Perimenopause: The lead up to the real thing

Woman exercising in pool.

Our ovaries start to sunset in our 40s, with the onset of perimenopause. Throughout the decade, the ovaries gradually begin to make less estrogen. Perimenopause can start earlier, but it often marks the march toward 50.

Signs of perimenopause

You might notice the occasional hot flash, where heat just radiates from your inner core, regardless of the temperature. You might sweat at night. A cough or a sneeze might result in a little urine leakage—or you might feel a sudden need to go. (“Urinary urgency” is the medical term for the latter.)

Or you might feel a sudden rage that just feels different than a typical reaction. For 70 percent of women, irritability is the most common perimenopause symptom (see the 2008 study abstract, A new female-specific irritability rating scale).

Other perimenopause symptoms can include: breast tenderness, worse premenstrual syndrome, lower sex drive, fatigue, irregular periods, vaginal tryness or discomfort during sex, and trouble sleeping. If this sounds like the end of a prescription-drug warning, it might be that perimenopause is the warning of what’s to come during menopause itself!

Common Perimenopause Symptoms

How long does perimenopause last?

Perimenopause lasts until menopause, which occurs when the ovaries stop releasing eggs, marked by when a woman has not had a period for a year. In the last year or two of perimenopause, the drop in estrogen speeds up, and many women have menopause symptoms (see above).

The average length of perimenopause is four years. However, for some women perimenopause may last only a few months (lucky) or continue for 10 years (not as lucky).

Yes, you can get pregnant during perimenopause.

Fertility plummets during perimenopause. But you can still become pregnant. If that’s not a desired outcome, you’ll definitely need to use some form of birth control until you’ve reached menopause (again, a year of not having your period). If becoming pregnant is the goal, there are treatments to help you get pregnant. Just talk to your Welia Health provider.

Ways to ease perimenopause symptoms

Low-dose birth control pills can help you find relief from hot flashes. Similarly, birth control skin patches, a vaginal ring or progesterone injections (other hormone-based birth controls) may control hot flashes as well. Talk to your Welia Health provider to see if these solutions might be an option for you.

The following lifestyle approaches may also help relieve perimenopause symptoms and just enhance your general well-being:

  • Exercise
  • More sleep (try going to sleep and waking up at the same time each day)
  • Less alcohol consumption
  • Smoking cessation
  • Getting to a healthy weight and maintaining it
  • Taking a multivitamin (though it’s best to check with your doctor first)
  • Getting enough calcium in your diet

If you’re having problems with your sex drive, talk to your doctor. If vaginal dryness is an issue, vaginal lubricants might help. Mental health counseling can be beneficial during perimenopause as well.

We encourage you to speak with your doctor about your specific perimenopause symptoms and treatment goals. Together we can make a plan that’s right for you. Perimenopause doesn’t have to be as miserable as it sounds! Let us help you make this the best stage of life yet.