Most women know about menopause—the point when your periods stop for good. But the changes actually start years before that, during a stage called perimenopause.
When does perimenopause start?
“Perimenopause starts as your ovaries begin to produce less estrogen, which can result in irregular periods and a variety of other potentially bothersome symptoms.,” says Lauren R. Maher, MD, Carilion Women’s. This usually happens in your 40s, but it can be earlier for some women.
Changes from perimenopause don’t happen all at once. Your hormone levels can go up and down from month to month, which is why your periods (and how you feel) might start to vary.
Perimenopause is different from premature menopause, which is when menopause happens before age 40.
How long does perimenopause last?
Most women are in perimenopause for about 4 years. But for some it can last anywhere from a few months up to 10 years. You’ve officially reached menopause once you’ve gone 12 months without a period. This usually happens around age 51.
Signs of perimenopause
Everyone’s experience is different, but these are the most common symptoms:
- Period changes – Cycles may change length or skip months, and periods may get heavier or lighter
- Hot flashes and night sweats – Suddenly feeling hot, flushed or sweaty, especially at night
- Sleep problems – Difficulty falling or staying asleep
- Mood changes – Feeling more irritable, anxious or emotional
- Vaginal dryness – This can make sex uncomfortable
- Changes in sex drive – Some women notice decreased libido
- Brain fog – Trouble concentrating or remembering things
You might also notice changes in your skin, hair or weight (especially around your middle).
Ways to manage perimenopause symptoms
Perimenopause doesn’t have to be miserable. Your doctor can recommend ways to help you manage symptoms and feel more like yourself. Options include:
- Hormone therapy – This treats several symptoms of perimenopause and can come as a pill, patch, ring, gel or cream
- Low-dose birth control pills – For women in early perimenopause, these can help with irregular periods, hot flashes and mood swings
- Antidepressants – Certain antidepressant medicines can reduce hot flashes and help with mood
- Veozah (fezolinetant) – This hormone-free medicine acts on the part of your brain that regulates body temperature to prevent hot flashes
- Vaginal creams – These can help relieve dryness and discomfort
“Lifestyle habits like staying active, eating a balanced diet, getting good sleep and managing stress can also help lessen symptoms,” notes Dr. Maher.
If you have symptoms of perimenopause, reach out to your family doctor or OB/GYN. They can help you understand what’s normal, rule out other causes and find the best way to relieve your symptoms.
