Going through perimenopause can feel like your body is changing against your will. Hot flashes surprise you at work. Your period keeps you guessing if it will show up on time. Sleepless nights leave you draggy and blue. No wonder perimenopause gets a bad rap! But here’s an empowering secret: understanding how it unfolds puts you in charge. When you know what to expect, you can minimize the drama and even thrive!
This guide breaks down everything you need to know to take control of perimenopause. Read on to learn why it happens, how long it lasts, the most common symptoms, and tons of lifestyle tips and medical solutions to help you rock this change of life with confidence and ease!
What Exactly is Perimenopause?
Perimenopause simply means “around menopause.” It’s the transition phase leading up to the point where your ovaries stop releasing eggs. That endpoint is menopause. The hallmark of perimenopause is hormonal fluctuations. Your ovaries start sputtering out less estrogen. But it doesn’t happen evenly. (Nothing ever does with hormones!)
Sometimes estrogen surges cause perimenopause symptoms like killer hot flashes. Other times, when estrogen drops very low, the result is a dried-out vagina or mood swings. These unpredictable hormonal ups and downs are responsible for the myriad of symptoms women experience during the menopause transition.
When Does it Usually Start?
For most women perimenopause starts between ages 45 and 55. The average age is 51. But for some it begins earlier or later. Smokers often start perimenopause sooner, sometimes as early as 35. That’s because the chemicals from cigarettes damage ovaries.
Genetics plays a role too. If your mom or sisters had an early menopause, you likely will too. Things like autoimmune disorders, chemotherapy treatment, or ovary removal can also trigger premature perimenopause.
Whenever it starts, perimenopause typically lasts about 4 years. But it ranges anywhere from a few months to over 10 years. There’s no way to predict how smooth or rough your journey will be. Symptoms also come and go. You might sail along symptom-free for months. Then they’ll return with a vengeance. Ups and downs are totally normal during this period.
Perimenopause Versus Premenopause: What’s the Difference?
These two terms stir up confusion. Premenopause refers to all the fertile years leading up to perimenopause. So basically from your first period until hormones start fluctuating. Perimenopause itself is the menopause transition—when your ovaries begin tapering off estrogen production. The hallmark change signaling the start of perimenopause is unpredictable menstrual cycles.
The Timeline: What to Expect
Just like puberty, perimenopause unfolds in stages. Understanding the typical progression helps you know what’s “normal” versus needing medical attention. There are 3 phases:
The average age when perimenopause starts is 45-47. The first tip-off is usually wacky periods. Cycles might shorten or lengthen. Bleeding can get heavier or lighter too. Some women also have mid-cycle spotting. Because ovulation is erratic, early perimenopause is when periods start getting unreliable.
Other early-stage signs:
- Hot flashes & night sweats
- Trouble sleeping
- Vaginal dryness
- Urinary urgency or leaking
- Increased PMS symptoms
- Anxiety or mood swings
- Lack of concentration
- Low libido
By the late 40s or early 50s, most women are solidly in perimenopause. Hormone levels continue fluctuating up and down. But overall estrogen production is declining more rapidly. The dose of symptoms also intensifies for many women.
Besides more severe hot flashes and sleep troubles, it’s common to have:
- Heavy, prolonged periods
- Increased PMS mood issues
- Problems with memory and focus
- Vaginal pain with sex
The last 1-2 years before menopause is the wildcard time. Estrogen levels are lowest now, fueling the most extreme symptoms. But this is also when estrogen stability returns for some women.
In late stage perimenopause it’s common to have:
- Very heavy or light periods
- Spotting between periods
- Worsening sleep troubles
- More mood swings and irritability
- Forgetfulness and brain fog
The hallmark of late perimenopause is skipping periods. When you haven’t had a period for a year, you’ve reached menopause. The average age for menopause is 52.
Should I See my Doctor?
Getting a well-woman checkup yearly includingbloodwork is smart during perimenopause. There are also some warning signs that signal it’s time to get checked out:
See your doctor if:
- Heavy periods prevent normal activity
- You bleed longer than 7 days
- You’re bleeding more often than every 21 days
- You spot or bleed after sex
- You have new pelvic pain or discomfort
- Symptoms like hot flashes impact your quality of life
Tracking your cycle is also wise during perimenopause. Note symptoms alongside your period details. Review the patterns with your doctor. They can provide perspective on what’s normal during this period. Usually things like mid-cycle spotting, short and long cycles, and occasional missed periods are typical.
But any symptoms that concern you are worth discussing. Keeping your doctor updated allows them to offer solutions to ease this transition!
Can I Get Pregnant During Perimenopause?
Yes! It sounds counterintuitive. But about 1 in 10 women entering perimenopause gets pregnant. Some chalk it up to mixing up its symptoms with pregnancy signs. But it also happens because periods are so irregular. That makes it harder to predict ovulation.
The likelihood of pregnancy decreases throughout perimenopause though. Even if you’re still getting periods, estrogen and egg quality are lower. By the late 40s chances of pregnancy drop to 5%. Still, protection is wise if you want to prevent pregnancy. Consider talking to your doctor about birth control options.
Perimenopause Tests: What to Expect
If you see your doctor with perimenopause concerns, they’ll ask about your symptoms and health history. They’ll likely give you a pelvic exam checking your uterus, ovaries, and cervix. Getting a pap test is also wise to screen for issues like cervical cancer or abnormal cell changes.
Your doctor may order blood tests too. These help confirm perimenopause by detecting hormone levels. Blood levels of follicle stimulating hormone (FSH) often increase and estrogen decreases during this transition.
Comparing levels year after year can provide insight about menopause timing. Your doctor might check other hormones too like luteinizing hormone, progesterone, and testosterone. Thyroid tests are often wise too since low-thyroid and perimenopause symptoms overlap.
Some doctors offer genetic tests to estimate when you’ll reach menopause. These confirm if you carry gene variants that cause early menopause. Talk to your doctor about whether genetic testing makes sense for you.
At-home urine perimenopause tests are also available. These aim to detect changes in FSH levels. But research shows mixed reliability. Your doctor takes many factors into account for diagnostic. Tracking your cycle and symptoms can provide just as much helpful insight to understand your transition.
You can’t halt perimenopause since it’s a natural process. But you CAN influence how smoothly it unfolds. Many women find simple healthy lifestyle measures dramatically ease the chaos!
There’s an intimate two-way dialogue between your hormones and emotions. When already on-edge from hormone rollercoasters, stress intensifies symptoms. Finding healthy ways to minimize stress makes a BIG difference in managing mood, sleep, hot flashes, and more. Practices like meditation, yoga, walking in nature, journaling, or talking to empathetic friends can help you chill out.
Quality sleep is vital for balancing hormones and coping with changes. But night sweats and anxiety often impair sleep during perimenopause. Keeping a consistent bedtime, limiting alcohol and screen time at night, and relaxing before bed with music, reading or meditation helps. Ask your doctor about supplements that aid sleep too.
Eat Healthy Fats
Hormones need fat for production and balance. Choosing ‘good’ fats from nuts, seeds, avocado, olive and coconut oil provides the fatty fuel your body craves. These also help steady erratic blood sugar which stabilizes mood and energy. Limiting refined carbs and sugar prevents hormone-disturbing blood sugar spikes too.
Moving your body most days—even just walking—has remarkable effects on perimenopause! Physical activity boosts your mood, ease anxiety, improve sleep quality, and may also reduce hot flashes. Aim for 30 minutes daily of gentle cardio like walking, swimming, or dancing. Yoga and pilates are great too. They relax your sympathetic “fight or flight” nervous system which commonly goes haywire during this transition.
Certain vitamins and herbs help compensate for declining hormones:
- Calcium and vitamin D keep bones strong when estrogen dips. Aim for 1200-1500 mg of calcium and 2000 IU vitamin D3 daily.
- B complex vitamins boost mood and energy by supporting brain chemical balance.
- Black cohosh has antispasmodic properties that may decrease hot flashes and anxiety.
- Maca root contains phytoestrogens that mildly mimic estrogen’s benefits without risks. It may relieve hot flashes, vaginal dryness, mood swings and low libido.
- Flax, chia and hemp seeds also supply hormone-harmonizing phytoestrogens. Sprinkle them on salads or blend into smoothies.
Ask your doctor about the safety of supplements if you take any medications or have health conditions. While generally well-tolerated, herbs can interact with some drugs. It’s wise to take the ‘start low, go slow’ approach with herbs—especially when also using treatment.
Mild dehydration strains your body—and even small deficits can trigger perimenopause symptoms like fatigue, dizziness, confusion, and constipation. Sipping water and herbal tea all day keeps fluid levels optimal so symptoms don’t intensify. For each cup of coffee (a diuretic) drink an extra glass of water.
Alcohol disrupts sleep and interacts poorly with waning hormones. Too much acts like a depressant aggravating mood issues during perimenopause too. If you drink alcohol, keep it to 1 drink daily max. Considerparticipating in “Dry January” campaigns to assess if less alcohol helps you feel steadier.
Between hormone shifts, vaginal dryness, burning, anxiety and irritability, your libido can take a nosedive during perimenopause. The key is communicating with your partner and experimenting. Try water-based lubricants. Increase foreplay. Explore sensuality without intercourse. Changing positions avoids pain. Read sexy lit erotica together. Most importantly, stay intimatethrough hugging, kissing and sensual touch even when you don’t feel like sex.
Medical Solutions for Perimenopause Symptoms
If healthy lifestyle measures aren’t providing sufficient relief, consider adding some medical solutions. There are prescription and over-the-counter options.
Taking estrogen or progesterone pills, using creams or gels, getting pellet implants, or using skin patches replaces declining hormones. Adding “systemic” hormones that circulate in your bloodstream provides the most complete relief. But oral hormones also carry some health risks too especially if used long-term.
Lower dose vaginal estrogen creams, tablets or rings provide benefits locally without whole-body risks. These relieve vaginal dryness and discomfort during sex without boosting your overall estrogen level much. This focused approach works when vaginal problems are your main struggle.
Talk to your healthcare provider about balancing hormone therapy benefits and potential risks. You’ll discuss your symptoms, health history, risks for blood clots, stroke and certain cancers. Starting hormones before age 60 or using them less than 5 years reduces risks. Weighing quality of life issues guides the decision too.
Birth Control Pills
Many doctors prescribe low-dose estrogen birth control pills for a few years to smooth perimenopause. These pills regulate cycles and stabilize estrogen levels. Often PMS symptoms, heavy periods, and hot flashes improve a lot. The hormones also provide reliable contraception.
Some newer experimental birth control pills, like a pill called Lo Loestrin, contain just 10 micrograms of estrogen. Such “ultra-low” doses make side effects and health risks less likely compared to traditional “low dose” pills with 20-35 micrograms estrogen.
Other Medical Options
Beyond hormones and birth control, several other medical therapies reliably improve perimenopause symptoms:
- Antidepressants like low-dose SSRIs ease hot flashes, night sweats, and mood issues. Paroxetine (Brisdelle) is the first non-hormonal hot flash treatment approved by the U.S. Food and Drug Administration (FDA)
- Gabapentin is an anti-seizure drug that stabilizes nerve signals and prevents hot flashes too.
- Clonidine reduces hot flashes and night sweats for many women and also aids sleep.
Of course everyone is different. It often takes some trial-and-error under your doctor’s guidance to discover the best solutions for your unique situation. But between proven lifestyle tweaks and medical options, you can ensure perimenopause doesn’t have to knock you off track! There are solutions to stay healthy and thrive through this change.
Take Control: Your Perimenopause Roadmap
Perimenopause marks the transition into the liberating and wise Crone years. But the chaos and uncertainty of changing hormones means it doesn’t always feel so empowering! The huge value lies in understanding what unfolds, why it happens, and how to remedy tough symptoms.
You’ve now got that insider guide to perimenopause. Arm yourself with the right information and solutions for your personal situation. That allows you to ride the ups and downs smoothly so you flourish through perimenopause! Here’s a quick roadmap:
- Get savvy about what marks normal vs problematic symptoms to know what warrants medical care. Tracking your cycles and symptoms helps you learn your patterns too.
- Tend to a healthy lifestyle daily through eating clean, exercising, chilling out, and getting enough sleep. Supplements can optimize your foundation.
- Communicate with your doctor early about significant symptoms bothering you so you can proactively address them together.
- Consider adding hormone therapy, medications, or other medical relief when symptoms disrupt your quality of life.
- Surround yourself with supportive people who understand this transition, so you don’t feel alone or defective!
- Most importantly, be extremely compassionate, patient and loving with YOURSELF every step of the way. This too shall pass and better times await!
Staying upbeat and proactive allows you to move through perimenopause feeling healthy and strong. And that confidence sets you up for an incredible journey into the second half of life!