Hot flashes, mood swings, irregular cycles: all are tell-tale signs of perimenopause. Perimenopause, often referred to as the “menopausal transition,” is a natural biological process that happens before menopause. During these years before the end of your period, your body goes through significant hormonal changes—which can bring horrible perimenopause symptoms, frustration, and even confusion as to exactly what’s going on inside your body.
Even though it can be challenging, perimenopause is an entirely natural transition period in a woman's life. Understanding what it is and what to expect is the first step toward effectively managing its effects and maintaining overall health and well-being. In this article, we’ll cover:
- Perimenopause defined
- What does perimenopause feel like?
- Can you get pregnant during perimenopause?
- Perimenopause treatment
First: what exactly is perimenopause? It’s helpful to first know what menopause is first, then work backwards.
Menopause is when you’ve gone 12 consecutive months without a menstrual period. Perimenopause is the years leading up to menopause. During perimenopause, your body’s production of estrogen and progesterone—two key hormones that regulate the menstrual cycle—starts to fluctuate. These hormonal shifts can result in a wide range of physical and emotional symptoms that vary from person to person (more on that later).
When does perimenopause start?
Perimenopause typically begins in a woman's late 30s to early 40s, but it can vary from person to person. Some women may start experiencing perimenopausal symptoms earlier, while others may not notice any significant changes until their late 40s. The duration of perimenopause can vary as well, lasting anywhere from a few years to over a decade before reaching menopause.
What does perimenopause feel like?
Perimenopause is often described by some of its most common symptoms, particularly hot flashes and night sweats. Yet perimenopause can feel like a whole slew of symptoms. When you’re in perimenopause, you might feel hot flashes and night sweats, but also feel irritable, fatigued, and unfocused.
Perimenopause symptoms include:
- Hot flashes and night sweats:
- Irregular periods
- Mood changes
- Sleep disturbances
- Vaginal dryness and discomfort
- Decreased libido
- Weight gain
- Memory and concentration issues
- Breast tenderness
- Hair changes
- Bone health
- Digestive problems
- Joint pain
- Skin changes
PMS vs. perimenopause symptoms
If you’re reading the above list and thinking, “those are symptoms I get before my period!” you’re not wrong. Premenstrual syndrome has many similar symptoms to those of perimenopause. The main difference is when you feel these symptoms.
If you’re experiencing these symptoms only about two weeks before your period, it’s likely PMS. If these symptoms are happening at any point in your cycle, and you’re in your late 30’s or beyond, it might be perimenopause.
Can you get pregnant during perimenopause?
While it’s not as common to get pregnant during perimenopause, yes, you can still get pregnant.
It’s not as common to get pregnant during this time because of the changes within your menstrual cycle. According to the American Pregnancy Association, your chances of getting pregnant become slim because you ovulate less frequently during perimenopause. When you don’t ovulate, there’s no egg to fertilize.
If there is an egg to fertilize, these eggs are harder to fertilize and grow into a healthy fetus. That’s because eggs age with us. Women in their 40s, which are likely going through perimenopause, have a 5% chance of conceiving every cycle.
>>MORE: Learn everything you need to know about pregnancy and perimenopause, whether or not you’re trying to conceive.
It's important to note that perimenopause is a natural phase of life, and while it may come with challenges, it is not a condition that needs to be treated or "cured." Instead, there are tons of ways—both natural and medical—to help manage and alleviate perimenopause symptoms.
Through a mix of diet, movement, stress, and sleep changes, you might find relief. Here’s how different lifestyle modifications can help with specific perimenopause symptoms:
- Balanced diet: Incorporate foods rich in calcium, vitamin D, and magnesium to support bone health. Phytoestrogen-rich foods like soy and flaxseed may help with hormonal fluctuations. Reducing caffeine, alcohol, and sugar intake can also minimize mood swings and hot flashes.
- Regular exercise: Engaging in regular physical activity can help manage weight, improve mood, and boost energy levels. Aim for a mix of cardiovascular exercises, strength training, and flexibility exercises to maintain overall health. (Learn what workouts are best for each part of your cycle.)
- Stress management: Explore stress reduction techniques such as yoga, meditation, deep breathing exercises, or mindfulness to avoid exacerbating perimenopause symptoms and promote emotional well-being.
- Adequate sleep: Hormonal fluctuations during perimenopause can disrupt sleep patterns. Create a comfortable sleep environment and establish a healthy sleep schedule to ensure you get the rest you need.
If lifestyle modifications aren’t helping but you want to focus on natural treatment, you have a few options. Be sure to consult with a healthcare provider before adding any supplements to your regimen.
- Herbal Supplements: Herbs like black cohosh and evening primrose oil have been used to alleviate perimenopausal symptoms.
- Acupuncture: Some women find relief from symptoms like hot flashes and mood swings through acupuncture sessions.
- Vaginal estrogen: For vaginal dryness and discomfort during intercourse, vaginal estrogen in the form of creams, tablets, or rings can provide relief. These localized treatments have minimal systemic effects.
Hormone replacement therapy (HRT)
Hormone replacement therapy involves the use of estrogen and, sometimes, progesterone to alleviate perimenopausal symptoms. It can effectively reduce hot flashes, vaginal dryness, and mood swings.
However, it's essential to discuss the risks and benefits of HRT with a healthcare provider, as it may not be suitable for everyone.
If hormone replacement therapy isn’t the right medical intervention for you, there are other options that can help with specific symptoms.
Some antidepressants, like serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs), may help manage mood swings and hot flashes. Gabapentin, a medication typically used for seizures and nerve pain, has shown promise in reducing hot flashes in some women.
Counseling and support
Perimenopause can be emotionally challenging. Seeking counseling or joining support groups can help women navigate this transition and find strategies to cope with the emotional aspects of perimenopause.
Remember that every woman's experience with perimenopause is unique. It's crucial to work closely with a healthcare provider to develop a personalized treatment plan that addresses your specific symptoms and needs. By combining lifestyle modifications, medical interventions, and support, you can effectively manage perimenopause symptoms and embrace this natural stage of life with confidence.
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