Perimenopause is the transitional period leading up to menopause. Menopause itself is a single point in time—12 months after your last menstrual cycle—and typically occurs around age 51. Perimenopause, on the other hand, can last anywhere from 2 to 10 years. During this time, hormonal fluctuations can create a variety of symptoms that change over time.
Even if your cycles remain regular, you could still be in perimenopause. Identifying the signs early allows you to take proactive steps to manage symptoms and maintain quality of life.
Early Perimenopause: Hormonal Changes
In the early stages of perimenopause, estrogen levels are often high while progesterone levels drop. This can lead to relative estrogen dominance, even if estrogen appears normal on lab tests.
Common symptoms include:
- Water retention and bloating
- Constipation
- Fatigue and low energy
- Mood swings
- Sleep disturbances
Hormones act as messengers in the body, so fluctuations can affect communication with tissues and organs, leading to these symptoms.
Late Perimenopause: Approaching Menopause
Late perimenopause generally occurs in the five years before menopause. Symptoms may intensify during this stage and include:
- Hot flashes and night sweats
- Vaginal dryness
- Brain fog and memory changes
- Fatigue
- Mood changes
- Joint pain
- Hair thinning or loss
- Skin changes
Because estrogen impacts nearly every tissue in the body, decreasing hormone levels can affect multiple systems. Lifestyle factors also influence symptom severity. For example, higher body fat can increase estrogen production, potentially worsening estrogen dominance, though lean women can also experience significant symptoms.
Strategies to Manage Symptoms
Perimenopause doesn’t have to be endured passively. Key strategies to thrive include:
- Education – Understanding hormonal changes helps you make informed decisions.
- Find a Knowledgeable Practitioner – A menopause-certified professional can guide you through options.
- Lifestyle Adjustments – Prioritize sleep, hydration, stress management, whole foods, fiber, and protein. Incorporate regular exercise, including resistance training and daily movement.
- Adaptogens and Supplements – Certain adaptogens can help balance hormones and ease symptoms.
- Flexibility – Symptoms and effective treatments vary. What works for one woman may not work for another.
Menopause should be seen as a time of opportunity rather than decline. In some cultures, this stage is considered a period of empowerment and renewal, a mindset that can be adopted to approach perimenopause more positively.
Perimenopause is an evolving journey, and symptoms fluctuate as hormones shift. By staying informed, seeking expert guidance, and making intentional lifestyle adjustments, you can reduce symptom intensity, improve your well-being, and embrace this phase of life as one of vitality and growth.
