Perimenopause begins sooner than you think 

“Menopause doesn’t happen until your 50s,” your mom told you. So, then, what’s the deal with these hot flashes, night sweats, crazy changes in your periods and feelings of depression and rage, you wonder?  

Well, what your mom probably didn’t tell you is that those are perimenopause symptoms, and they can start up to 10 years before menopause. 

What is perimenopause?  

Natural menopause is defined as going 12 months without a period, and perimenopause is the time leading up to that. During this time, your hormones are changing, and the drop in estrogen is driving much of what you’re experiencing, including physical symptoms, emotional changes and perimenopause weight gain.  

Every woman is different, but the average age of menopause in the U.S. is 52. Women’s experiences with perimenopause vary as well. Some have severe symptoms, while others barely notice it’s happening. How long it can last ranges, too, but perimenopause symptoms can start sooner than you might realize. So, if you’re in your 40s, it’s smart to be aware of what to watch for.

“Perimenopause is a whole-body transition with various symptoms but these are temporary and mild- moderate for many,” says Vidhi Shah, M.D., an internal medicine doctor with Sutter. “Hormonal and non-hormonal options for treatments are a game changer.”  

Perimenopause symptoms

There isn’t a test you can take that tells you that you’re in perimenopause. For many women, the first sign of this transition is a change in their menstrual cycle. As ovulation slows, you may notice shorter cycles or an occasional skipped period. Your periods might become shorter or longer, and they might be heavier or lighter than usual. Because there is so much variation in what women experience, the key thing to watch for is a change in your normal.

Other common perimenopause symptoms include:

• Brain fog and forgetfulness
• Changes in cholesterol levels
• Having to pee more frequently
• Hot flashes
• Insomnia or other sleep problems
• Less interest in sex
• Lower bone density
• Mood swings, irritability, depression
• Night sweats
• Vaginal dryness  

Some women also experience perimenopause weight gain, as hormone changes slow your metabolism.  

Managing perimenopause symptoms

Getting through this time in your life feeling your best may require a combination of lifestyle approaches and medical therapies. At home, you can:

• Avoid screen use before bed to improve sleep quality
• Dress in layers to help make it easier to cope with hot flashes
• Eat a healthy diet that includes lean protein, fruits and veggies, whole grains and healthy fats
• Find healthy ways to manage stress, such as meditation and breathing techniques
• Get plenty of physical activity, including walking and strength training
• Keep the temperature at home cooler or use a fan
• Limit your caffeine intake
• Quit smoking and other tobacco products, and avoid or limit alcohol 

When to talk to your provider

If your perimenopause symptoms are affecting your quality of life, talk to your provider. Medications can help with different symptoms. For example:  

• Antidepressants to help with mood swings, depression or anxiety
• Hormone therapy to combat dropping estrogen
• Medications for hot flashes and overactive bladder
• Vaginal creams and lubricants to help with dryness and pain during sex

Most women will experience some combination of perimenopause symptoms. Your provider can help you determine the best approach for managing your symptoms so that you can feel your best, while balancing the risks and benefits of these therapies.