Understanding your cycle and the journey toward menopause is a powerful way to take control of your wellbeing. By becoming more aware of the changes your body is going through, you can tackle the symptoms of perimenopause with confidence and positivity. Embracing this knowledge empowers you to make informed choices, manage your health proactively, and feel more in tune with your body as you navigate this important life stage.

What Is Perimenopause?

Perimenopause is a natural stage in a woman's life that marks the transition towards menopause; the end of reproductive years. The term "perimenopause" means "around menopause" and describes the period when your body begins the natural transition to menopause. This stage is marked by fluctuations in hormone levels, particularly estrogen and progesterone, leading to various physical and emotional changes.

As the ovaries gradually produce less estrogen during perimenopause, changes in menstrual cycles and the onset of various symptoms occur, which can impact your quality of life. While every woman experiences perimenopause differently, it signifies the approach towards the end of fertility and the road to menopause.

What Are the 34 Symptoms of Perimenopause?

Perimenopause is often accompanied by a wide range of symptoms, some more common than others. The most frequently cited 34 symptoms include:

• Irregular periods: Changes in menstrual cycle length or flow.
• Hot flashes: Sudden feelings of intense heat, often accompanied by sweating.
• Night sweats: Hot flashes that occur during sleep.
• Vaginal dryness: Reduced moisture in the vaginal area, leading to discomfort.
• Loss of libido: Decreased interest in sexual activity.
• Mood swings: Emotional instability, including irritability and depression.
• Sleep disturbances: Trouble falling or staying asleep.
• Fatigue: Persistent feelings of tiredness and low energy.
• Memory problems: Difficulty concentrating and occasional forgetfulness.
• Weight gain: Particularly around the abdomen.
• Hair thinning: Loss of hair or thinning hair.
• Dry skin: Reduced skin elasticity and moisture.
• Bloating: Abdominal discomfort and swelling.
• Breast tenderness: Soreness or sensitivity in the breasts.
• Headaches: Increased frequency or severity of headaches.
• Joint pain: Stiffness and aching in joints.
• Muscle aches: General muscle discomfort.
• Urinary incontinence: Difficulty controlling urination.
• Heart palpitations: Unexplained rapid or irregular heartbeats.
• Anxiety: Increased feelings of worry or unease.
• Depression: Persistent low mood or lack of interest in activities.
• Osteoporosis risk: Decreased bone density leading to fractures.
• Dizziness: Lightheadedness or balance issues.
• Gastrointestinal issues: Digestive problems like constipation or diarrhea.
• Allergies: New or worsening allergic reactions.
• Body odor changes: Altered or stronger body odor.
• Tingling extremities: Numbness or tingling in hands and feet.
• Gum problems: Increased sensitivity or bleeding gums.
• Burning mouth syndrome: A burning sensation in the mouth or tongue.
• Electric shock sensations: Sudden, brief sensations of electric shocks.
• Irregular heartbeat: Noticeable irregular heartbeats.
• Panic attacks: Sudden, overwhelming feelings of anxiety or fear.
• Tinnitus: Ringing in the ears.
• Cold flashes: Sudden feelings of intense cold, sometimes following a hot flash.

 

How Long Does Perimenopause Last?

Perimenopause typically lasts for about 4 to 8 years, although this can vary from one woman to another. This stage begins with subtle hormonal changes and continues until menopause, defined as the point when you haven't had a menstrual period for 12 consecutive months.

In the early stages of perimenopause, you might experience minor symptoms like irregular periods, which may intensify over time. As estrogen levels continue to fluctuate and eventually decrease, symptoms like hot flashes, night sweats, and mood changes may become more pronounced.

The transition to menopause occurs when the ovaries significantly reduce their hormone production, leading to the cessation of menstruation. Once menopause is reached, many of the symptoms of perimenopause begin to subside, although some, like vaginal dryness and bone density loss, may persist.

When Does Perimenopause Start?

Perimenopause typically begins in a woman's 40s, though it can start as early as the mid-30s or as late as the early 50s. The timing of perimenopause is influenced by factors such as genetics, lifestyle, and overall health.

One of the earliest signs of perimenopause is changes in the menstrual cycle. You may notice your periods becoming irregular—shorter, longer, heavier, or lighter than usual. These changes result from fluctuating hormone levels, particularly estrogen and progesterone.

It's essential to recognise that the onset of perimenopause is gradual. Symptoms may start subtly but can become more noticeable as you progress through this stage. Regular check-ups with your healthcare provider can help monitor these changes and offer guidance on managing symptoms effectively.

What Are the First Signs of Perimenopause?

The first signs of perimenopause can vary, but common early indicators include:

• Irregular periods: Changes in the menstrual cycle are often the first noticeable sign, with periods becoming unpredictable in terms of frequency, duration, and flow.
• Hot flashes: These sudden feelings of warmth, often accompanied by sweating, are a hallmark symptom of perimenopause.
• Mood swings: Hormonal fluctuations can lead to emotional changes, including irritability, anxiety, and depression.
• Sleep disturbances: Many women experience trouble sleeping, which may be due to night sweats or changes in hormone levels affecting sleep quality.
• Fatigue: A persistent feeling of tiredness or lack of energy is common as your body adjusts to hormonal changes.
• Vaginal dryness: Decreased estrogen levels can lead to reduced vaginal lubrication, causing discomfort during intercourse or other activities.
• Breast tenderness: Your breasts may feel sore or tender, particularly before periods.
• Weight gain: Many women notice an increase in abdominal fat, partly due to hormonal shifts.

These early signs of perimenopause can sometimes be mistaken for other conditions or simply attributed to aging. However, if you notice these symptoms, it's a good idea to discuss them with your healthcare provider, especially if they are affecting your quality of life.

When to Worry About Perimenopausal Bleeding

While changes in your menstrual cycle are a normal part of perimenopause, certain patterns of bleeding should prompt a visit to your healthcare provider. You should seek medical advice if you experience:

• Extremely heavy bleeding: Soaking through a pad or tampon every hour for several hours.
• Bleeding between periods: Spotting or bleeding between periods can be a sign of other health issues.
• Prolonged periods: If your periods last longer than usual, especially if they extend beyond 7 days.
• Postmenopausal bleeding: Any bleeding after you haven't had a period for 12 months should be evaluated.

These symptoms could indicate conditions such as fibroids, polyps, or other issues that may require medical attention. Your healthcare provider can perform tests to determine the cause of abnormal bleeding and recommend appropriate treatment if necessary.

Am I Perimenopausal?

If you're experiencing some of the symptoms mentioned earlier, you may wonder if you're perimenopausal. While the symptoms of perimenopause are a strong indicator, the only way to confirm it is through a combination of symptom tracking, medical history, and sometimes, hormone tests.

Tracking your menstrual cycle and any accompanying symptoms can provide valuable information. For example, noting when your periods become irregular, how often you experience hot flashes, or changes in your mood can help your healthcare provider make an accurate diagnosis.

Additionally, hormone tests may be used to measure levels of estrogen, follicle-stimulating hormone (FSH), and other markers to determine if you're entering perimenopause. However, hormone levels can fluctuate throughout the month, so these tests are not always definitive.

If you're unsure, a helpful starting point is taking an online quiz or self-assessment, such as the Menopause Test offered by Psychology Today. While not a substitute for professional medical advice, it can give you a better idea of whether you might be experiencing perimenopause.

Can You Get Pregnant During Perimenopause?

Yes, it is still possible to get pregnant during perimenopause. Although fertility declines as you age and ovulation becomes less frequent, as long as you are still menstruating, there is a chance of pregnancy.

However, because ovulation becomes more unpredictable during perimenopause, it can be more challenging to determine your fertile window. If you are not planning to become pregnant, it's important to continue using contraception until you have gone 12 consecutive months without a period, which marks the official onset of menopause.

If you're trying to conceive, consider natural ways to support fertility, such as maintaining a healthy diet, taking fertility-boosting supplements, and managing stress through mindfulness or meditation. Consulting with a fertility specialist may also be beneficial as age-related fertility decline can make it more challenging to get pregnant naturally.

How to Stop Perimenopause Itching

Itching during perimenopause is often caused by declining estrogen levels, which can lead to dry, thinning skin. This condition, known as pruritus, can be particularly bothersome, but there are natural ways to manage it effectively:

• Moisturize regularly: Use a high-quality, fragrance-free moisturizer to keep your skin hydrated.
• Stay hydrated: Drinking plenty of water helps maintain skin hydration from the inside out.
• Use gentle skincare products: Avoid harsh soaps and opt for gentle cleansers designed for sensitive skin.
• Take cooler showers: Hot water can strip your skin of natural oils, so try using lukewarm water instead.
• Consider natural supplements: Supplements like Omega-3 fatty acids and Vitamin E can help improve skin health.
• Practice mindfulness and relaxation techniques: Stress can exacerbate itching, so techniques like meditation, journaling, and yoga can help reduce stress levels.

If itching persists or is severe, it's advisable to consult with a healthcare provider to rule out other underlying conditions and discuss additional natural treatments.

What Does a Hot Flash Feel Like During Perimenopause?

Hot flashes are one of the most common and well-known symptoms of perimenopause. A hot flash typically begins with a sudden feeling of warmth, usually in the upper body, particularly the face, neck, and chest. This sensation can be mild or intense and may be accompanied by sweating, redness, and sometimes a rapid heartbeat.

Hot flashes can last anywhere from a few seconds to several minutes. After the initial wave of heat, many women experience a subsequent cold flash as their body temperature returns to normal. Night sweats are hot flashes that occur during sleep, often causing significant discomfort and disrupting sleep.

While hot flashes are generally harmless, they can be uncomfortable and affect your quality of life. Natural strategies to manage hot flashes include dressing in layers, keeping your environment cool, and avoiding known triggers such as spicy foods, caffeine, and alcohol. Regular exercise, mindfulness practices, and a balanced diet rich in phytoestrogens (plant-based estrogens) can also help manage symptoms.

Am I Perimenopausal Quiz

If you're curious about whether you're experiencing perimenopause, you might find it helpful to take an online quiz, like the Menopause Test from Psychology Today. This quiz can provide insight into your symptoms and help you determine if it's time to discuss your experiences with a healthcare provider.

 

Further Reading:

1. What vitamins are good for Perimenopause