Sometimes it seems like the only constant in women’s health is change. From the first signs of puberty, to potential pregnancy, to menopause, our bodies are perpetually undergoing shifts and developments. If you’re a woman of a certain age, or a woman approaching a certain age, you may know that perimenopause — the transitional stage between menstruation and menopause — comes with symptoms and signs of its own. Just like any biological process, the perimenopausal stage may present differently for different women, but there are usually some tell-tale signs that perimenopause is ending and menopause is about to begin. Read on to learn more about these signs so you can be aware of the changes happening in your body.
What is perimenopause?
Mayo Clinic defines perimenopause as the time during which your body transitions into menopause. During this time, estrogen — the hormone most closely associated with female sexual reproductive health — fluctuates unevenly, causing a variety of uncomfortable symptoms. Most women experience this transition in their 40s or 50s, but some can start in their mid-30s. Menopause education website Evernow notes that those who smoke cigarettes may experience the onset of perimenopause earlier than those who do not.
Are perimenopause and premenopause the same?
You may be wondering — what’s the difference between perimenopause and premenopause? They both happen before menopause, after all. The University of Pennsylvania clarifies the difference between the two: Premenopause is the stage that occurs between the first menstrual period and perimenopause, and perimenopause, which lasts about six years, is the stage right before menopause, when menstrual periods cease, and women are no longer fertile. Women can still get pregnant during perimenopause, but due to a decreasing number of eggs in the ovaries as women age, the chances of pregnancy decrease. It’s important to check with your doctor if you’ve missed a period to determine the cause.
What are the symptoms of perimenopause?
There are two stages of perimenopause, says Women’s Health San Antonio. Early perimenopause, which usually occurs between ages 35 and 42, and late perimenopause, which typically starts between 45 and 50. The University of Pennsylvania notes that, in general, women with either stage of perimenopause may experience:
- Increased acne
- Night sweats
- Heart palpitations
- Trouble sleeping
- Hot flashes
- Vaginal dryness
- Longer, heavier, or irregular periods
- Breast tenderness
These symptoms are due to varying levels of estrogen and carry certain risks with them. Perimenopause itself doesn’t cause any diseases — but a change in hormone levels, cholesterol, and blood pressure, which may occur alongside symptoms, can cause other health issues. Make sure you consult with your doctor to find the best symptom management plan for you.
What is the difference between early and late perimenopause?
In a video, women’s health expert and educator at Harvard medical school Dr. Heather Hirsch explains that because there are no tests to determine what stage of perimenopause you’re in, it’s hard to give an exact diagnosis in the moment — so retrospective diagnoses are more common. There are, however, some differences between the stages.
In early perimenopause:
- Your periods may happen closer together, in shorter or quicker durations.
- You may have changes in memory, lack of concentration, or brain fog.
- You may have increased anxiety.
In late perimenopause:
- Your periods are more spaced out and less frequent.
- You may experience some symptoms of menopause, like mood changes, night sweats, hot flashes, and more.
To watch Dr. Hirsch and see more of her content, check out her video and channel below.
What are the signs that perimenopause is ending?
Once you know you’re in it, you’re ready to be out of it. But how can you tell? Mayo clinic says that perimenopause has officially ended once you’ve gone a full year without a period — at which point, you’ve entered into menopause. Considering perimenopause lasts about six years, however, a year is a long time to wait without knowing for sure whether or not perimenopause is on its way out. While you may still experience the same symptoms you had in early perimenopause, late perimenopause may present differently. Here are some additional signs that perimenopause may be ending:
Less frequent menstrual periods: If your periods are only happening every 60+ days and you’re skipping a cycle here and there, perimenopause may be ending soon, says Evernow.
Change in menstrual flow: The ending of perimenopause is marked not only by a change in the timing of your periods, but also the consistency of flow. Madison Women’s Health says that both heavier and lighter bleeding than you usually experience can be a sign of late perimenopause.
Hot flashes and night sweats: That’s right — some of the more well-known symptoms of menopause are a tell-tale sign that it’s right around the corner, according to health blog LifeRenu. If you start to feel hot and sweaty without engaging in strenuous exercise or being in a high-temperature environment, or if you wake up drenched in sweat, you may have had a hot flash or night sweats.
Vaginal Dryness: The hormone experts at BioID note that dropping levels of estrogen can cause uncomfortable vaginal dryness that may continue into menopause. This may present as itchiness, soreness, or pain during intercourse.
Sleep issues: Night sweats can certainly disrupt your sleep, but hormonal fluctuations in late perimenopause can also make it harder to relax, fall asleep, and stay asleep, says LifeRenu.
How to Manage Symptoms
Perimenopause and menopause are normal, natural stages of life that women experience. While there is some comfort in the solidarity that you’re not alone, your symptoms are difficult and can admittedly be distressing. The Canadian Center for Menstrual Cycle and Ovulation Research provides three simple tips on managing symptoms of perimenopause:
Take time for yourself.
Self-care is not an indulgence — it’s a necessity. This means making time for things that benefit you, like exercising, meeting with friends, and getting rest and relaxation. Taking care of yourself will help keep you mentally, physically, and emotionally stable so that you can tackle whatever perimenopause throws your way.
Confide in someone trustworthy.
Hormonal mood changes, on top of grappling with a major change in your body, can be overwhelming. Talking to someone you trust — whether it’s a friend, family member, or counselor — about your symptoms, thoughts, and feelings, can help.
Talk to your doctor about medication.
Over-the-counter pain medications may help you deal with period troubles like cramping and headaches, and certain vitamins can help manage other symptoms, like hot flashes and sleep problems. Consult with your doctor to see what medications could benefit you.
Being a woman isn’t always easy, especially as you age. But no matter how difficult it can be, every age is a new opportunity, and experiencing those opportunities is a gift. As Oprah Winfrey said, “The way I see it, every year can be a brand new journey. Think about it: You get one chance to be 25, 38, 44, 61, and every age before and between. Why wouldn’t you want to experience all the wonder in each step on your path?” Enjoy every stage of life for its unique characteristics — even the ones that involve hot flashes. You’ve got this!
This content is not a substitute for professional medical advice or diagnosis. Always consult your physician before pursuing any treatment plan.