For many women, perimenopause begins in their 40s, but for some it can start in their 30s or even earlier. If you’re nearing menopause, you may start noticing certain symptoms several years before menopause actually begins. This time leading up to menopause, known as perimenopause, is the period when the ovaries start to produce less estrogen. This decline in hormones can cause symptoms such as irregular periods, hot flashes, and emotional changes.
Perimenopause typically lasts about 4 years, but for some women, it can last much longer. In the final years of perimenopause, the drop in estrogen accelerates, until the ovaries stop releasing eggs and menopause begins. While many symptoms of perimenopause are similar to those of menopause, understanding the difference will help you understand what’s happening with your body, and help you determine if you can benefit from treatments such as hormone replacement therapy.
Symptoms of perimenopause
Women who are in perimenopause usually experience some of these symptoms:
- Irregular periods. As hormone levels fluctuate, ovulation becomes irregular, and your cycles may become longer or shorter than usual. Your flow may become heavier or lighter, and you may skip some periods. If these variations in your cycle last around seven days, you are likely in the early stages of perimenopause. If you begin to experience delays of 60 days or more between periods, you are likely in late perimenopause. A woman is considered to be in menopause when she has gone twelve months without a period. If you have very heavy periods or blood clots, you may want to see a doctor to rule out other causes, such as uterine fibroids.
- Hot flashes are the most frequent symptom of both menopause and perimenopause. Some women may also experience a rapid heart rate or chills. Hot flashes that occur at night can also cause night sweats and disrupt sleep.
- Mood swings. Depression and irritability are common during perimenopause, and can be made worse by sleep disruptions resulting from night sweats. The emotional changes experienced during perimenopause can include anxiety, a lack of motivation, aggressiveness, and difficulty focusing. Regular exercise and calming practices such as meditation can often help manage these emotional changes.
- Bladder problems, including urine leakage when coughing and sneezing. Low estrogen levels may also make you more susceptible to urinary infections or bladder infections. Some women also experience a need to urinate more frequently.
- Vaginal dryness and discomfort during sex. Some women may also begin to notice a decreased sex drive. However, if you had satisfying sexual intimacy prior to perimenopause, there is no reason this shouldn’t continue to be true during perimenopause and beyond.
- Bone loss. As hormone levels decline, you may start to lose bone more quickly than you can replace it, which increases your risk of osteoporosis. Make sure your diet includes plenty of calcium. And since vitamin D is necessary for calcium absorption, take a vitamin D supplement if your levels are low.
- Menstrual migraines. Fluctuations in hormone levels can cause the onset or worsening of migraines. Migraines that are hormone related typically stop after menopause, when hormone levels stabilize.
Should you see a doctor for perimenopause symptoms?
Many women simply tolerate these symptoms because they aren’t severe enough to seek medical attention. Because perimenopause symptoms occur gradually, you may not realize that they’re all connected to fluctuations in hormone levels.
If perimenopause symptoms make it difficult for you to cope with everyday life, hormone replacement therapy may help. Many doctors are now recognizing HRT as an effective preventive treatment for women in their 40s, stating it could help them avoid even more severe symptoms as they transition into menopause.
Garcia Weight Loss and Wellness Centers offer bio-identical hormone replacement therapy to keep you feeling your best well into your senior years. Contact us today for a no-cost consultation to learn how hormone replacement therapy can benefit you!
Medically reviewed by Jay J. Garcia, MD on May 5, 2017