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What You Need to Know about Perimenopause

If you are in your 40s, you may be experiencing changes such as waking up in a sweat at night, mood swings and irregular periods with heavy bleeding. You may also be wondering, “Why am I having menopausal symptoms? I’m still getting my period.” Chances are, you may be going through perimenopause.

Symptoms of perimenopause can vary greatly, so it is often challenging for doctors to diagnose. This can lead to a confusing and frustrating time for women. That’s why we’ve mapped out what you need to know about perimenopause – and, what you can do to help manage your symptoms. We hope that learning more about this topic will help you feel more comfortable about what you may be going through. And remember, your Women’s Health CT provider is here to guide you and answer any of your questions! Let’s get started.

What is perimenopause and what is the earliest sign?
Perimenopause is a common phase of the aging process that typically occurs in the early 40s or mid 30s to late 40s, well before a woman officially enters menopause. It begins when periods are still regular, but the cycle length is shortened slightly. This is due to the fluctuation of estrogen levels and low progesterone (female hormones). On average, perimenopause can last from 4 to 6 years, but can also last for 10 years or more. It ends after a woman has gone 12 months without having her period (menopause).

The stages of menopause include:

  • Perimenopause: as you know, this phase begins before menopause
  • Menopause: the permanent cessation of menstrual periods
  • Postmenopause: menopausal symptoms such as hot flashes, can decrease

How do I know if I am in perimenopause?
Since a woman’s hormones levels can fluctuate during perimenopause, it may be tricky for your doctor to make a diagnosis. However, Dr. Jerilynn Prior, endocrinologist and director of The Centre for Menstrual Cycle and Ovulation Research, says that if you have three of the first nine symptoms listed below, then it’s likely that you are in perimenopause.

Another option is to track your cycle to figure out what hormonal changes you may be experiencing. Simply record the day on which your period starts and the total number of days between Day 1 of one cycle and Day 1 of the next cycle. There are apps (like Clue and Flo) available for storing your notes, or you can mark in a calendar. You can also make a note of any symptoms. Be sure to share this information with your Women’s Health CT provider to discuss next steps.

Symptoms of may include (not all women experience symptoms):

  • Heavy flow - higher estrogen levels can lead to a heavier flow.
  • Disrupted sleep - middle of the night waking, having trouble falling asleep, waking early
  • Mood changes - new or increased feelings of anxiety, irritability or depression
  • Night sweats and hot flashes - a change in hormone levels can cause changes in our internal thermostat
  • Sore breasts - erratic estrogen levels can cause breast tenderness to occur
  • Headaches – premenstrual headaches can begin or increase during this time
  • Weight gain – the high estrogen of early perimenopause makes gaining weight more likely
  • Cramps – often times, cramps that once occurred in your 20s have returned
  • Shorter cycles – slightly shorter cycles by an average of 27 days
  • Low libido – lack of interest in sex is common
  • Vaginal dryness – this can be caused by the decline in estrogen levels
  • Brain fog – memory issues or being forgetful

You’re not alone.
Many women are most likely experiencing similar symptoms. Click here to visit Women Living Better’s website where you can take a deeper look into symptoms and see survey results from other women.

The stages of perimenopause – and how to tell what stage you may be in.
There are two stages of perimenopause, early and late. Early perimenopause typically begins when a woman is 35 to 42 years old. Late perimenopause generally begins at 45 to 50 years of age. For a detailed description of early and late perimenopause and symptoms, brought to you by Women Living Better, click here

How can I ease my symptoms?
Your Women’s Health CT provider can work with you to recommend treatment options to help ease symptoms. Some options may include, birth control pills and vitamins or herbal supplements. Life style changes such as being on a healthy diet, not smoking or drinking alcohol, getting enough rest and staying at a healthy weight can also help.

For more information about perimenopause, please contact your Women’s Health CT provider.


“Perimenopause: Rocky road to menopause,” Health.harvard.edu, September 20, 2017

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