Perimenopause Symptoms: The What, The Why, and The When

By Christina Hanna, MPH, CHES • Published 6/6/2023

Medically Reviewed by MD, OB-GYN

group of five perimenopause age women walking and smiling in athleisure attire

Have you noticed a change in your periods? Unexplained weight gain? Mood swings?

If you’re in your 40s, these symptoms could be a sign that you’re experiencing perimenopause.

What is perimenopause?

Perimenopause is a phase of life — it’s the years leading up to menopause. It can also be referred to as being part of the menopausal transition. During perimenopause, estrogen levels rise and fall unevenly. Those changing hormone levels and symptoms associated with perimenopause can start 8-10 years prior to reaching menopause, often in your 40s. And many of those symptoms are the same symptoms you normally associate with menopause. Menopause is the point in time when it has been 12 months since your last period.

Is it perimenopause?

When it comes to our own bodies, most of us know what’s normal and what’s not. If you notice changes, talk to your doctor. There’s no blood test for perimenopause — it’s called a diagnosis of exclusion. After a discussion about your symptoms, a doctor may recommend tests and exams to rule out any other conditions or health issues. If nothing appears to be wrong, one explanation may be perimenopause.

A change in periods is often the first sign, but there are also other signs of perimenopause. During perimenopause, around 85% of people may experience at least one of the symptoms associated with hormonal changes, including:

  • Irregular or changes in periods
  • Hot flashes and night sweats
  • Urinary problems
  • Insomnia and other sleep problems
  • Mood changes, including anxiety and irritability
  • Thinning hair and dry skin
  • Weight gain
  • Vaginal dryness or pain during sex
  • Loss of breast fullness
woman speaking to her doctor about the signs and symptoms of perimenopause

What treatments are available for perimenopause?

There are treatments to help with bothersome symptoms like hot flashes or sleeplessness, including hormone replacement therapy and low-dose birth control pills. Depending on other symptoms and how they’re affecting your quality of life, you can work together with your doctor to produce a treatment plan that may work for you. If you’re curious about potential treatment options for specific symptoms, check out our Symptom Guides.

Many doctors will also suggest lifestyle changes to help improve your health. Studies have shown that women with better health experience fewer symptoms and are better able to cope with ones they do get. These lifestyle habits usually include the basics like healthy eating, as much quality sleep as possible (we know that one can be tough!), limiting alcohol, avoiding tobacco, reducing stress, breathing exercises, and regularly exercising. We know that lifestyle changes and changing habits can be tough. Remember to just take it one step at a time.

Throughout perimenopause and menopause, your experience and symptoms may shift, so stay connected with your provider to adjust your treatment plan as needed.

Questions to ask your doctor about perimenopause

If you’re having symptoms for the first time, having new symptoms, or symptoms are interfering with your day-to-day life, consider talking to your doctor or a telemedicine provider about what’s going on. Here’s a list of questions you might consider asking your healthcare provider to gain more information:

  • Is treating women experiencing menopause part of your practice? If not, can you recommend someone who does?
  • How can I tell if what I’m experiencing is caused by perimenopause, or some other condition?
  • How will perimenopause affect my health overall?
  • How long should I keep using birth control?
  • Do I need treatment for perimenopause? If so, what treatments are best for me?
  • Is hormone therapy (MHT/HRT) right for me?
  • What are the side effects of HRT and how can I deal with them?
  • Will perimenopause affect my sex life?
  • How does perimenopause affect other diseases or conditions I have?
  • Are there any medications, supplements, or natural remedies you recommend?
  • What changes should I make to my eating habits?
  • How much and what kinds of exercise should I be doing?
  • Are there other lifestyle habits that could be especially helpful for me?
  • Is there anything I should stop doing or taking?

Having a better understanding of perimenopause and your personal experience with it can help you be proactive in caring for yourself and your symptoms — now and throughout menopause.

Last Updated 2/15/2024



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