What Is Perimenopause?

We hear a fair bit about menopause, but perimenopause is generally not talked about as much. Read on to learn about the three phases of “the big change,” perimenopause, menopause, and postmenopause, and ways to treat and prevent some of the symptoms you might experience.

3 Stages of Menopause


Perimenopause is the period of time leading up to the menopause transition. For some women, the first sign may begin with menstrual irregularities. However, newer research shows that other symptoms of menopause frequently occur before changes in your menstrual cycle. There is no set timeframe for the perimenopause phase. It can last months or a decade or more, with the average time being four years.

During perimenopause, your estrogen and progesterone levels move up and down dramatic hills and valleys as your body gets closer to no longer ovulating. These hormone fluctuations cause most of the symptoms you might experience during perimenopause.


Perimenopause ends after 12 consecutive months without a period that is not due to another cause. When you reach this milestone, you are officially in menopause. Your ovaries no longer produce eggs, and your hormones stabilize in their new lower levels.


Postmenopause is the rest of your life after reaching menopause. Estrogen and progesterone are permanently low. Symptoms you’ve experienced during perimenopause and early to mid-postmenopause will begin to fade over time, while others, such as vaginal dryness and bone loss, will worsen.

 Unfortunately, your risk of certain health conditions associated with low estrogen increases in postmenopause, but there are plenty of strategies you can use to alleviate your risk. Once you recognize you’re in perimenopause, you can begin making small changes to your lifestyle and self-care that will help protect you in the long run.

Understanding Perimenopause 

Menstrual cycle irregularity is one sign you are in perimenopause.

Perimenopause commonly starts in your early to mid-40’s, although it can happen as early as your mid-30’s or as late as your mid-50’s.  

As you age, your ovaries start producing less estrogen while your body prepares to stop maturing and releasing eggs. This reduction in estrogen triggers changes in progesterone, LH (luteinizing hormone,) and hCG (human chorionic gonadotropin) levels as your body attempts to continue ovulating in a lower estrogen environment.  

In short, your reproductive hormones become off-balance and experience frequent fluctuations during perimenopause. These hormone changes can trigger common symptoms of perimenopause:

  • Hot flashes
  • Night sweats
  • Sleep problems
  • Vaginal dryness
  • Low libido
  • Headaches
  • Brain fog
  • Mood swings
  • Depression
  • Anxiety
  • Joint pain
  • Irregular periods

Menstrual cycle irregularities can mean the length of time between periods may be longer or shorter, your flow may be light to heavy, and you may skip some periods.

If you’ve always had irregular periods, this might not be as obvious a sign as it is for people who have always had regular periods. If you have suspicions you’re in perimenopause but can’t tell for sure, talk to your healthcare provider about where you are in your fertility evolution. You can also download Midday to assess and track your menopause stage.

Dealing With Perimenopause Symptoms

Of course, not everyone will experience all of these symptoms, but chances are you’ll have at least a few of them. If your symptoms are interfering with your quality of life, there are steps you can take to ameliorate them.

Talk to your healthcare provider about your options for symptom management or use Midday for holistic support and to learn more about whether options like hormone therapy are right for you.

Seek support if you are experiencing worsening or new mental health difficulties. Therapy, antidepressants, and anti-anxiety medication are all options as you maneuver your way through the aging process while dealing with wild hormone fluctuations.  

Examine your diet and consider adopting a heart-healthy, plant-intensive diet. Research shows that eating what’s commonly referred to as a Mediterranean diet can help minimize weight gain while protecting heart and bone health. Once you reach postmenopause, you are at greater risk of developing cardiovascular disease and osteoporosis, and giving your body the nutritional support it needs as early as possible can be protective of your long-term health.

Perimenopause is a great time to ensure you’re getting plenty of exercise, both aerobic and strength-building. Aside from the obvious benefits of heart health and weight control, experts have found that regular exercise can minimize hot flashes and improve sleep and mood in perimenopause.

Knowledge = Power

Perimenopause is a natural stage of human fertility that can best be managed when you have plenty of knowledge of what to expect. You have many resources to choose from as you decide how you want to support yourself through the process. Diet and exercise adjustments and medical management of perimenopause symptoms can be helpful, but education is one of your most important and empowering tools in helping you find your best path through perimenopause and beyond.

Looking for more expert support on menopause stages, symptoms, and how you can get relief? Download Midday from the App Store or visit us at Midday.Health

Jennifer Turkyilmaz, RN, BSN, is a medical writer who worked for many years in women’s health as a high-risk pregnancy nurse. She is also a newly menopausal woman who wishes she had known more about what to expect before it happened to her.

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