frequently as a result of hormonal shifts and a metabolism that is not functioning at full speed. This can be maddening, but the good news is that a two-pronged approach—”diet and exercise”—can largely mitigate the situation. We emphasize that these are not quick fixes. They call for commitment and time to show significant results. - Memory and Concentration Issues
Certain ladies say they are having problems with their memory or are just not able to concentrate like they used to. This was mentioned in many of the personal accounts we read. We also found some comments from health professionals that said this is not uncommon. Apparently, it’s quite typical for some women to have this experience. - Breast Changes
Changes in breast tissue can also occur due to hormonal shifts, along with changes in tenderness or size. Breasts can feel different during this time, which is a normal part of the perimenopausal process. - Joint and Muscle Pain
Joint or muscle discomfort during perimenopause may affect some women. This may have a basis in hormones—especially estrogen—as well as inflammation and other unidentified causes. On the modest assumption that 25 percent of women experience increased joint or muscle pain during perimenopause, that would mean 1.5 million American women are affected.
Why Do These Symptoms Occur?
The symptoms that arise from perimenopause are mainly due to the changing levels of hormones, especially estrogen and progesterone. As a woman nears menopause, her ovaries produce less and less of these hormones, and a number of bodily functions and systems start to feel the effect. Estrogen levels drop—which, of course, happens just before menopause—but the low level of progesterone is what makes some women feel more moody and more likely to cry, for instance.
Managing Perimenopause Symptoms
Although perimenopause can be difficult, women can use a number of strategies to manage their symptoms more effectively. - Lifestyle Changes
Embracing a wholesome manner of living is likely to have a powerful effect on the way factors associated with perimenopause affect women. Symptoms and the level of their severity may be modified by frequent sessions of moderate-to-vigorous exercise; a nearly 8-week-long diet-type regimen featuring balanced meals, high in fruits, vegetables, and whole grains; and ample hydration throughout the day. Could too much caffeine and too much alcohol be part of a cure for what ails women during this time? These are just two possibilities that are discussed in “The First 20 Minutes” by Gretchen Reynolds. - Stress Management
Stress can worsen perimenopause symptoms, so it is all the more crucial now to find effective ways to manage stress. Consider these practices: - Mindfulness
- Meditation
- Yoga
- Deep breathing exercises
These can help you reduce stress levels and promote emotional well-being.
- Hormone Therapy
For certain females, severe symptoms may warrant using hormone therapy (HT) to obtain relief. Medications are involved in HT. These medications contain hormones. The hormones in HT replace the hormones that the body is no longer producing. Women in this situation need to consult with their healthcare providers. They must discuss the potential benefits of HT as well as the associated risks. - Non-Hormonal Treatments
Treatments that do not involve hormones are available for managing specific symptoms. Certain understudies and understudy supplements to the committee may reduce mood swings and hot flashes. But when it comes to non-hormonal treatments, everyone is different. You should discuss your symptoms and the following medications with your medical team to find what works best for you. - Support Networks
Creating a support network of friends, family, or support groups can provide much-needed emotional support during perimenopause. Women can band together and share the diverse experiences that perimenopause can bring. They can laugh, cry, and commiserate with one another. And in doing so, they can forge a formidable network that counters the attempts of perimenopause to make women feel isolated.
When to Seek Medical Advice
Although many of the symptoms of perimenopause are completely normal, they are a good excuse to visit the doctor if any of the following apply:
- You have seeming non-stop, major, or even life-threatening symptoms (like depression).
- You’re bleeding heavily or your periods are behaving weirdly.
- You’re following the advice you found in life-style magazines, but you’re still suffering.
- You’re worried about your sex life or your significant other.
Conclusion
Recognizing the symptoms of perimenopause is crucial for women who are approaching this stage of life. While every woman will undergo perimenopause, not all are clear on the signs to look for, and even fewer seem confident in the management strategies they employ to combat the symptoms. Moreover, if the prelude to menopause is indeed the “window of opportunity” (Crawford et al. 2007) for addressing a woman’s declining health (physical, mental, and sexual) with healthy living strategies, then that makes the timely recognition of perimenopausal symptoms that much more significant.