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Symptoms of Perimenopause

Going through menopause is a major life change for women. While the time spent “transitioning to menopause” can include uncomfortable symptoms, not all women experience negative changes and many women actually have a positive or neutral attitude towards menopause. (No one is begging for hot flashes, but no longer having to pack tampons for a beach trip is certainly a nice perk!)

According to the American College of Obstetricians and Gynecologists, the definition of menopause is “the time when a woman’s menstrual periods stops permanently and is confirmed after one year of not getting a period.” Physiologically, this means the ovaries have stopped producing estrogen and progesterone. Most women reach menopause between 45 and 55 years of age. Menopause can also occur if the ovaries are surgically remove;  however, a hysterectomy (removal of just the uterus) – does not cause a woman’s hormones to change.

What is perimenopause?  

The years leading up to menopause are often referred to as perimenopause. The term’s loose definition is for good reason: the hormone changes of perimenopause can for last for months or for years. 

What are the symptoms of perimenopause?

  • During perimenopause, your hormones are fluctuating. (And as women, we know shifts in hormones rarely mean we’re going to feel awesome! Symptoms may include:  
  • Period changes: Probably one of the earliest indicators of perimenopause is changes to your menstrual cycle. Your body’s change in hormone levels may no longer follow the monthly pattern that was so predictable. As a result, your periods may shift between spotting and heavy bleeding, and may be more or less frequent.  Because everyone’s body is unique, it can be helpful to keep track of the bleeding in a journal or on the health app on your smartphone.  
  • If the bleeding become very heavy, your cycle last more than 7 days or is more than every three weeks – it is important to contact your provider.
  • Hot flashes: Hot flashes are one of the most common symptoms associated with perimenopause. A hot flash is a sudden feeling of heat that overcomes the body and face. They can last from a few seconds to several minutes, or in extreme cases, even longer. (It’s good to remember to always dress in layers! No one wants to be stuck in a turtle neck at Thanksgiving Dinner during a hot flash.)
  • Sleep disturbance: Having trouble getting a good night’s sleep? You’re not alone. Many women in perimenopause struggle with irregular sleep cycles, insomnia, or waking up long before your body’s standard wake up time. And, all those hot flashes certainly aren’t helping – hello, night sweats!
  • Vaginal and urinary tract changes: As estrogen levels decrease throughout the course of perimenopause, the lining of the vagina may become thinner, dryer and less elastic. These changes may cause pain or discomfort during sex and more frequent urination (another reason to wake up in the middle of the night). 

Additional symptoms associated with perimenopause include mood swings, weight gain, forgetfulness, dry skin and a reduced sex drive. If you’re beginning to experience perimenopausal symptoms, it is important to meet with your women’s health provider to discuss the severity of your symptoms. Your provider may be able to suggest lifestyle changes or medications to ease symptom severity.