Overview
What is perimenopause?
Perimenopause is the time of transition leading up to the final menstrual period. During perimenopause, your estrogen and progesterone levels begin a slow, irregular, and unpredictable decline. This hormonal irregularity causes you to experience symptoms such as sporadic periods and hot flashes.
Most individuals begin perimenopause in their 40s. The average transition time is four years but can last up to 10 years.
You can still get pregnant during perimenopause. If you don’t wish to become pregnant, use some type of birth control until at least 12 months after your last period.
What is menopause?
Menopause is a condition that occurs when your ovaries no longer make the hormones estrogen and progesterone. You stop having periods and can’t get pregnant naturally. Post-menopause begins 12 months after your last period.
As part of the aging process, menopause occurs in most people between ages 45 and 60, with the average being 51. Some people experience early (before age 45) or premature (before 40) menopause due to:
- Cancer treatments like chemotherapy and radiation
- Certain autoimmune diseases
- Family history of early menopause
- Surgery to remove the ovaries (oophorectomy)
- Smoking
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Most perimenopause symptoms begin in your 40s when hormone levels start declining. Perimenopause symptoms and the percentage of people affected by them include:
- Irregular periods (affects 100% of individuals)
- Hot flashes and/or night sweats (80%)
- Mood disturbance (68%)
- Sleep difficulties (60%)
- Vaginal dryness or pain with penetration (50%)
When you haven’t had a period for 12 months and entered menopause, you may still experience perimenopause symptoms plus:
- Brain fog or difficulty with concentration
- Thinning hair and dry skin
- Changes in sexual desire
- Weight gain, particularly around the abdomen (stomach)
- Decreased muscle mass
Symptoms such as irregular periods and hot flashes are the best indicators that your body is transitioning into perimenopause and menopause. Most of the time, perimenopause and menopause are clinical diagnoses, meaning labs are not required to make the diagnosis.
In some situations, your doctor may request blood tests to evaluate your levels of:
- Follicle-stimulating hormone (FSH): This hormone increases with menopause, but levels are irregular in perimenopause.
- Estrogen (estradiol): This hormone decreases with menopause, but levels are irregular in perimenopause.
- Thyroid-stimulating hormone (TSH): An underactive thyroid can mimic menopause symptoms.
After menopause, you may be at risk for certain conditions. Talk with your doctor about:
- Cardiovascular (heart and blood vessel) disease
- Osteoporosis and bone fractures
- Urinary incontinence
- Painful sex or low libido
- Unhealthy weight or prediabetes symptoms
- Cancer risk assessment
- Joint pain or stiffness
You might not know you are in perimenopause because its symptoms can resemble those of other conditions, including:
- Depression
- Premenstrual syndrome (PMS)
- Stress
Talk with your doctor when symptoms begin. They can tell you what to expect and help you manage your symptoms.
Some period-related symptoms are not normal. Contact your doctor right away if you experience:
- Heavy bleeding with clots
- Periods that last longer than ten days or occur every other week
- Vaginal bleeding after menopause (postmenopausal bleeding)
Menopause
We offer safe and effective hormonal and nonhormonal therapies to help manage menopause symptoms, including hot flashes, mood changes, and vaginal dryness.
Menopause
Perimenopause
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hormone therapy
menopause symptoms
night sweats
hot flashes
vaginal dryness
healthy aging