This stage of life occurs before menopause. Learn how to recognize the signs.
While menopause is marked by a full year without a period, perimenopause may start years earlier.
Though symptoms of perimenopause are different for everyone, recognizing the early signs may help you better understand your body and how to best manage your symptoms.
Period changes
During perimenopause, you may experience changes in your menstrual cycle. Your periods may arrive closer together or further apart, or be longer or shorter than usual. Your flow may also vary.
This may be due to fluctuations in the amount of estrogen and progesterone in your body, which are the hormones that regulate your cycle.
Hot flashes
During perimenopause, you may also start having hot flashes, which are sudden feelings of warmth. Hot flashes commonly occur over your face, neck, and chest. You may also have hot flashes at night, known as night sweats.
These symptoms may be caused by hormonal shifts affecting your body’s temperature regulation.
Altered sleep patterns
Falling or staying asleep during perimenopause may be more difficult. Decreased progesterone may lead to insomnia. Night sweats may also impact your sleep quality and wake you up more frequently.
Mental health changes
As your hormones fluctuate, you may experience quick and intense changes in mood. Anger, anxiety, depression, and irritability may all occur during this time.
Brain fog
You may notice feeling mentally foggy during perimenopause. This is often temporary and may be caused by changes in your sleep or hormonal fluctuations.
Shifts in libido
During perimenopause, you may experience a fluctuation in your sex drive.
Vaginal changes
Vaginal dryness, irritation, or discomfort may occur during perimenopause, due to fluctuating estrogen levels.
Due to vaginal and urinary tract tissue changes, you may also experience urinary symptoms such as urgency or an increased frequency of UTIs.
The doctor is in
Think you may be starting perimenopause? Shilpa Amin, MD, FAAFP, recommends this next step:
“First, I recommend consulting with your primary care physician (ideally someone who has women’s health expertise) or your gynecologist to make sure other hormonal imbalances (e.g., thyroid dysfunction) or physiological causes (e.g., uterine fibroids, endometrial conditions) aren’t causing these symptoms.
“If you are indeed entering perimenopause, your doctor(s) may recommend a variety of lifestyle adjustments and treatments, depending on your symptoms and overall health.”
This is an excerpt from Unpaused, Healthline and Optum Now’s newsletter dedicated to helping people navigate menopause.
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The takeaway
Knowing the early signs of perimenopause will help empower you to navigate this life stage with confidence.
Lifestyle adjustments, stress reduction, and talking with your doctor as needed may help you thrive during this time.