Symptoms Of Perimenopause

Topics covered

What Does Perimenopause Mean?

Average Age For Perimenopause

Dealing With Perimenopause Hot Flashes

Menstruation Changes During Perimenopause – What's Normal And What's Not

Perimenopause, Birth Control, And The Pill As A Symptom Reliever

Perimenopause Symptoms And Natural Treatments

Treating Mood Swings During Perimenopause

Weight Gain And Perimenopause

What Are The Symptoms Of Perimenopause?

What Does Perimenopause Mean?

You may have thought you were going crazy at first. Your body seemed to be working against you and your mind wasn't far behind. Be assured there is nothing wrong, it’s just a stage of life called perimenopause, and this may be your time.

What is Perimenopause?

For hundreds, even thousands, of years, women's health was neglected and led to early death in many cases. But in this new enlightened age, the importance of women’s health has put issues like perimenopause on the front burner. Now, not only do women understand their bodies better, but health care practitioners are taking women's issues more seriously.

Perimenopause is the transitional stage between reproduction and menopause. We all know about menopause. We may have lived through the turmoil with our mother or grandmother. The topic may not have been discussed, but we knew something was happening and things weren't quite “normal” anymore. There were mood swings, cooling fans, even tweezers kept handy.

This period (pardon the pun) can be a worrisome time for women. The perimenopause stage can last for a few years or even ten to fifteen years before it is officially declared you have entered menopause. The length of time depends on the individual woman. Perimenopause is to be taken seriously since the symptoms can be of concern for many years and at times can be debilitating.

During perimenopause you will still have a menstrual cycle, albeit erratic. You may have been on a regular cycle of every 28 to 30 days during your reproductive stage. During perimenopause you might get a period every 14 days or every 60 days, and then again not for 6 months. Changes in hormone levels of estrogen and progesterone can be blamed for this sketchy cycle, as well as other symptoms experienced by women who are in the perimenopause stage.

Officially perimenopause is not over until a woman has gone twelve consecutive months without a menstrual period. It is crucial to know this because there are many “late in life” children born to parents who thought that perimenopause was actually menopause. These two stages in a woman's life are very different.

Birth control is still highly recommended during perimenopause. Because the menstrual cycle is so erratic, there is no guarantee when fertility is occurring, how often, or if all. In other words, you can get pregnant during perimenopause.

Average Age For Perimenopause

All women are different. We may go through the same phases in life, but how soon or late, and for how long depends on the history of other women in our family. Perimenopause transitions us into the time when we will stop producing eggs and pregnancy possibilities are a thing of the past; the time called menopause.

During perimenopause, women often experience a wide variety of symptoms from hot flashes to headaches to mood swings to hair loss to hair in the wrong places to weight gain to... well you get the point. For many women the real question is when can you expect all of this to occur.

The Truth about the Image

The thought of menopause can conjure up all sorts of undesirable images. You may picture a shriveled old woman with a cane and chin hairs. You may think of a humped back and a wobbly cane. Surprisingly, that menopausal woman is a caricature and most women today are neither shriveled or wobbly  As a matter of fact, during the perimenopause stage, you may be feeling the best you've ever felt!  But, how do you know when perimenopause starts?

There are many factors that can influence at which age you may begin to experience perimenopausal symptoms. Some are early and some are late. The best thing you can do for yourself is be prepared. Take a look at the following indicators in order to get yourself ready:

Family history – This is an indicator of onset of menses as well as perimenopause and menopause. Girls who menstruate early (around age 10 to 12) do so because other women in their family also started early. If your mother was 55 before she entered the menopause stage, then chances are you will be about that age also. This is not always the case but is a good indicator.

No offspring – Women who do not give birth may see an earlier timetable for the stage of  perimenopause. The lack of increased hormones during birth may have something to do with it.

Hysterectomy – This surgery is not performed as often as it once was because alternative treatment methods are more readily used. But when the uterus is removed alone or with the ovaries, hormonal changes occur. This process can contribute to early perimenopause and menopause.

Smoking – If you currently smoke, please quit. Cigarette smokers begin perimenopause one or two years earlier than the average non-smoking woman. Along with that, there are real health hazards attributed to cigarette smoking regarding blood clotting and other diseases during the maturing years.

Cancer treatments – Any radiation or cancer therapies can alter the normal hormonal levels and lead to an earlier than expected perimenopausal time or menopause.

The time for perimenopause is not set in stone for any woman. Many factors can increase or decrease your time of perimenopause, whether environmental or hereditary. Look at all the factors that will contribute to the age you will enter the perimenopause stage and educate yourself.  This is always the best defense against the unexpected – be prepared.

What Causes Perimenopause?

The answer is simple. Nothing really causes it. Just like nothing causes puberty. The body transitions into different stages throughout life. Perimenopause occurs as we move from our reproductive years to our non-reproductive years. There is no mystery, just patience as we move through this stage.

Perimenopause is likened to puberty by many. This is with good reason. The hormonal fluctuation is similar as are the symptoms; erratic periods, mood swings, sleeping disturbances, and blemishes. Many women report similar feelings during perimenopause as during puberty and knowing that, just like puberty, this is temporary, helps them get through this time is their life.

Perimenopause can be a scary time for women. Even though we're still visiting the “feminine protection” aisle in the store, we can't be sure when, or if, our next period will arrive. Along with that, we're experiencing hot flashes, night sweats, irritability, confusion, weight gain, and sometimes even pimples! Take heart; this stage is temporary, just like puberty. With understanding and some tender-loving-care, you'll get through this stage and be ready for the next!

Menstruation Changes During Perimenopause – What's Normal And What's Not

Unlike menopause, perimenopause doesn't keep you out of the feminine products aisle; in fact, you'll be standing there scratching your head wondering what to choose. Once you enter menopause, you will be able to stop wearing pads and tampons every month. During perimenopause, it's another story. You will still have periods, but they will most likely become erratic, unusual, and definitely unpredictable. Here are some things that you need to know about the perimenopausal time of life and what to expect with your period:

Preparing for the Unknown

During perimenopause, your hormone levels begin to fluctuate. Estrogen and progesterone seem to be going off the rails. This can result in changes in your menstrual cycle; changes which can have you wondering if you've gotten the date wrong again, if your period will ever stop, or start, or if you'll ever be able to leave the house without an arsenal of pads, tampons, and panty liners.

A typical cycle is 28 days with anywhere from three to five days of active discharge. When you hit the transition called perimenopause, you may have a period every 14 days, or not again for 2 to 3 months, or more. Your actual discharge may last from five days to two weeks. During perimenopause, your period is totally unpredictable.

The type of bleeding is also variable. Some women go from a normal cycle to one where they have light spotting for three or four days. That can change from month to month. You may be gushing one month and spotting the next. You could also experience heavy flow so severe that you may need to call your doctor.

When to Consult your Doctor

If you experience the following, talk to your doctor:

Heavy bleeding where you are changing pads each hour.

Heavy bleeding with thick blood clots.

Heavy bleeding combined with pain and cramping.

Bleeding between periods, no matter how light, even spotting.

Bleeding more than eight days in a row.

More than one period a month.

Even though heavy or unusual bleeding and discharge may be just a symptom of perimenopause, your doctor will want to discuss these symptoms as they can be signs of other problems. A physical exam and diagnostic tests could reveal fibroids, endometriosis, cysts, or predisposed cancerous conditions. Your doctor can advise you on the best course of treatment if one of these is your diagnosis. One such procedure is called endometrial ablation. You may, however, be prescribed hormones or birth control pills to even out the uneven hormone assault to get your periods in line again.

Be especially alert of any changes in you menstrual cycle during the perimenopause stage and stay informed. This stage in your life doesn't have to be confusing and frightening as long as you know what to expect. Learn everything you can about your changing body - this is the best thing you can do for your health!

What is a Hot Flash?

Dealing With Perimenopause Hot Flashes - Hot Flashes And Night Sweats

No, it's not a firefighter's term. A hot flash doesn't involve a fully involved fire. Unless, of course, you are a woman experiencing a perimenopausal hot flash. Then, you could argue that, yes, you have been fully involved with this “facial fire.” Until you’ve had a hot flash you can't comprehend what it really is or how it can make you feel.

For those who have struggled with hot flashes, it is not a flush or a blush. It can be described as if you are sitting on a plate under the heating lights in a restaurant kitchen.

Hot flashes are uncomfortable for several reasons. There is no way to put the fire out; you sit there burning up without any relief, even though you normally will grab the nearest thing you can find to fashion a fan. Until the hot flash passes you deal with heat plus the fact that your face is turning beet red. Yes, not only do you feel hot, but you look hot as well. It's a physical feeling as well as an embarrassment. Your upper lip and hairline break out in a sweat. All the world can see you're having a hot flash.

Any time day or night, in private or public, you are not safe from hot flashes. Hot flashes can wake you up out of a sound sleep and can cause night sweats. This can feel like the bedding is on fire until you break out in a sweat that douses you in a puddle of cold. You may have to get up and change the bedding and put on dry pajamas.

Preparing yourself for this unpleasantness, as well as letting those near and dear to you know about what's happening, is important to your, and your loved ones' sanity.

This whole night sweat/hot flash thing may lead to sleepless nights which in turn may create other problems in your life. Lack of sleep can cause increased stress levels, over-eating, weight gain, irritability, lack of focus and concentration, memory issues, and relationship problems. This is in addition to other symptoms of perimenopause that you are already experiencing. So, hot flashes and night sweats are not just a joke. How do we treat this problem?

Possible Treatment for Hot Flashes

There are ways that hot flashes can be lessened so you can function normally in your daily life. Consult your doctor to hear all the options. Ask about both conventional and alternative treatments. Here are a few simple suggestions:

Change your diet – What we eat has a lot to do with how our bodies react to certain conditions. With hot flashes, the name of the game is reducing the amount of processed foods, particularly carbohydrates that we eat. Switch to whole grains and fresh fruits and vegetables. Avoid sweets, caffeine, and alcohol. Some say salt and sugar are the culprits. Others say diet soft drinks are harmful. Whatever you are consuming, take a close look at it and see if what you're ingesting could be hurting your health.

Herbal supplements – Your doctor may suggest an all-natural approach to your symptoms. Hot flashes have been treated with black cohosh and red clover. Black cohosh, for example, has been used for years as a plant based remedy that can mimic some of the functions of estrogen to decrease menopausal symptoms. Doctors that specialize in alternative medicine may be able to recommend reputable suppliers of various supplements to be sure you are getting the best quality products.

As you can see, there aren't a lot of choices or options for controlling hot flashes. That's why it is so important to choose one of the few options available to you and stick to it. Hot flashes don’t have to incinerate your life. Learn to cope and reduce the effects of hot flashes with the above suggestions and your doctor’s help. Don't forget your sense of humor. Being subjected to hot flashes is not fun, but being prepared with a laugh or two can only help.

Perimenopause, Birth Control, And The Pill As A Symptom Reliever

Perimenopause is nothing if not erratic. You simply can no longer predict your period, your fertile times, or your times of ovulation. Once upon a time, you could track your reproductive cycle on the calendar like, well, clockwork. No more. 

Pregnancy in the Wings 

No matter how careful you are about charting your reproductive calendar, all bets are off.  Women take notice: until your period has ceased for 12 consecutive months, you can still get pregnant.

During this stage of irregular menstrual periods, an egg may not always be released when you have a period and you may not always ovulate, but there is no way to tell. Be sure to talk to your doctor about birth control methods to get you through this uncertain time. Birth control pills as well as other methods can be prescribed to prevent accidental pregnancy from occurring. 

Birth Control Pills Prescribed for Symptoms

The oral contraceptive pill can be useful in dealing with certain symptoms of perimenopause. If you are a busy and active woman, having a period that you can’t predict is worrisome. Where before you were used to charting your 28 or 30 days and being prepared at the usual times, perimenopause is full of surprises.  You may get your period at 14 days or 60 days; you may experience “gushing” or “spotting” for weeks on end. You have no way of knowing what's going to happen. Birth control pills can help to regulate your periods by delivering a specific dose of hormones each day.

Another reason to take an oral contraception pill is to control vaginal dryness. This can be a problem during sexual intercourse. Many women report the act of intimacy changing from a time of pleasure to a time of pain. Restoring certain levels of estrogen and progesterone can increase vaginal lubrication, therefore eliminating or alleviating the dryness and pain.

Your gynecologist can prescribe the oral contraceptive that is right for you, whether it is strictly to prevent pregnancy or to alleviate other symptoms. Remember that just like other medications, oral contraceptives have side effects for women, especially those who are over 35. Check with your doctor about all side effects and talk frankly about your smoking and/or alcohol habits as they have direct correlation to dangerous side effects.

Remember: One entire year without a period means you in menopause; not nine months, six months, or even eleven months.  Write down each and every period during this time and check with your doctor often.  You may go nine months without a period and think you're on your way to menopause when, bam!, you've got another period.  That means you start the count over – and every time you get a period, the count starts again, no matter how long between periods.  Yes, if you start your period on December 31 and you go all the way until December 30 the next year and have another period, you start the 12 month countdown over.  Sorry.  That's the safest way.  If you get to December 30 of the next year without a period, you are officially in menopause.

If you are practicing birth control now, don’t stop when perimenopause starts. This is a mistaken notion; just because your period hasn't shown up for a few months doesn't mean you're “safe.”  There are many women who go nine, ten, or eleven months without a period and then are surprised with one or two last periods.

Always discuss the benefits and risks of birth control methods with your doctor during perimenopause.  This can be a very confusing time for women as their body is changing as much as it did during puberty.  Be aware of the changes and take all the precautions necessary to ensure your continued good health during this confusing, but wonderful time of life.

Perimenopause, Menopause, and PMS

Treating Mood Swings During Perimenopause

When you first start having perimenopausal symptoms, you may not put two and two together; after all, you're too young to be going through menopause. The changes in your body can confuse you and drive you to distraction. It is not uncommon to be confused and for mood swings to occur. If you are experiencing episodes that you don't understand such as extreme mood swings, there are treatment options.

Mood swings can have many causes. Sleep patterns may be interrupted by night sweats or hot flashes. Studies show that when a person doesn't get enough sleep each night, episodes of irritability, lack of focus, and extreme stress may occur. Along with these symptoms, your immune system weakens because the body is not getting the downtime it needs to repair and restore from the day’s activities.

Mood swings can be brought on by difficult or changing situation in your life. A normal interaction with a child who asks for something repeatedly can pluck that last nerve and send you screaming out of the room. A cross word can send you into tears. An extra project at work combined with sleep deprivation can lead to poor work performance and/or missed deadlines.

It can seem like everything has gone to hell in a hand basket in no time at all. This slow descent into the abyss we call stress can lead to depression in many perimenopausal women. Not being able to get a handle on the symptoms leaves you in a vulnerable state without your normal coping mechanisms you've relied on during all those “normal” years.

Treatment Options

You are not alone in your despair. There are many options for treating this very common part of perimenopause:

Support – This can be a group sponsored by your doctor, church, hospital, online group, or simply a group of friends who are also going through the same situation. Talking with others about your symptom can ease the burden. Women experiencing the same things may also be able to suggest ways that may help you cope better.

Meditation – Taking time out in a quiet place to listen to your inner self can help you prepare for the day with a full suit of armor. Yoga is a type of meditation that also involves body stretches which prove to increase your fitness level and that mind-body connection.

Exercise – There's a reason exercise keeps coming up. Exercise is great for a variety of ailments. Physical activity increases oxygen levels in the brain and also releases the body’s natural antidepressants; endorphins. You think more clearly, experience greater mobility, and relieve tension and stress with exercise. That is why exercise is mentioned so often.

Antidepressants – There are many reasons why antidepressants are prescribed; some reasons are obvious, while others, not so much. There are antidepressants which actually have helpful side effects which benefit perimenopausal symptoms; such as sleeplessness.  Your doctor may prescribe antidepressants for many different reasons, for instance, to help you cope with mental and physical changes that are causing quality of life problems. You don’t have to stay on antidepressants forever. Your doctor will help you wean off  the antidepressants when you and your doctor feel you are ready.

Mood swings can be managed during perimenopause even though you might not think so right this minute. You do not have to suffer alone.  Ask your doctor for information regarding the current research on ways to fight mood swings during this stage in your life.

Perimenopause Symptoms And Natural Treatments

Make no mistake; all women who experience perimenopause will be confused and will be looking for all the relief they can get. Even though you are experiencing this phase in your life, you don't have to suffer alone. There are many treatments available to you, including many natural treatments. Let's look at a few:

Lifestyle Changes – The Most Natural Remedy Of Them All

We don’t often understand how much of what we choose to do has a bearing on how our bodies react to the natural aging process. What we choose to do is what we call our “lifestyle.”

A lifestyle some people choose, for instance, is smoking. Smoking can cause lung cancer, respiratory illnesses, colon cancer, high blood pressure, slow healing times after surgery, and early onset of perimenopause and menopause. This is how just one lifestyle choice affects health.

By taking steps to change how we live our lives, we can increase our enjoyment of life and the quality of life we all hope to enjoy.

Here are some lifestyle changes that can make this transition in your life more bearable:

Quit smoking – We have already touched on this somewhat. However, if you're not convinced yet, go on the American Cancer Society website to see just how smoking affects all the systems in your body. Not worried about your lungs, keep reading. Smoking causes systematic deterioration that will surprise you.

Get sleep – Certain symptoms can hinder your sleep process, but you need to try to get at least 6 to 8 hours of sleep a night. These hours will help keep you focused and able to fight the symptoms that you are having. I know it seems on oxymoron; I can't sleep because of night sweats, but I need sleep to combat my night sweats. Do ALL the prescribed sleep methods (dark room, sound machine, rituals, etc.) as well as medication if need be to get that sleep.

Eat natural foods – Soy products contain plant-type estrogen that can boost falling estrogen levels and minimize the resulting symptoms. Eat tofu, soybeans, and other natural, whole foods to boost your estrogen naturally during this transition time.


A doctor who specializes in homeopathic medicine and is open to alternative treatments can suggest to you what to take and where to get it. Here are some of the more common alternatives used currently and how they help:

Black cohosh - This is an herb that is part of phytotherapy (using herbs and roots for alternative medicinal purposes). It can mimic what estrogen does in the body and reduce the incidence of night sweats and hot flashes, which can be particularly brutal.

Red clover – This clover helps with night sweats and hot flashes. To a lesser degree, tests are indicating that there may be improvements in bone health with this plant. Watch for this treatment in the news as it becomes more widely accepted.

Evening primrose oil – This particular supplement can be instrumental in reducing breast tenderness. Flaxseed and black current oil are also in this category.

St. John’s Wort – This has been used for years as a mood enhancer. If mood swings are your problem, a little of this can even out your moods and help you feel normal once again.

Ginseng – This increases energy levels when suffering from fatigue. Many women report feeling revitalized while taking ginseng.

Before you agree to artificial hormone replacement therapy (HRP), take a look at what natural remedies can help you with your perimenopausal symptoms. Remember to talk to your doctor before taking any supplements no matter how natural they are. Research everything available and educate yourself on all the possibilities of natural healing remedies.

The 3 Things Every Woman Must Know About Perimenopause

What Are The Symptoms Of Perimenopause?

We all know what menopause is. But, there is a transition phase before menopause. Many women who are experiencing symptoms find it unsettling to associate those symptoms with menopause because they don’t think that they are old enough for menopause.

They may be right. Menopause is the cessation of menstruation, and these women haven't stopped having their period yet, although it could be getting sort of erratic.

Perimenopause begins when periods start to become irregular on a regular basis (now that's a conundrum). This stage may continue for years, even 10 years or more. During this time, there are other symptoms that indicate perimenopause is taking place.

Symptoms of Perimenopause

Yes, perimenopause does exist and can begin as early as the mid-30s and last until the mid to late 50s depending on family history and other factors. If you are experiencing any of these symptoms, you may have reached this phase of your life.

Irregular menstrual periods

Mood swings

Hot flashes

Night sweats

Vaginal dryness

Decreased sex drive


Bone loss

Decreased fertility

High cholesterol

Weight gain


Heart palpitations

Difficulty sleeping

Urinary incontinence or urgency

Yes, that's quite a long list. Occurring alone, any one of these symptoms could be a sign of another condition. Together, however, they often bring perimenopause to mind.


There is no definitive diagnostic test for perimenopause. Your doctor will take down your medical history as well as the symptoms that have brought you to the office. Your doctor will ask a series of questions to get a better idea of what’s going on; the questions may follow these lines:

How long have you had these symptoms?

How old are you?

How old was your mother or grandmother when they began menopause?

Are you still having menstrual periods?

How have your menstrual periods changed?

Knowing the answers to these questions and notating other issues that have been bothering you will make it easier for your doctor to come up with an idea of where you are in the perimenopause and menopause schedule.

Many symptoms of menopause are not problematic. Some women don’t even consult a physician. But, if any symptom seems to be disrupting the flow of your life and you can’t seem to get it under control (like hot flashes and insomnia), make an appointment to talk to your doctor about possible solutions.

Weight Gain And Perimenopause

One symptom of perimenopause is unexplained weight gain. Even in women who have never battled weight in their entire lifetime, all of a sudden, weight becomes an issue.

When first exhibiting signs that you think are typical of menopause, you are not menopausal. This erratic stage is actually called “perimenopause.”  Your hormones begin to behave erratically and do all sorts of strange things which bring on these symptoms that make you feel crazy inside. 

The two hormones in question are estrogen and progesterone. They are the sexual reproductive hormones that you first met in puberty. During puberty, these two hormones control egg production and release and building up the uterine lining in preparation for a baby. During perimenopause these two hormones start to slowly, and erratically, wind down. What was once predictable, the crisp start and stop of each period, becomes cloudy, untimely, confusing, and generally confusing.

These two hormones are slowing down and that signals another slow down – your metabolism. This change in your metabolism may creep up on you. You may have always enjoyed a donut every morning with your coffee and all of a sudden it seems that you can't even eat a cracker with your pants getting tight.  You aren't eating any more than usual, but you're seeing weight gain where you never did before; most notably in your middle. You are not alone.  

Ways to Combat Weight Gain

You don’t have to accept that late-in-life weight if you are prepared to fight. Here are some ways to combat it and also lessen the severity of perimenopausal symptoms.

Eat a healthy diet – Getting the nutrients you need from your food is the best way for the body to utilize those nutrients. Vitamin D and calcium work together to increase bone strength and help you stay slim and trim. Try low fat dairy products packed with Vitamin D and calcium. Also increase fiber intake and choose sensible fats like olive oil and salmon.

Get plenty of exercise – To remain vibrant and independent as you age, exercise is the key. If you have been living a sedentary life, begin with 30 minutes three days a week and move up to six days a week and 45 to 60 minutes of physical activity. The important thing is to choose something you like to do and stick with it.

Stress management – We often eat out of boredom or stress. Overeating is easy when you are stressed as eating and food are comforts. Look for comfort in activities like yoga, anger management, relaxation techniques and even family gatherings. Exercise is also a big stress buster.

You can lower your chances of mid-life weight gain by using the suggestions above. Perimenopause is not the end of a good life and it doesn't have to be the beginning of an expanding middle.  Rather, you can view perimenopause as a gateway into a new phase in your life.

More by this Author

  • Indian toilets: How To Use An Indian Toilet

    It is said that when travelling in India it's generally best to stay away from the use of public toilets as they would have Squat style toilets. The toilets in the hotels would frequently provide Western...

Comments 1 comment

HERBCYCLOPEDIA profile image


What about Japanese traditional herbal medicine? Japanese use three herbs that are focused on the treatment of menopause symptoms, namely Keishibukuryogan, Kamishoyosan and Tokishakuyakusan.

They are used for both peri- and post-menopausal women. In a clinical trial with more than 1,500 women, these herbs improved subjective sleep disturbances, alleviated perspiration, and reduced systolic/diastolic pressure and heart rate.

    Sign in or sign up and post using a HubPages Network account.

    0 of 8192 characters used
    Post Comment

    No HTML is allowed in comments, but URLs will be hyperlinked. Comments are not for promoting your articles or other sites.

    Click to Rate This Article