The term "perimenopause," which translates to "around menopause," describes the period of time when your body naturally enters menopause, signaling the end of the reproductive years. The menopausal transition is another name for perimenopause.

Women begin perimenopause at various ages. Sometime in your 40s, you may start to experience menstruation irregularities or other indicators that menopause is approaching. However, some females start noticing changes as early as their mid-30s.

During perimenopause, the amount of estrogen, the primary female hormone, fluctuates irregularly throughout your body. Your menstrual periods may extend or shorter, and you can start experiencing menstrual cycles without an egg release from your ovaries (ovulate). In addition, you might suffer menopause-like symptoms including vaginal dryness, sleep issues, and hot flashes. There are treatments that can help reduce these symptoms.

You've officially hit menopause and the perimenopause stage is ended once you've gone 12 months without a monthly cycle.

Perimenopause Vs. Premenopause

Although premenopause and perimenopause are commonly used synonymously, they really have distinct meanings. When you are in premenopause, you do not experience perimenopause or menopausal symptoms.

You are still in your reproductive years and experience periods, whether they are regular or irregular. There may be some hormonal changes going on, but your physique hasn't changed much. On the other hand, you'll begin to feel the effects of menopause during perimenopause. They may consist of:

  • alterations to your menstrual cycle.
  • bursts of heat.
  • disruptions to sleep.
  • mood changes.

What causes perimenopause?

Your ovaries progressively stop producing eggs, which results in the normal process of perimenopause. Ovulation may become irregular before ceasing altogether. Before your final period, the menstrual cycle lengthens and the flow may become erratic.

The body's fluctuating hormone levels are what lead to symptoms. You can experience symptoms similar to those of PMS if your estrogen levels are greater. Hot flashes or nocturnal sweats may occur when your estrogen levels are low. These hormonal alterations might coexist with regular periods.

Symptoms of Perimenopause

Some subtle and not-so-subtle changes in your body might occur during the menopausal transition. You could encounter:

Irregular periods. The interval between periods may be greater or shorter, your flow may be mild to strong, and you may skip some cycles as ovulation becomes more unpredictable. You could be in the early stages of perimenopause if the duration of your menstrual cycle consistently changes by seven days or more. You are most likely in late perimenopause if it has been more than 60 days since your last menstruation.

Sleep issues and hot flushes. During perimenopause, hot flashes are frequent. Varying is the frequency, duration, and intensity. Hot flashes or night sweats are frequently the cause of sleep issues, although they can also cause erratic sleep on occasion. 

Mood swings. Perimenopause may cause mood fluctuations, irritation, or an increased risk of depression. These symptoms may be brought on by hot flashes that interrupt sleep. The hormonal changes of perimenopause are not the only causes of mood disturbances.

Bladder and vaginal issues. Your vaginal tissues may become less elastic and lubricated as your estrogen levels drop, making sexual activity uncomfortable. You can be more susceptible to vaginal or urinary infections if your estrogen levels are low. Urinary incontinence may be brought on by a loss of tissue tone.

Decreasing fertility Your chance of getting pregnant falls when ovulation becomes erratic. However, pregnancy is still possible as long as you are still getting your period. Use birth control until you haven't had a period in 12 months if you want to prevent getting pregnant.

Modifications to sexual function. Sexual arousal and desire may fluctuate during perimenopause. However, if your sexual relationship was adequate prior to menopause, it will probably remain so into perimenopause and beyond.

Loss of bones. Your chance of developing osteoporosis, a condition that causes weak bones, rises when your estrogen levels decline because you begin to lose bone more quickly than you can replace it.

Changing levels of cholesterol. Your blood cholesterol levels might be negatively impacted by declining estrogen levels, including an increase in low-density lipoprotein (LDL) cholesterol, sometimes known as "bad" cholesterol, which raises your risk of heart disease. In addition, as women age, their levels of high-density lipoprotein (HDL), or the "good" cholesterol, fall, which raises their risk of heart disease.

When Perimenopause occurs?

Long before you reach menopause, there is perimenopause. In actuality, hormonal changes begin to manifest 8 to 10 years before menopause. Even before the commencement of perimenopause, this occurs in your 30s or 40s.

The major female hormone generated by the ovaries, estrogen, declines during perimenopause. Additionally, estrogen levels may fluctuate more erratically than they would during a conventional 28-day cycle. Other symptoms, such as irregular periods, may result from this.

Your body will gradually generate less estrogen as perimenopause progresses. You can still become pregnant despite the substantial decline in estrogen. The duration of perimenopause can range from a few months to four years.

When the ovaries generate so little estrogen that eggs are no longer produced, menopause officially begins. Your menstruation also stops as a result of this.

Once a year has passed without a period, your doctor will make the diagnosis of menopause.

  • If you do, you could experience menopause earlier than usual:
  • have a history of early menopause in their family.
  • that you smoke.
  • having undergone an oophorectomy or hysterectomy.
  • received cancer therapy.

Risk factors

Menopause is a typical life stage. However, some women could experience it earlier than others. Even while it's not always definitive, some research points to a few variables that may increase your likelihood of beginning perimenopause sooner, such as:

Smoking. Women who smoke start menopause 1 to 2 years earlier than women who don't smoke.

Family background. Women who have experienced early menopause in their families may do so again.

Therapy for cancer. Early menopause has been connected to chemotherapy and pelvic radiation therapy for cancer treatment.

Hysterectomy. Typically, menopause is not brought on by hysterectomies that just remove the uterus but leave the ovaries in place. Your ovaries continue to generate estrogen even when you are no longer menstruating. However, such a procedure can result in menopause starting sooner than usual. In addition, removing one ovary may cause the remaining ovary to cease producing eggs earlier than intended.

What hormonal alterations occur during perimenopause?

Your diminishing estrogen levels are mostly to blame for the hormonal changes you go through throughout perimenopause. Estrogen is produced by your ovaries and is essential for the preservation of the reproductive system. Your estrogen levels start to fall as you reach perimenopause. As estrogen levels fall, progesterone, another hormone made by the ovaries, is thrown out of equilibrium. Together, these two hormones are in charge of ovulation and menstruation. During perimenopause, hormone levels frequently change and ride a rollercoaster of ups and downs.

Can perimenopause be treated?

There is no known way to prevent perimenopause. Perimenopause is a normal stage of aging. When your periods cease and you reach menopause, perimenopause is "cured." To aid with symptom relief, however, your doctor may suggest an over-the-counter or prescription perimenopause therapy. Your provider could advise:

Antidepressants: These drugs aid in the treatment of depression or mood swings.

contraceptive tablets. These drugs usually reduce symptoms while regulating hormone levels.

Estrogen therapy: This therapy keeps estrogen levels steady. You can use a lotion, gel, patch, or swallowable tablet to provide estrogen treatment.

Gabapentin: For some women, the seizure drug gabapentin (Neurontin®) also improves hot flashes.

Suppository creams: You may learn more about prescription and over-the-counter choices from your doctor. Treatment can improve vaginal dryness and reduce sex-related discomfort.

Your doctor will go over the advantages and disadvantages of perimenopause therapy with you and advise the best course of action depending on your requirements. A good diet, some mild exercise, and staying away from substances or actions that cause hot flashes can all help.

Menopause and perimenopause home remedies.

There are various techniques you may do at home to reduce your symptoms. Your mood, weight gain difficulties, and even (ironically) your hot flashes can all be helped by regular exercise. Make it a point to engage in some sort of physical activity each day. Just avoid exercising just before bed because it might worsen insomnia. If you have insomnia, it may feel hard to get enough sleep. Before going to bed, try soothing activities like mild yoga or a warm bath. Avoid taking naps throughout the day since this might affect your capacity to sleep at night.

Here are a few other techniques you may use to treat symptoms.

  • Keep an eye on your nutrition and steer clear of heavy meals.
  • If you smoke, give it up.
  • Only consume alcohol sparingly.
  • Caffeine should only be consumed in tiny amounts in the morning.

Your body produces so little estrogen during menopause that your ovaries stop producing eggs. You stop getting your menstruation at this stage.


Period irregularities are a defining feature of perimenopause. The majority of the time, this is normal and of no consequence. But if, visit your physician.

You have to change tampons or pads every hour or two for two or more hours because of the intense bleeding.

Bleeding continues over the seven-day mark.

Between menstruation, bleeding happens.

Usually, periods are spaced no more than 21 days apart.

These warning signs might point to a reproductive system issue that needs to be identified and treated.

Menopause transitions into perimenopause. You can begin experiencing menopause-like symptoms during perimenopause, such as hot flashes, mood swings, or vaginal dryness. The majority of menopausal symptoms are controllable. However, there are drugs and other therapies available if you need assistance controlling symptoms. Once a year has passed without a period, the perimenopause is over. You then start menopause.

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