Health Topics

What is Perimenopause?

Perimenopause, or menopause transition, is the stage of a woman’s reproductive life that begins 8 to 10 years before menopause.

What is Perimenopause?

Perimenopause, or menopause transition, is the stage of a woman’s reproductive life that begins 8 to 10 years before menopause, when the ovaries gradually begin to produce less estrogen. It usually starts in a woman's 40s, but can start in the 30s as well.

Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last one to two years of perimenopause, the reduction of estrogen accelerates. At this stage, many women experience menopausal symptoms.

How long does perimenopause last?

The average length of perimenopause is four years, but for some women this stage may last only a few months. Perimenopause ends the first year after menopause (when a woman has gone 12 months without having her period).

What are the signs of perimenopause?

You will know you are transitioning into menopause when you begin experiencing some or all of the following symptoms:

  • Hot flashes
  • Breast tenderness
  • Worsening of premenstrual syndrome
  • Fatigue
  • Irregular periods
  • Vaginal dryness; discomfort during sex
  • Urinary urgency (a pressing need to urinate more frequently)
  • Difficulty sleeping
  • Mood swings

How do I know if changes in my periods are normal perimenopausal symptoms or something to be concerned about?

Irregular periods are common and normal during perimenopause. But, other conditions can cause abnormalities in menstrual bleeding. If any of the following situations apply to you, see a doctor to rule out other causes.

  • Your periods are very heavy, or accompanied by blood clots
  • Your periods last several days longer than usual
  • You spot soon after your period
  • You experience spotting after sex
  • Your periods occur closer together

Potential causes of abnormal bleeding include hormonal imbalances, birth control pills, pregnancy, fibroids, blood clotting problems or, rarely, cancer.

How is perimenopause diagnosed?

Often your doctor can make the diagnosis based on your symptoms. Blood tests to check hormone levels are rarely helpful; however, checking the thyroid status may be beneficial.

Can I get pregnant if I am perimenopausal?

Yes. Despite a decline in fertility during the perimenopause stage, you can still become pregnant. If you do not want to become pregnant, you should continue to use some form of birth control until you reach menopause (you have gone 12 months without having your period).

For some women, getting pregnant can be difficult once she is in her late 30s to early 40s due to a decline in fertility. But, if becoming pregnant is the goal, there are fertility-enhancing treatments and techniques that can help you get pregnant.

Are there treatments that can reduce the symptoms associated with perimenopause?

Many women experience relief from hot flashes after taking low-dose birth control pills (hormone therapy) for a short period of time. But, certain women should not take hormone therapy, so talk to your doctor to determine if it is right for you.

You may also feel better if you do things that enhance your general well-being, such as:

  • Exercise
  • Stop smoking if you smoke
  • Get more sleep and try going to sleep and waking up at the same time each day
  • Decrease the amount of alcohol you drink
  • Get to a healthy weight and stay there
  • Take a multivitamin supplement and ingest enough calcium
  • Drink at least eight glasses of water each day

Talk to your doctor if you are experiencing problems with your sex drive. He or she may be able to recommend a counselor or therapist to help you and your partner work through this issue.