How Do I Know If I’m Starting Perimenopause?

We always tell patients that irregular periods are never “normal.” However, there are a couple of exceptions to that. The first is when you’re pregnant, and the second is when you start perimenopause.

Perimenopause: The Precursor to Menopause

Did you know that what most people refer to as menopause is actually perimenopause? You arrive at official menopause when you haven’t had a period for twelve consecutive months. The majority of “menopause symptoms” are the symptoms of perimenopause, and they begin to regulate again after menopause.

Perimenopause is the name for the years leading up to menopause, when hormone levels begin to fluctuate, signaling a decrease in ovulation and the eventual end of female fertility. As with menstrual cycles and female reproduction in general, every woman is different. But on average, most women achieve menopause between ages 48 and 58, with the average age being 51.

7 Signs of Perimenopause

If you are 40 years old or older, the following are signs you may be in perimenopause. Always mention any changes in your menstrual cycle, moods, or sleep patterns to your OB/GYN at the annual wellness visit. We can help you determine whether it’s perimenopause or something else.

Here are seven of the most common signs of perimenopause.

1. Having difficulty falling or staying asleep

One of the reasons healthy sleep habits are so important is that our bodies produce and regulate hormones during those hours. During perimenopause, hormone balances are upset due to decreases in estrogen and progesterone, and these fluctuations can disrupt sleep.

Tips: Try to finish eating at least three hours before bedtime, avoid stimulants (caffeine, alcohol, chocolate, etc.) during the evening hours, and create a soothing bedtime ritual.

2. Night sweats

Those same hormone fluctuations cause night sweats. So, don’t be alarmed if you wake up with heart pounding and covered in sweat with the urge to rip the bedding off. This is normal, but avoiding alcohol and other stimulants can help.

3. Irritability and mood swings

Many of the symptoms of perimenopause mimic those of puberty, which isn’t surprising since hormone fluctuations are the root cause. Your spouse/partner and family members may notice your increased irritability before you do, so prepare them and devise a code word that reminds you to take a deep breath and gain some perspective.

4. Skipped or irregular periods

As we mentioned above, the reproductive system is winding down, and that includes the ceasing of your menstrual cycle. While menopause is determined when patients haven’t had a period in 12 consecutive months, you’ll notice changes in your periods for the years leading up to menopause.

This can include:

• Shorter-than-normal cycles as your body has its last fertility hurrah.
• Bleeding that may be lighter or heavier than you’re used to.
• Periods that last far shorter than normal.
• Skipped periods.

Tip: Continue using birth control throughout the entirety of perimenopause, no matter how irregular periods may be. If you’re having any periods at all, even if it’s one in four months, you’re ovulating and can get pregnant.

5. Gaining more weight than usual (and struggling to take it off)

A slower metabolism also accompanies perimenopause and menopause. This means you’ll probably put on weight faster than usual and have more difficulty losing the extra pounds.

Sticking to a reasonable anti-inflammatory diet and getting at least 30 minutes of exercise per day go a long way toward supporting weight management. Plus, healthy lifestyle changes are the most natural way to minimize perimenopause symptoms.

6. Changes in libido (and more discomfort than usual)

Sex drive is a complicated thing because it’s dependent on multiple factors. One of those is hormone balance, and as estrogen and fertility decrease, so can the sex drive. Estrogen decreases also cause thinning of skin and mucosal tissues, making the vaginal canal drier and more tender than it has been before. In addition to using lubrication, we can talk about ways to balance hormones during perimenopause, which can also boost libido.

7. Red alerts on your physical tests

Once women reach menopause, they’re more likely to be diagnosed with things like high cholesterol, high blood pressure, or pre/type 2 diabetes. So, don’t be surprised if lab results aren’t the “all clear” you’ve been used to before your late 40s. Again, healthy lifestyle changes go a long way toward supporting overall health and well-being, so now’s the time to start making good decisions about diet, exercise, and stress management if you’ve been slacking.

Northwest Women’s Clinic Supports Patients Through Perimenopause