What is perimenopause?
Learn all about the stage where hormones are in major flux.
Perimenopause is like your first time on a roller coaster: when the safety harness latches, you really don’t know what to expect. That’s because some women experience intense symptoms during this stage that disrupt their lives, while others feel nothing; for some women, symptoms stick around for up to a decade, while others zoom through. So while we can’t tell you exactly what perimenopause will be like for your unique body, we can give you a range of experiences, share what’s going on, and offer solutions if you are bothered by symptoms.
What’s perimenopause?
This is when your hormones fluctuate wildly as your body enters the menopause transition. Perimenopause, which is when you’ll experience a lot of the symptoms, can begin up to 10 years before you actually hit menopause (which is defined as the moment you’ve gone a full year without a period and happens at the average age of 52).
Once you skip a period or reach a variation in your period lengths that’s greater than seven days, you’ve officially entered perimenopause, says Dr. Stephanie Faubion, M.D., the director for the Center for Women's Health at the Mayo Clinic, medical director for The Menopause Society, and member of the WeightWatchers Scientific Advisory Board.
Then you stay in the perimenopause stage until you’ve reached a full year without a period (that’s menopause).
How long does perimenopause last?
Perimenopause can last anywhere from two to eight years — with the average being four years.
What are common perimenopause symptoms?
Estrogen and progesterone levels start to drop, but they do it in an erratic fashion with dips and spikes (sometimes shooting higher than during your reproductive years). These rapidly fluctuating hormones are what trigger the symptoms, including:
Acne
Hair loss
Irregular and/or heavy periods
Low libido, vaginal dryness, and pain with sex
Mood swings, anxiety, and depression
Trouble sleeping
“Vasomotor symptoms” like hot flashes and night sweats
Weight gain and more belly fat
What are the treatments for perimenopause symptoms?
“This period of transition is treatable in so many ways, and it’s critical for people to realize that they can get help,” says Dr. Margaret Nachtigall, M.D., associate professor of obstetrics and gynecology at NYU School of Medicine.
Due to the variety of symptoms, and the fact that they can often mimic other health conditions (such as thyroid disease), it’s a good idea to see your doctor when you experience any of them, even if you think you’re too young for perimenopause. They will be able to recommend different lifestyle changes or treatments that can help you feel better.
First, make sure your self-care is buttoned up. “Get enough sleep, eat a healthy diet, exercise, find an outlet for your stress — all the things that keep you optimally healthy will also help you have an easier time with perimenopause symptoms,” says Nachtigall.
Beyond that, you may want to try medication options. A low-dose oral contraceptive pill can help with symptoms like hot flashes, or an IUD that has a progestin can help with heavy periods. Menopause hormone therapy (MHT), more commonly known as hormone replacement therapy, is the gold standard for treating symptoms of menopause with estrogen and progesterone; it’s delivered through an oral medication, stick-on patch, or vaginal cream.