If you’re a woman in your 40s, you may experience bodily changes as you begin the transition to menopause. This transition period—which can last 3 to 5 years—is called perimenopause. Perimenopause is a natural part of life and is nothing to worry about. But it can be helpful to know what to expect.
During perimenopause, your estrogen levels fluctuate and gradually begin to drop. This continues until your monthly cycle stops. This is the time you’ve reached menopause. But in the meantime, these fluctuating hormones can cause problematic symptoms. (Healthline, 2020)
Everyone experiences perimenopause differently. The symptoms you have may not be the same ones your friends have. Some women don’t experience any physical symptoms at all except changes in their monthly period. Below are some common signs you may be transitioning to menopause:
1. Hot Flashes and Night Sweats
One of the most common symptoms that perimenopausal women experience is hot flashes. As the name suggests, hot flashes are sudden waves of body heat usually accompanied by rapid heartbeat, sweating, and reddening of the skin. These often occur in the face, head, and chest areas.
Hot flashes usually last just under five minutes and are followed by chills. When these happen at night, they can cause night sweats, which can disrupt sleep and make it difficult to get enough rest.
2. Worsened PMS and Irregular Menses
Due to the hormonal fluctuations, you may start experiencing worsened premenstrual syndrome. This may include breast tenderness caused by erratic estrogen production. You may also experience headaches, food cravings, and feelings of impatience and edginess. Because the production of progesterone is also declining during this period, there’s no softening effect to balance out the edginess. Most women begin to feel better when their period starts. (Drugs, 2020)
Speaking of periods, because our ovaries are declining in function during this time, ovulation may become erratic. This can result in changes in the menstrual flow and in the length of time between periods. You may also experience severe cramps.
If you’re experiencing persistent changes in your cycle, you may be in the early stage of perimenopause. On the other hand, if the cycle between your menses lasts about 60 days, you may be on the last stage before menopause. (WebMD, 2020)
3. Mood swings
It’s estimated that around 10% to 20% of perimenopausal women experience mood symptoms, sometimes extreme. Many factors can contribute to these, like the sleep disturbances caused by nightly sweats, hormone fluctuations, life stress, and poor overall health. If you have a history of depression, you may be at risk for mood symptoms. Your OB/GYN can help by suggesting natural and pharmaceutical remedies. Each woman is different, so what works for a friend, may not work for you. Journal your symptoms for your next visit to your doctor so a customized treatment can be made for you.
4. Vaginal Dryness and Lowered Sex Drive
Usually occurring in the later part of perimenopause, falling levels of estrogen produced by the body can result in our vagina losing lubrication and elasticity. This can cause irritation and itching and may even make intimacy painful. Low estrogen levels can leave you more vulnerable to infection while the loss of tissue tone can contribute to urinary incontinence.
Decreased hormone levels, which contribute to the feelings of tightness and pain during intimacy often result in a lowered “libido” or sex drive.
5. Weight Gain and Loss of Bone Density
Slower metabolism is another symptom caused by hormonal changes in our body during perimenopause. Because of this, you may find that your pants are starting to feel a little too tight. But you may also be experiencing transient weight gain due to increased fluid retention that happens during erratic estrogen production. (Mayo Clinic, 2019)
When to See Your Doctor
In some cases, irregular bleeding may be a sign of another underlying condition.
See your doctor if you’re also experiencing these symptoms:
- Extremely heavy flow that requires you to change your pad or tampon every hour or two
- Periods that last longer than 7 days
- Periods — not spotting — that happen more frequently than every 3 weeks
At your appointment, your doctor will ask about your medical history and about any symptoms you’ve had. From there, they may give you a pelvic exam and order tests (such as a blood test, a biopsy, or an ultrasound) to rule out more serious issues.
Menopause is often the relief of these symptoms and the end of monthly periods. It is a welcome change in our perimenopausal bodies. Some women experience these negative effects after menopause. Sometimes a hormone replacement therapy is prescribed by your doctor. Just know that you are not alone! There are even social media support groups to help you get through this time. We hope our discussion of perimenopause helps you know what to expect during the years a woman goes through “the change”.
Perimenopause. 7 May 2019, www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666
Signs You’re in Perimenopause. www.webmd.com/menopause/ss/slideshow-signs-perimenopause
“Menopause And Perimenopause Guide: Causes, Symptoms and Treatment Options.” Drugs.com, May 2020, www.drugs.com/health-guide/menopause-and-perimenopause.html
Premenopause, Perimenopause, and Menopause, June 2020, www.healthline.com/health/menopause/difference-perimenopause#outlook