Perimenopause: What to Know

Perimenopause is the time in your life when your levels of estrogen start to go down. Estrogen is the female hormone made by your ovaries.

Perimenopause can start 2–8 years before menopause. It can cause changes to your menstrual period.

During this time, your ovaries may or may not make an egg. In many cases, you can still get pregnant.

What are the causes?

Perimenopause is a natural change in your homone levels that happens as you get older.

What increases the risk?

• You have an abnormal growth (tumor) of the pituitary gland in your brain.
• You have a disease that affects your ovaries.
• You've had certain treatments for cancer. These include:
  • Chemotherapy.
  • Hormone therapy.
  • Radiation therapy on the area between your hips (pelvis).
• You smoke a lot or drink a lot of alcohol.
• Other family members have gone through menopause early.

What are the signs or symptoms?

• Hot flashes.
• Irregular periods.
• Night sweats.
• Changes in how you feel about sex. You may have less of a sex drive or feel more discomfort around your sexuality.
• Vaginal dryness.
• Headaches.
• Mood swings.

• Depression. This is when you feel sad or hopeless.
• Trouble sleeping.
• Memory problems or trouble focusing.
• Irritability. This means getting annoyed easily.
• Tiredness.
• Weight gain.
• Anxiety. This is feeling worried or nervous.

You can also have trouble getting pregnant.

How is this diagnosed?

• Your medical history.
• An exam.
• Your age.
• Your history of menstrual periods.
• Your symptoms.
• Hormone tests.

How is this treated?

In some cases, no treatment is needed. Talk with your health care provider about if you should get treated.

• Menopausal hormone therapy (MHT).
• Medicines to treat certain symptoms.
• Acupuncture.
• Vitamin or herbal supplements.

• Heart disease.
• Breast cancer.
• Blood clots.
• Diabetes.
• Osteoporosis.

Follow these instructions at home:

Eating and drinking

• Eat a balanced diet. It should include:
  • Fresh fruits and vegetables.
  • Whole grains.
  • Soybeans.
  • Eggs.
  • Lean meat.
  • Low-fat dairy.
• To help prevent hot flashes, stay away from:
  • Alcohol.
  • Drinks with caffeine in them.
  • Spicy foods.

Lifestyle

• Do not smoke, vape, or use nicotine or tobacco.
• Get at least 30 minutes of physical activity on 5 or more days each week.
• Get 7–8 hours of sleep each night.
• Dress in layers that can be taken off if you have a hot flash.
• Find ways to manage stress. You may want to try:
  • Deep breathing.
  • Meditation.
  • Writing in a journal.

General instructions

• Take your medicines only as told.
• Keep track of your periods. Track:
  • When they happen.
  • How heavy they are.
  • How long they last.
  • How much time passes between periods.
• Keep track of your symptoms. Track:
  • When they start.
  • How often you have them.
  • How long they last.
• Use vaginal lubricants or moisturizers. These can help with:
  • Vaginal dryness.
  • Comfort during sex.
• You can still get pregnant if you're having any periods. Make sure you use birth control if you don't want to get pregnant.

Contact a health care provider if:

• You have a very heavy period or pass blood clots.
• Your period lasts more than 2 days longer than normal.
• Your period comes back sooner than 21 days.
• You bleed after having sex.
• You have pain during sex.
• You have pain when you pee.
• You get very bad headaches.
• You have trouble with your eyesight.

Get help right away if:

• You have chest pain.
• You have trouble breathing.
• You have trouble talking.
• You have very bad depression.