Perimenopause is a term that was created to explain the years between the start of menopause (sometimes called premenopause) and menopause itself. Actually, premenopause and perimenopause are sometimes used interchangeably, but they’re not the same. You can learn more about premenopause here.

What is perimenopause?

Perimenopause, which is sometimes referred to as a menopause transition, usually begins several years before menopause. During perimenopause, a woman’s ovaries gradually begin to produce less estrogen.

Compared with a normal 28-day cycle, estrogen levels can fluctuate widely during perimenopause, which can cause irregular periods and other symptoms. As you progress through perimenopause, your body will make less and less of the hormone. However, you’re still possible to get pregnant during this time, so be sure to use birth control if you want to avoid pregnancy.

Read about natural relief from perimenopause

At what age does perimenopause begin?

Perimenopause usually starts in women who are in their 40s, although it can start during the 30s or even earlier in rare cases. The average length of perimenopause is four years, although again, the range is wide. The use of chemotherapy or undergoing ovarian surgery can cause perimenopause or menopause to occur sooner.

Some women are done with perimenopause after only a few months, yet others live through this transitional period for up to 10 years. If you are entering perimenopause and wondering how long you may be in this stage, ask your mother how she fared. This may give you a hint of what’s to be!

What are the symptoms of perimenopause?

It may come as no surprise that the symptoms of perimenopause are very similar to those of menopause. That’s because once your hormones begin to fluctuate, anything is possible! Let’s be clear that not everyone experiences all of these symptoms. In fact, many women have relatively mild to moderate discomfort during this transitional stage and live with only a few of the symptoms.

That said, here are the more common symptoms of perimenopause:

• Hot flashes and/or night sweats
• Worse premenstrual syndrome
• Reduced libido
• Tender breasts
• Fatigue
• Vaginal dryness that can cause discomfort or pain during sex
• Mood swings
• Difficulty sleeping
• Irregular periods
• Urinary urgency
• Urine leakage when you sneeze, cough, or laugh
• Headache
• Weight gain
• Changes in hair strength, texture, thickness
• Increase in heartbeat

The dividing line between perimenopause and menopause is not distinctive. You don’t have perimenopause one day and menopause the next. However, as your estrogen levels decline, you may begin to experience symptoms of menopause.

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Some additional symptoms you may experience while you are still in perimenopause include the following:

• Depression
• Irritability or anxiety
• Insomnia
• Dry skin

Another issue associated with perimenopause and menopause is a rise in cholesterol levels. The uptick in cholesterol is one reason why women in postmenopause years are at a higher risk of developing heart disease. Therefore, you should have your cholesterol levels checked every year.

We want to point out that even though irregular periods are common during perimenopause, you may want to see your doctor if you experience any of the following situations:

• Presence of blood clots in your menstrual flow
• Periods that last several days longer than usual
• Spotting between periods
• Spotting after sexual intercourse
• Periods that are occurring closer together

These situations may signal other problems, such as fibroids, endometriosis, cysts, or polycystic syndrome. Therefore, a call to your doctor is suggested to get to the bottom of these issues.

To help ease these and other symptoms of perimenopause, you might try upping your exercise routine. Physical activity not only can reduce hot flashes; it also can improve insomnia.

Other ways to deal with symptoms include doing gentle yoga, taking warm baths, avoiding large meals, refraining from drinking alcohol, and limiting caffeine

Is there a perimenopause test?

Most women don’t bother asking their doctor for a test to confirm they are entering or are in perimenopause. In fact, the diagnosis of perimenopause is typically made simply by explaining your symptoms to your healthcare provider.

However, a blood test can be done to check your hormone levels. It’s best to have several blood tests does over a period of months because the levels can change significantly during perimenopause.