What To Know About Perimenopause

Changes and uncharted waters are a normal part of life that we all must traverse, no matter how uncomfortable they make us feel. Like how having your first period sent you into a panic mode, entering menopause can make you feel it's the end of the world. In case you don't know what menopause is, it's a phase you enter after you've gone 12 months without a menstrual period, per NHS. A natural biological process, menopause usually happens in your 40s or 50s. While the official end of seemingly endless menstrual cycles should have brought us relief, exiting bloody periods and entering menopause is like jumping out of a frying pan into the fire. Apart from intense emotional ups and downs, a decline in estrogen levels during menopause also results in hot flashes, dizziness, fatigue, and muscle and joint pains.


Menopause looks like a dreadful chapter that most women are forced to embrace, but it's not like this climacteric just hits out of nowhere and throws you off your guard. Before entering menopause, you'll go through a phase called "perimenopause." According to Cleveland Clinic, perimenopause is the process where your body starts transitioning to menopause. It's like a rite of passage between premenopause and menopause, a transition from your reproductive years towards the end of them. Here's what happens when you start perimenopause.

Symptoms of perimenopause

According to theĀ Mayo Clinic, during perimenopause, the levels of estrogen in your body go up and down irregularly. The length of your menstrual cycle also fluctuates, and you may begin having menstrual cycles where your ovaries don't release eggs for fertilization. During perimenopause, most women begin experiencing menopausal symptoms such as irregular periods, hot flashes, night sweats, vaginal dryness, fatigue, brain fog, mood swings, and sleeping issues. "Typically, what starts to happen in those years prior to [when] the ovaries just stop working is that they're kind of malfunctioning, so to speak," explains professor of obstetrics and gynecology Dr. Monica Christmas (via Verywell Family). Even though your fertility declines during the perimenopause stage, you still have a high chance of conceiving because there's still a menstrual cycle during this time.


Aside from somatic effects, sudden hormonal changes brought on by perimenopause can also put women at a higher risk for depression, says psychiatrist Jennifer Payne to Johns Hopkins Medicine. Estrogen and progesterone fluctuations can lead to mood swings, which make it more difficult for women to deal with stressful situations and even trigger a depressive episode, especially for those who have already experienced chronic depression issues. Perimenopause can last anywhere between a few months for some people and four to ten years for others. Although there's no one-size-fits-all treatment for perimenopausal issues, there are solutions to help you manage these symptoms.

How to stay well during perimenopause

How you can manage your perimenopausal symptoms has a lot to do with your specific situation and medical history, so it's best to speak to your healthcare providers to explore the most optimal options for you, obstetrician-gynecologist Dr. Tamika K. Cross tells TZR. Having said that, you can still experiment with different types of medications to address specific concerns. For instance, those struggling with heavy or irregular periods might benefit from a low dose of oral contraception, cyclic progesterone, or IUDs with progesterone, Dr. Cross says. Hormone replacement therapy (HRT) and non-hormonal alternatives such as acupressure and herbal therapy can also help with easing perimenopausal or menopausal symptoms. To cope with hot flashes, dress in breathable layers to maintain body temperature, wear cooling accessories, and stay in cool temperatures.


At the same time, sticking to a healthy diet also helps to relieve your symptoms and lift your mood. According to ZOE, a well-rounded, fiber-rich diet containing lots of veggies, fruits, whole grains, nuts and seeds, fish, lean meats, and healthy fats like olive oil or omega-3 can help you manage or even prevent some perimenopausal symptoms. For instance, a Mediterranean diet or low-GI carbs foods can work wonders for reducing hot flashes, improving bone health, and keeping your mood swings in check. Meanwhile, limit the consumption of alcohol, caffeine, sugar, and processed foods, as they can make your hot flashes, mood swings, and insomnia worse.