Perimenopause – What’s It All About?

Do you know if your symptoms mean you are in perimenopause?


There is a quite a lot of confusion when women talk about being in menopause, or peri or even post menopause as it can happen at quite different ages.

So what is it?

Perimenopause is when you are starting to transition into menopause and it starts several years before true menopause itself.

It’s the time when the ovaries gradually begin to make less oestrogen and for the majority of women that usually starts in the 40s, but can start in your 30s or even earlier.

Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs altogether. In the last 1 to 2 years of perimenopause, this drop in both oestrogen and progesterone is more noticeable and you may start experiencing menopause symptoms.

How long does it last?

The average length of perimenopause is 4 years, but for some women this stage may last only a few months or continue for longer than average.

Perimenopause ends when a woman has gone 12 months without having her period, and you are then in menopause proper.

This is what can be confusing as many women believe that this is also the end of menopause, but that can last anything up to 5 years on average and many women continue to have hormonal symptoms even after having no periods for several years.

What can you expect?

Women in perimenopause have at least some these symptoms though fortunately not all women get all of them:

* Hot flushes

* Breast tenderness

* Worse PMS/PMT

* Lower sex drive

* Fatigue

* Irregular periods

* Vaginal dryness; discomfort during sex

* Urinary leakage and/or urgency

* Mood swings

* Trouble sleeping

So when should I be concerned?

All the above are normal and experienced by many women and certainly Irregular periods are common and normal during perimenopause, BUT other conditions can cause changes in menstrual bleeding.

Causes of abnormal bleeding include hormone problems, birth control pills, pregnancy, fibroids, blood clotting problems or, rarely, cancer.

If any of the following situations apply to you, see a doctor to rule out other causes:

* Your periods are very heavy, or they have blood clots.

* Your periods last several days longer than usual.

* You spot between periods.

* You have spotting after sex.

* Your periods happen closer together.

How Is it diagnosed?

Often your doctor can make the diagnosis of perimenopause based on your symptoms.

A blood test to check hormone levels may also help, but your hormone levels are changing during perimenopause.

It may be more helpful to have several blood tests done at different times for comparison.

Can I get pregnant if I am Perimenopausal?

Yes, and this is the reason why many women have ‘late surprise’ babies because despite a decline in fertility during the perimenopause stage, you can still become pregnant.

If you do not want to become pregnant, you should use some form of birth control until you reach menopause (you have gone 12 months without having your period).

This is why women using birth control also need to be aware that it is not always compatible with using bioidentical hormones so do do check before using.

What can help?

The medical treatment is to be given either HRT, antidepressants or low-dose birth control pills to help with symptoms.

However many women react badly to these high dose artificial hormones and prefer other options that can control perimenopause symptoms related to hormone balance.

Rebuilding your body’s own natural levels with bioidentical hormones is certainly helpful for many women and generally it is high oestrogen and low progesterone levels (oestrogen dominance) behind many of the common symptoms.

Traditionally herbal remedies have been used for centuries and again many women find them effective, particularly if hormone imbalance is also addressed.