Advertisement
This ad is displayed using third party content and we do not control its accessibility features.
Close Banner
Advertisement
This ad is displayed using third party content and we do not control its accessibility features.

Your Guide To Perimenopause: What To Expect & How To Feel Your Best During It

Sarah Garone, NDTR
Author:
May 15, 2024
Sarah Garone, NDTR
Licensed Nutritionist
By Sarah Garone, NDTR
Licensed Nutritionist
Sarah Garone, NDTR is a licensed nutritionist and freelance health and wellness writer in Mesa, AZ whose work has appeared in numerous publications.
3 women describe how their sex lives changed after menopause
Image by Santi Nuñez / Stocksy
May 15, 2024

If you're a woman of a certain age, you know it's coming eventually—you just might not know when. It could begin next month, next year, or not for another decade. We're talking about perimenopause. 

Though we all know the window of menstruation doesn't last forever, there's still plenty of confusion around the time leading up to your last period. Like, exactly how long does this stage last, and how is it different from actual menopause? We spoke to women's health experts to get the lowdown on how to get through this inevitable phase with your health (and sanity) intact.

What is perimenopause?

First things first: What is perimenopause? "Perimenopause is the five to seven years before a woman reaches her final menstrual period. She is still having periods, but she is also experiencing the symptoms of menopause, such as hot flashes/night sweats, mood changes, and weight change," explains board-certified OB-GYN Brandye Wilson-Manigat, M.D.

Got it. So what about premenopause? You may sometimes hear this term used interchangeably with perimenopause, but technically, they're not the same. "Premenopause" simply means you are in any stage before menopause, whereas "perimenopause" refers to the hormonal transition that immediately precedes menopause. 

Menopause itself, on the other hand, is quite simple to pinpoint. "Menopause is the permanent cessation of menstruation, defined by when you've had your final menstrual period," Manigat says. This designation is given, she says, when you've had 12 consecutive months without any bleeding. 

In this sense, you officially become menopausal on a single day (exactly 12 months after your last period). But, according to Manigat, this stage goes on for the rest of your life. "The terms menopausal and postmenopausal are frequently interchanged to describe this period of a woman's life." 

 

What triggers perimenopause?

In chatting with friends or family members, you've probably noticed that some women hit the hormonal transition of perimenopause before others. Lauren Streicher, M.D., health medical director of community education and outreach at Midi, a virtual care clinic for perimenopause and menopause, says this mostly comes down to two factors: estrogen production and genetics.

"Perimenopause is triggered by fluctuations in ovarian estrogen production, [and] the main thing that influences when someone enters perimenopause and menopause is genetics," she says. "If your mom and older sister were still using tampons in their mid-50s, there is a good chance you will be too." 

Still, she notes that ethnicity may also be a factor. At least one study1 has suggested that, compared to Caucasian-American and Japanese American women, Hispanic American and Black-American women tend to enter menopause earlier. Lifestyle and personal health history could also move the perimenopausal needle.

"Menopause tends to occur earlier in smokers and women with autoimmune diseases such as hypothyroidism, rheumatoid arthritis, and Type 1 diabetes," she says. "Women that work the night shift also tend to wind down early."

One rumor about onset that's not true: Getting your first period at a younger age means you'll hit perimenopause younger (and get over it sooner). "Contrary to popular belief, the age at which you started menstruating does not determine when you will stop—which seems kind of unfair," Streicher says. In fact, a 2018 study2 found that women who had their first period at younger ages had longer menopausal transitions. Um, super unfair!

How long does perimenopause last?

There's good news and bad news about the potential duration of perimenopause. Research shows that perimenopause lasts four years3, on average. But in some cases, it can drag out for as long as a decade. 

As for when you can expect to see the first inklings of perimenopausal changes? On average, symptoms appear in your mid-40s4, but anywhere from your late 30s to mid-50s are all fair game. 

Perimenopause symptoms

Sometimes it seems like everything under the sun could be a perimenopause symptom. According to Streicher, there are over 30 physical indicators of this stage of life. Some of the most common include:

  • Fatigue
  • Hot flashes and night sweats
  • Mood changes
  • Change in menstrual cycle length (number of days from the start of one period to the start of the next period)
  • Skipped or missed periods 
  • Heavier periods
  • Brain fog
  • Sleep disturbances
  • Dry skin, brittle hair, and hair loss
  • Body and muscle aches
  • Vaginal dryness
  • Increased urinary urgency and frequency
  • Weight gain

Every woman will have a unique timeline of which of these she experiences and when. However, Manigat says some are more likely to show up first. "Fatigue, mood changes, and hot flashes [or] night sweats are likely to be the first symptoms a woman notices."

If you're unsure whether a symptom is due to perimenopause or something else, the only way to find out is to visit your doctor. "While sometimes it is challenging to know if something is menopause, midlife, or both, an experienced menopause expert is able to evaluate someone's symptoms in the context of their personal medical history, their family history, and sometimes blood work," says Streicher.

How to cope with symptoms

Hot flashes, poor sleep, brain fog, oh my! When perimenopause has you feeling off-kilter, Manigat encourages turning to a few DIY solutions. 

To head off hormonal heat, she suggests layering easy-to-remove clothing and carrying a handheld fan to cool yourself off in a, well, flash. Keeping up with your fluid intake may also help.

"Staying hydrated, not with just plain water but something electrolyte-based, replenishes the body's fluids lost during hot flashes or night sweats and keeps the body's internal temperature steady," she says.

That's not all electrolyte-based hydration might do. "The other benefit is fewer trips to the bathroom than with using plain water." 

Other symptoms can get a much-needed kick in the pants from regular exercise. "Body movement helps not just with weight management but also with mood changes, as it leads to the release of feel-good hormones into your system, as well as decreased stress levels," Manigat says. 

When to see your doctor

Though certain unpleasant symptoms may be considered "normal" in perimenopause, that doesn't mean you have to suffer them in silence. Streicher advises seeing your clinician any time symptoms become bothersome. (And if your GP isn't helpful, don't be afraid to switch to a more experienced expert.) 

In fact, though a recent editorial5 in the medical journal the Lancet claimed that menopause has been over-medicalized, Streicher disagrees. "Under 10% of women get appropriate treatment," she says. "The other, untreated women are doomed to put up with symptoms that impact on their day-to-day lives, with a significant increased risk of developing life-threatening cardiovascular disease, osteoporosis, cognitive issues, and sexual problems."

Manigat agrees that even seemingly minor symptoms of perimenopause may be cause for medical attention. "For instance, irregular, heavy menstrual bleeding, if not treated, can lead to a low blood count (anemia), which worsens fatigue and sometimes requires a blood transfusion."

Poor sleep, meanwhile, could worsen feelings of depression and fuel weight gain, which increases the risk of high blood pressure and diabetes.

And besides helping you find the right treatments, speaking with your doctor can help alleviate any embarrassment or anxiety you may feel about your symptoms. The more conversations you have about perimenopause, the less mysterious it will feel. "I think the increased focus on women's health issues in general, and menopause/perimenopause specifically, is a good thing," Manigat says. "[It] opens the door to more conversations about this stage of life for women, which has been sorely lacking."

Watch Next

Enjoy some of our favorite clips from classes

Watch Next

Enjoy some of our favorite clips from classes

What Is Meditation?

Mindfulness/Spirituality | Light Watkins

Box Breathing

Mindfulness/Spirituality | Gwen Dittmar

What Breathwork Can Address

Mindfulness/Spirituality | Gwen Dittmar

The 8 Limbs of Yoga - What is Asana?

Yoga | Caley Alyssa

Two Standing Postures to Open Up Tight Hips

Yoga | Caley Alyssa

How Plants Can Optimize Athletic Performance

Nutrition | Rich Roll

What to Eat Before a Workout

Nutrition | Rich Roll

How Ayurveda Helps Us Navigate Modern Life

Nutrition | Sahara Rose

Messages About Love & Relationships

Love & Relationships | Esther Perel

Love Languages

Love & Relationships | Esther Perel

Related Videos (10)

What Is Meditation?

Box Breathing

What Breathwork Can Address

The 8 Limbs of Yoga - What is Asana?

Two Standing Postures to Open Up Tight Hips

How Plants Can Optimize Athletic Performance

What to Eat Before a Workout

How Ayurveda Helps Us Navigate Modern Life

Messages About Love & Relationships

Love Languages

Advertisement
This ad is displayed using third party content and we do not control its accessibility features.

More On This Topic

more Health
Advertisement
This ad is displayed using third party content and we do not control its accessibility features.
Advertisement
This ad is displayed using third party content and we do not control its accessibility features.