Perimenopause means "around menopause" and refers to the time period during which a woman's body makes its natural transition toward permanent infertility (menopause). Perimenopause is also called the menopausal transition.
Women start perimenopause at different ages. You may notice signs of progression toward menopause, such as menstrual irregularity, sometime in your 40s. But some women notice changes as early as their mid-30s.
The level of your estrogen — the main female hormone — rises and falls unevenly during perimenopause. Your menstrual cycles may lengthen or shorten, and you may begin having menstrual cycles in which your ovaries don't release an egg (ovulate). You may also experience menopause-like symptoms, such as hot flashes, sleep problems and vaginal dryness. Treatments are available to help ease these symptoms.
Once you've gone through 12 consecutive months without a menstrual period, you've officially reached menopause, and the perimenopause period is over.
During the perimenopausal period some subtle — and some not-so-subtle — changes in your body may occur. Some things you might experience include:
When to see a doctor
If you do experience symptoms that interfere with your life or well-being, such as hot flashes, mood swings or changes in sexual function that concern you, see your doctor.
As you go through the menopausal transition, your body's production of estrogen and progesterone rises and falls. Many of the changes you experience during perimenopause are a result of decreasing estrogen.
Menopause is a normal phase in a woman's life. But it may occur earlier in some women than in others. Although not always conclusive, some evidence suggests that certain factors may make it more likely that you start perimenopause at an earlier age, including:
Irregular periods are a hallmark of perimenopause. Most of the time, this is normal and nothing to be concerned about. However, see your doctor if:
Signs such as these may indicate the presence of an underlying problem with your reproductive system that requires diagnosis and treatment.
Preparing for your appointment
You'll probably start by discussing your symptoms with your primary care provider. If you aren't already seeing a doctor who specializes in the female reproductive system (gynecologist), your primary care provider may refer you to one.
What you can do
Some basic questions to ask include:
Questions your doctor may ask
Tests and diagnosis
Perimenopause is a process — a gradual transition. No one test or sign is enough to determine if you've entered perimenopause. Your doctor takes many things into consideration, including your age, menstrual history, and what symptoms or body changes you're experiencing.
Some doctors may order tests to check your hormone levels. But other than checking thyroid function, which can affect hormone levels, hormone testing is rarely necessary or useful to evaluate perimenopause.
Treatments and drugs
Drug therapy is often used to treat perimenopausal symptoms.
Before deciding on any form of treatment, talk with your doctor about your options and the risks and benefits involved with each. Review your options yearly, as your needs and treatment options may change.
Lifestyle and home remedies
Making these healthy lifestyle choices may help ease some symptoms of perimenopause and promote good health as you age:
In addition to conventional therapies, many women transitioning toward menopause want to know more about complementary and alternative approaches to treating symptoms. Researchers are looking into these therapies to determine their safety and effectiveness, but evidence is still often lacking.
Some of the options studied include:
Low-risk complementary therapies, such as acupuncture, yoga and paced breathing may help reduce stress and improve psychological well-being. However, research on the ability of acupuncture and exercise to decrease hot flashes is inconclusive. There is evidence that relaxation helps reduce stress, which may in turn help improve symptoms of hot flashes.
Talk with your doctor before taking any herbal or dietary supplements for perimenopausal or menopausal symptoms. The FDA does not regulate herbal products, and some can be dangerous or interact with other medications you take, putting your health at risk.
Last Updated: 2013-04-20
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