Perimenopause is that fun time in a woman’s life when her body starts moving toward menopause, producing less estrogen, progesterone, and testosterone, along the way.1 We’ve heard it referred to as “a bucking bronco,” and “puberty but in reverse,” because as the body slowly stops producing these hormones, it’s usually a pretty wild ride of symptoms.
The good news is—there are several ways to help mitigate symptoms and make the transition as smooth as possible these days, which we’ll get into below.
In fact, we’ll get into all of it here: when it starts, what to expect, and what you can do.
Perimenopause vs Menopause
Often we hear people use the phrase “going through menopause” to describe a gamut of uncomfortable symptoms like hot flashes and low libido (and many more fun ones, which we’ll get into momentarily.) However, what people are really talking about here is perimenopause.
Perimenopause is that transitional time when hormones are starting to decrease. It can last for up to 10 years, and it ends in menopause. Menopause means your periods have ended. When you haven’t had a period for 12 months, you’ve officially crossed the finish line into menopause.
But all of the symptoms leading up to that? That’s perimenopause.1
When Perimenopause Starts
Perimenopause tends to begin about four to 10 years before menopause. Depending on the person, this can mean it starts anywhere from your mid or late thirties into your mid or late fifties.
On average, it tends to start mid-40s-ish, but we know plenty of women for whom some symptoms started in their late thirties.1
If this extremely wide range of ages makes you nervous—there is a way to narrow it down a bit. Research shows that the age a woman reaches menopause is strongly correlated with the age her mother reached menopause. So if you’re able to, ask your mom when she went through perimenopause and then stopped having periods altogether, and this may give you a rough map for how it’ll go down for you.2
Perimenopause Symptoms
Irregular periods
During perimenopause, periods tend to become more irregular. If you were having them every 28 days on the dot, early signs of perimenopause might be a change to every 21, 35, or sometimes 25 days. It can be all over the place, because of fluctuating hormones.1
Changes in periods
Aside from a changing schedule, your period itself might change during perimenopause. A normally light flow might become super heavy, or vice versa.1
Vaginal dryness
Vaginal dryness is a common early sign of perimenopause. This happens because of the body’s dip in estrogen levels, which help lubricate the vagina.3
Low libido
Both estrogen and testosterone play a role in a woman’s libido. As we go through perimenopause, estrogen levels dip, and as we get older, testosterone levels dip. This last part is true for all genders. So this combination of lower estrogen and testosterone can mean a dip in libido, or sex drive.4
Changes in mood
Remember how puberty was so fun, filled with angst, anxiety, depression, crying spells and lots of feelings of what is happening to me? Well, you can think of perimenopause as puberty– a bunch of fluctuating hormones– but in reverse. So all of the ups and downs of fluctuating hormone levels can mean a lot of big emotions, changes in mood, depression, and for many women, one particular feeling: anxiety.1
Anxiety
Perimenopausal anxiety is a thing. Some people who have never had anxiety in their life may experience anxiety for the first time during these years; some people who are familiar with this rollercoaster may feel it amplified during these years. Again, blame the fluctuating and decreasing hormones.1 It’s pretty common for women to seek support for perimenopausal anxiety, either through supplements, HRT, anti-anxiety or antidepressant medications, and therapy.
Hot flashes or night sweats
Hot flashes and night sweats are the same thing—it’s just that a hot flash occurs during the day, and a night sweat occurs at night, typically during sleep. Both involve an overwhelming feeling of suddenly being very hot, sweating, sometimes anxiety, an increased heart rate, and possibly feeling chilled after the hot flash is over.5
Insomnia
Insomnia is a common one during perimenopause. This can be because hot flashes may be happening during the night, making sleep difficult; but it can also just be a thing on its own. As estrogen and progesterone levels decrease, going to sleep or staying asleep through the night may become more difficult.1
Urinary urgency
Having to pee a whole lot is another symptom of perimenopause. It’s primarily caused by fluctuating and decreasing estrogen levels, which affect the bladder and pelvic floor muscles.6
Joint pain
During perimenopause some people experience joint stiffness, discomfort, and reduced mobility because of declining estrogen levels.7
Action Plan for Symptoms
Okay, there is good news, believe it or not.
Because perimenopause symptoms are largely caused by a rollercoaster of fluctuating hormones and an overall decrease in estrogen– some supplements, medications, and lifestyle habits can make for a much smoother transition into menopause. (Of course, you can’t just not go into menopause. It’s a natural and beautiful next phase of life– but you can certainly make the transition feel gentler.)
Supplements
MENO Healthy Aging Powder: This easy, once-a-day powder includes ingredients like collagen and whey protein for bone and joint health, better skin, and maintaining muscle mass, as well as a healthy aging superfood blend for symptoms like brain fog. It also includes a myriad of vitamins and minerals– your daily multivitamin in one scoop of chocolatey goodness.*
MENO Menopause Relief: MENO vitamin capsules are a hormone-free way to minimize perimenopausal symptoms like hot flashes, mood swings, and insomnia. It does this with a little powerhouse ingredient called “black cohosh” extract which has been clinically shown to relieve these symptoms, for those who don’t want to mess with prescription hormones.*8
MENO Vaginal Moisture: This product blends ingredients like maca root, fenugreek seed, saffron, ginkgo leaf, and pueraria mirifica extracts which help balance hormone levels, encourage healthy blood flow—and so moisture and arousal—as well as promote relaxation.*
HRT
For those looking for a non-supplemental option, many women are singing the praises of HRT, or hormone replacement therapy. These days when most people discuss HRT in terms of perimenopause, they’re talking about bioidentical hormones, in the form of creams, IUDs, patches, or pills, that help balance out the bucking bronco of falling hormones during this time.
There are two main types of HRT: Estrogen only, and estrogen plus progesterone. For people who no longer have a uterus (who have had a hysterectomy, for example), estrogen-only HRT is safe. For everyone else, they’ll need estrogen + progesterone, in order to protect the health of their uterus. Some women also choose to add testosterone into the mix, as this hormone is also falling at this time.9
The important thing to note about HRT is that it won’t stop or prevent menopause; it certainly won’t prevent pregnancy; it shouldn’t raise your hormone levels above what they were prior to perimenopause; and it usually involves some trial and error to find your correct concoction. But it can help alleviate symptoms for those who are candidates.
Lifestyle Changes
Certain healthy habits can help minimize some of the more uncomfortable perimenopause symptoms:
- Eat lots of fibrous fruits, veggies, whole grains, plenty of lean protein, and healthy fats.
- Avoid sugar, processed food, and too much caffeine.
- Go for gains at the gym. It’s vital for women during this time to not only work out, but prioritize heavy lifting and strength training to maintain muscle mass and bone health.
- Get your sleep hygiene in check. Establish a regular bedtime and wake up time; limit screen time at least an hour before bed, make your bedroom dark and quiet, and keep the thermostat at around 67 for an ideal sleep environment.10
- Limit or quit alcohol. (Alcohol can severely add to insomnia and night sweats.)11
- Quit using tobacco or smoking cigarettes.
- Introduce a consistent mindfulness or meditation practice.
- Wear layers so you can remove or add as hot flashes wash over you.
- Maintain a healthy weight.
- Get support from a therapist who is familiar with the perimenopausal transition.
