What to Expect During Perimenopause: 8 Things You Should Know


What to Expect During Perimenopause | This post is a great beginners guide to the years leading up to menopause. We've outlined everything you need to know - when does perimenopause start, early warning signs, common symptoms, effects on menstrual cycle, and so much more. If you're experiencing insomnia, weight gain, irritability, moodiness, night sweats, and/or hot flashes, you may be entering perimenopause, and this post will shed light on other signs to watch for!

Perimenopause can be both challenging and exciting. It marks a big transition in a woman’s life. Being familiar with the causes and symptoms of perimenopause will help you enter this new phase with confidence.

What Is Perimenopause?

Also referred to as the “menopausal transition”, perimenopause is the period of time when your body is transitioning into menopause. This natural transition signals the end of your reproductive years.

Your body is preparing for the time when it will stop releasing eggs entirely. During this time, the levels of estrogen, which is the main female hormone, begin to rise and fall. This change in estrogen levels will cause significant changes in your body.

When Does Perimenopause Start?

Women start perimenopause at different ages. The majority of women begin noticing signs in their 40’s. However, some women will start seeing changes as soon as their mid-30’s or as late as their mid-50’s.

Certain risk factors may increase your chances of starting perimenopause earlier than normal. Those factors include:

  • Family history – If you have a family history of early menopause, you may be likely to start early yourself.
  • Smoking – Women who smoke may start perimenopause 1 to 2 years sooner.
  • Hysterectomy – During a hysterectomy, the uterus is removed, but the ovaries are sometimes left behind. The ovaries will continue producing estrogen, but due to the surgery, they may produce lower levels of estrogen or stop working sooner than normal.
  • Cancer treatments – Treatments that involve pelvic radiation or chemotherapy may cause early menopause.

How Is Perimenopause Diagnosed?

Perimenopause doesn’t need to be diagnosed by a doctor. Most often, the signs and symptoms of perimenopause are enough for many women to recognize.

There is no particular test that can diagnose perimenopause. Your doctor will take certain factors into account to help determine if you have reached this transition, including your menstrual history, your age, and any symptoms that you may be experiencing.

What To Expect During Perimenopause

Perimenopause can continue for as long as 4 to 8 years. It’s only when you’ve gone a full 12 months without a menstrual cycle that you’ve finally made the transition to menopause.

Although your fertility is declining, your body is still ovulating, which means you can still get pregnant. So you should continue to take precautions when it comes to birth control.

The biggest thing to expect is a roller coaster ride of hormone levels – not just estrogen, but progesterone as well. These two hormones are responsible for both ovulation and your menstrual cycle. Your body has been producing hormones since puberty, so your body will begin to find ways to adjust to this big change.

What Are The Early Signs of Perimenopause?

One of the earliest and most common signs of perimenopause is a change in your menstrual cycle. You may begin experiencing cycles that are shorter or longer than normal.

You may also begin to experience other symptoms such as hot flashes or vaginal dryness. Take a look at some of the most common symptoms experienced during perimenopause.

What Are The Symptoms of Perimenopause?

As a result of decreasing estrogen levels, women begin to experience certain changes. Symptoms of perimenopause differ and can vary in their level of severity. In fact, some women may not even notice some of the changes taking place in their bodies. Symptoms include:

  1. Hot flashes – 35-50% will experience hot flashes. Hot flashes are a sudden wave of heat all over the body that causes sweating and flushed skin. They can last anywhere from 5 to 10 minutes. For some, hot flashes are just a mild discomfort. But for others, the heat can feel intense and they end up covered in sweat, especially at night.
  2. Sleep problems – Forty percent of women will experience issues with sleep during perimenopause. Hot flashes are the most common cause of sleep problems. Hormonal changes can also cause insomnia in some women.
  3. Changes in mood – Some women may experience mood changes during perimenopause. Because perimenopause is so unpredictable, women may feel more irritable or anxious. Those with a history of depression, high levels of stress, or poor health could experience more severe mood swings.
  4. Vaginal dryness – Low levels of estrogen causes vaginal tissue to become thinner and drier, resulting in itching and irritation. Dryness can also cause pain during intercourse.
  5. Bladder problems – You’re more likely to experience urinary tract infections during menopause because of decreased estrogen levels. The change in tissue tone could also cause urinary incontinence.
  6. Bone loss – As estrogen levels decline, your body will begin to lose bone mass, making it harder to replace. This puts you at an increased risk of developing osteoporosis.
  7. Changing Cholesterol levels – Lower estrogen may cause your LDL or “bad cholesterol” levels to rise. This increases your risk of heart disease. The change in estrogen also affects your HDL or “good cholesterol”, which can also cause an increased risk of heart disease.
  8. Changes in Sexual Function – Sexual arousal and desire can change during perimenopause. If your sex life was satisfactory before you started, it will most likely continue that way once you reach perimenopause.

How Does Perimenopause Affect Your Menstrual Cycle?

Irregular periods are the biggest indicator of your body’s transition. During perimenopause, your cycles are no longer predictable. They may become shorter or longer or vary in intensity. Some women will experience lighter cycles while others may deal with very heavy cycles.

You may also find that your PMS (premenstrual syndrome) symptoms begin to change as well.

When Should I See a Doctor?

For most women, the symptoms experienced during perimenopause are easily tolerated. It’s only when symptoms become so severe that they interfere with your life and overall well-being that you should see your doctor.

Many women decide to see their doctor due to intense hot flashes or mood swings as well as changes in their sexual function.

Others should see their doctor if they begin having complications due to their irregular periods. You may require treatment if your bleeding is very heavy, lasts more than seven days, occurs between periods, or your periods are less than 21 days apart.

Perimenopause is experienced differently by every woman. Remember that the process is normal and what you’re feeling is normal as well.

If you feel that you may need help managing your symptoms or want to discuss treatment options, your doctor can help.


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