What’s Perimenopause and How Do I Know When I’m in It?

Hot flashes, trouble sleeping, mood swings. As a capper for the years spent dealing with our periods in the first place, the many symptoms of menopause seem like the worst cosmic joke. But consider perimenopause, the stage right before menopause, when we deal with some of the emerging symptoms of menopause and our periods on top of that. How is that fair?

Perimenopause is different from premenopause. During premenopause, you’re still menstruating and have no menopausal symptoms. You may undergo slight hormonal changes, but with no noticeable changes to your body or mood.

Perimenopause typically begins 8 to 10 years before menopause, during your 30s or 40s, as your estrogen levels decrease, or fluctuate less regularly. As perimenopause progresses, decreases in estrogen become more pronounced. Perimenopause ends when menopause begins. Oh joy!

What to Expect During Perimenopause

There’s no way to stop perimenopause or menopause from happening. But knowing what to expect and understanding how to cope with it are your best defense.

Some of the symptoms you may experience during perimenopause are:

  • Irregular periods
  • Periods heavier or lighter than normal
  • PMS that’s worse than usual
  • Breast tenderness
  • Weight gain
  • Hair loss
  • Heart palpitations
  • Headaches
  • Loss of sex drive
  • Difficulty concentrating
  • Forgetfulness
  • Muscle aches

As your estrogen levels drop, you may also start to experience some of the symptoms of menopause, such as hot flashes, night sweats, depression and anxiety, mood swings, insomnia, and vaginal dryness.

What You Can Do

While you can’t reverse the changes that come with perimenopause, you can address the symptoms and take action to improve the way you feel.

  • Eat healthy. Good nutrition has always been important to feel your best, and the same holds true during perimenopause and menopause. This is the time to get serious about getting enough calcium, and to start understanding the foods that trigger symptoms like hot flashes or night sweats (lowering your cholesterol may help with this, too). Keep up the healthy habits you hopefully already have in place, like drinking enough water, moderating your alcohol consumption, and avoiding excessive junk food.
  • Exercise. Regular exercise improves your mood and your sleep, prevents weight gain, and can help strengthen bone density.
  • Practice mindfulness. Yoga and mindfulness meditation promote relaxation and good mental health at any age, but they can be particularly helpful during the transition to menopause.
  • Stay sexually active. Sexual activity increases vaginal blood flow, which helps to keep your whole endocrine system healthy.
  • Talk to your doctor. There are many treatments your doctor can recommend, ranging from over-the-counter moisturizers to hormone treatments to antidepressants.

Also, review what’s working and what’s not working for you regularly, and talk to your doctor about it. The changes you’re going through will change themselves, and what works one year may be unnecessary or counterproductive the next. Symptoms that were acute will lessen, or go away entirely. It can be hard to see the upside, but it’s there, if you look hard enough.

You’ve got this.

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