Are you in your 30s or 40s and feeling a bit peculiar? It might be perimenopause. This phase, a prelude to menopause, brings with it a medley of changes—irregular periods, hot flashes, and mood swings, to name a few.
Are you in your mid-30s or early 40s and feeling a bit off lately? It might not just be stress or fatigue—it could be perimenopause. While menopause might seem like a distant concern, it’s important for women (and people assigned female at birth) to understand the signs of perimenopause, the precursor to menopause, so you can take steps to manage symptoms and stay healthy as you age.
Perimenopause is the transitional period leading up to menopause (peri means “near” so “near” menopause). It’s the time when you’re transitioning from having regular periods to having none in menopause. It’s a gradual process, and it looks different for every woman.
There are two stages of perimenopause, the early stage “can begin in some women in their 30s, but most often it starts in women ages 40 to 441.” The later stage usually happens when you are in your late 40s or early 50s, and this is when you’ll begin missing periods until they eventually stop.
During perimenopause, your body experiences what can only be described as hormonal chaos. As you enter perimenopause, your estrogen levels begin to decrease. “As estrogen decreases, it throws off the balance with progesterone, another hormone produced by the ovaries…It’s common for hormone levels to fluctuate during perimenopause —to go up and down like a roller coaster2.”
Symptoms vary widely from person to person and can include:
While some symptoms are normal during perimenopause, other conditions can cause abnormalities in your periods and may require medical attention to rule out underlying conditions. You should see a healthcare provider if2:
Perimenopause isn’t really something you can test for, and you don’t always need to see a healthcare professional for a perimenopause diagnosis. There are a growing number of at-home blood tests available online that claim to tell you how close to menopause you are. However, at-home hormone tests don’t always provide reliable results given the unpredictable nature of hormone fluctuations during perimenopause (also, just like you didn’t need a lab test to let you know when you were in puberty, and you don’t generally need one to tell you you’re in perimenopause).
That said, diagnosis is typically based on clinical evaluation, considering factors such as age, medical history, family history, and symptoms. Genetics can play a significant role in the timing of when you begin to experience perimenopause.
Unless symptoms are troublesome, perimenopause does not need to be treated. However, making some lifestyle changes may help ease uncomfortable symptoms and optimize your health as you age. Some changes your healthcare provider may recommend include:
Perimenopause can also impact your sex drive. Changing hormone levels may lead to changes in libido and vaginal dryness. There are solutions available, including lubricants and hormone therapy (for more on hormone therapy, check out Tall Tree Health’s blog “Do the Benefits of Hormone Replacement Therapy Outweigh the Risks? Research Says Yes”). Prioritizing communication with your partner and healthcare provider is essential to address any concerns.
Perimenopause is a natural phase of life, but that doesn't mean you have to suffer in silence. Discussing your symptoms with your healthcare provider can lead to personalized treatment options that are right for you, such as hormone therapy, antidepressants, or stress reduction techniques.
As you navigate perimenopause, understanding the signs, symptoms, and management strategies can help you through this transitional phase. Stay proactive about your health, prioritize self-care, and lean on your support network for guidance and encouragement.
