While perimenopause is a natural process, it's a unique experience for each person. Here are some signs to look for as you enter this next phase.
A lot comes with entering menopause. There are multiple phases and a range of symptoms that can affect each person differently. The stages of menopause can come with uncertainty, but we’re here to help you take the first steps in knowing what can happen and how to identify perimenopause —the transition period before menopause naturally occurs. Here’s what to expect from your first signs of perimenopause.
What is perimenopause? Perimenopause means “around menopause” and signifies the stage before menopause takes place in the body. Also called menopausal transition, perimenopause happens because your reproductive organs gradually stop producing eggs. This stage can last anywhere from a couple of months to multiple years—the average duration is two to four years. After 12 consecutive months without a menstrual period, perimenopause is over and menopause begins.
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When does perimenopause start? Women can start perimenopause at different ages. You’ll notice irregular menstrual cycles , a good indication that you’ve entered perimenopause, as early as your mid-30s, but most often in your 40s.
The levels of estrogen and progesterone —the two sex hormones crucial to reproductive and sexual health—fluctuate unevenly during perimenopause and menopause. Changing levels of estrogen and progesterone affect everything from menstrual cycles to mood changes and hot flashes. These are some of the first signs of perimenopause that can occur.
What are the first signs of perimenopause? The first signs of perimenopause are a range of physical, emotional, and mental symptoms that can indicate you’re experiencing some major hormonal changes.
Irregular menstrual cycles Experts generally agree that the first sign of perimenopause is irregular menstrual cycles.
During perimenopause, your ovaries aren’t producing eggs regularly anymore. Ovulation becomes unpredictable and, as a result, your menstrual cycle can lengthen or shorten, and flow may be inconsistent. Depending on the length of your menstrual cycle, you may be in early or late perimenopause. If you experience a change of seven days or more in the length of your menstrual cycle, you’re likely in early perimenopause. A length of 60 days or more between periods means you’re likely in late perimenopause.
Hot flashes and sleep problems Hot flashes are a common symptom of perimenopause, and an estimated 35% to 50% of perimenopausal women experience them, according to Harvard Health . They often happen rapidly and can last from one to five minutes, but the length, frequency, and severity can be different for everyone. They can appear as a sudden rise of body heat with sweating and flushing in the face, neck, and chest. Hot flashes can be unpredictable, and night sweats can result in sleep problems.
Vaginal dryness and change of sexual desire Lower levels of estrogen can cause your vaginal tissues to thin, and subsequently lose lubrication. This can result in itchiness and irritation.
Sexual desire can also change during perimenopause. It can be harder to get aroused and vaginal dryness can make intercourse painful. Vaginal dryness can also make you more prone to urinary or vaginal infections.
>>RELATED: Learn what causes a high sex drive or a low sex drive during perimenopause .
Mood changes Changes in hormone levels during perimenopause can cause mood changes, in addition to the stress of perimenopause’s physical symptoms, history of mental health, and life pressures.
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Studies have also shown a higher risk of depression during this period. You may feel anxiety , irritation, and experience short-term memory. While these are similar to premenstrual syndrome (PMS), it’s common to experience these mood changes throughout your cycle during menopause. If these symptoms are interfering with your well-being, reach out to your doctor.
How to treat the first symptoms of perimenopause Navigating the onset of perimenopause can be confusing and challenging, especially when you’re dealing with your first symptoms of perimenopause. What do you expect? What medication or lifestyle changes will help?
Managing irregular menstrual cycles Irregular periods are a staple of perimenopause, but that doesn;t mean they’re any easier to manage. Tracking your menstrual cycle can help you anticipate changes and manage symptoms that arise during different phases.
Because your cycle will be more irregular, simply counting a 28-day cycle typically won’t be as effective. Instead, tracking your hormone levels can give you clear and accurate insight into what your specific hormones are doing.
Besides tracking, incorporating stress-reduction techniques such as yoga, meditation, or deep breathing exercises can help promote hormonal balance. Additionally, speaking with your healthcare provider about hormonal birth control options or other medications may help you find a medical intervention that regulates your cycle.
Addressing hot flashes and sleep problems Hot flashes and night sweats can disrupt your ability to sleep, which can lead to fatigue and irritability. To combat this, keep your bedroom cool and well-ventilated. When dressing for bed, opt for moisture-wicking sleepwear that helps keep sweat off your skin.
You can also adapt your bedtime routine to help promote better sleep. Avoiding caffeine and alcohol, especially in the few hours before you go to bed, can ensure you don’t exacerbate symptoms. You can also practice relaxation techniques, like progressive muscle relaxation or aromatherapy.
Relieving vaginal dryness and changes in sexual desire To relieve vaginal dryness, over-the-counter vaginal moisturizers or lubricants can provide relief from dryness and discomfort during intercourse.
Managing changes in sexual desire can make connecting with your partner more challenging. Open communication with your partner about any concerns or changes in libido is crucial for maintaining intimacy and understanding.
Managing mood changes Hormonal fluctuations can contribute to mood swings, anxiety, or depression during perimenopause. Often lifestyle changes can help mitigate symptoms and provide energy and mood boosters. For example, incorporating regular exercise into your routine can help alleviate stress and improve mood by releasing endorphins. Practicing self-care activities such as journaling, spending time outdoors, or participating in hobbies you enjoy can help you find pleasure and excitement in everyday life.
If mood changes significantly impact your daily life, consider seeking support from a mental health professional who can offer counseling or medication options.
Navigating perimenopause requires patience and self-awareness as you adapt to the changes your body is experiencing. It’s far from easy, but incorporating these strategies and seeking healthcare professionals when needed can help you effectively manage the first symptoms of perimenopause with confidence.
First symptoms of perimenopause: the bottom line Perimenopause looks different for every woman. It’s a phase of physical and mental changes, and these are some of the signs you can look out for. It’s important to work closely with your healthcare provider to help navigate, manage, and embrace this next natural stage of life.
