Perimenopause Overview

Perimenopause  - Menopause Coach

Perimenopause, also known as menopausal transition, is the period between the start of irregular menstrual cycles and the final menstrual phase.

Estrogen levels during perimenopause rise and fall unevenly. Thus, your menstrual cycles may become both longer and shorter. In addition, there may be menstrual cycles in which your ovaries don’t release an egg.

Symptoms of Perimenopause

You might experience the following perimenopause symptoms:

  • Night sweats and sleep disorders. A lot of women have to deal with hot flashes during perimenopause. There are different levels of intensity, duration, and frequency. They are also the reason for sleep disorders.
  • Mood changes. Sleeping disorders associated with hot flashes may be the cause of mood changes and can cause depression.
  • Vaginal and bladder problems. Due to the drop in estrogen, the vaginal tissue loses its elasticity and make sex painful. This makes women more vulnerable to vaginal and urinary infections. In addition, tissue loss can lead to urinary incontinence.
  • Irregular periods. Once ovulation becomes more erratic, the length of time between perimenopause periods can be longer or shorter, and some cycles may be missed. 
  • Bone loss. You start losing bone faster than you replace it with decreasing estrogen levels, raising the risk of osteoporosis.
  • Change in cholesterol levels. Due to a decrease in estrogen, your cholesterol may change, and that increases the risk of cardiovascular disease.

Perimenopause Treatment

Drug therapy is the most common type of treatment used to deal with perimenopause symptoms.

  • Hormone therapy. Undoubtedly the best treatment choice for relieving perimenopausal symptoms up to this day. Based on your personal and family history, your doctor can prescribe estrogen at the lowest dose possible to alleviate symptoms.
  • Antidepressants. Some antidepressants associated with the class of drugs can minimize hot flashes. This is especially helpful both for women who can’t take estrogen because of their health condition and for women who have a hard time dealing with mood swings.
  • Vaginal estrogen. It comes in many different forms, including vaginal pills, tubes, or creams, and can help relieve vaginal dryness. This treatment produces only a small quantity of estrogen that the vaginal tissue absorbs. It can be used to alleviate vaginal dryness, sex pain, and certain urinary symptoms.

While perimenopause supplements are also commonly used to relieve perimenopause symptoms, I haven’t mentioned them, because there is no consistent evidence of risk-free benefit. For example, black cohosh can result in liver toxicity. Thus, you should first consult a doctor.

Average Age for Perimenopause

According to the statistics provided by the North American Menopause, perimenopause may last from 4 to 10 years, which means that perimenopause age on average in the mid to late 40s. However, in some cases, women may notice signs of perimenopause as early as the late thirties and early forties.

The best indicator about when your final phase will be is your mom’s age when she has reached menopause (in case she didn’t have a hysterectomy).


Question: What is perimenopause?

Answer: Perimenopause usually occurs a few years prior to menopause. It’s the time when ovaries barely produce any estrogen.

Question: How long does perimenopause last?

Answer: About four years on average. However, it may last from a few months to 10 years for some women. Perimenopause comes to an end when a woman has gone a year without having her period.

Question: How long is too long for a period during perimenopause?

Answer: A menstrual cycle for most women usually occurs every 30-35 days and lasts for no longer than a week.  Yet perimenopause cycles may last much longer. There will be a month when the ovaries may not contain enough estrogen and progesterone which completely prevents menstruation. And there will also be months when the imbalance may lead to an unnecessary thickness of the uterine lining, so it takes longer for the body to shed. You should give your doctor a visit if you have had periods that have been longer or more frequent than usual.

Question: How to lose weight during perimenopause?

Answer: Perimenopause weight gain is a big problem for many women, but it is possible to fix it. Follow these simple steps:

  • Increase your activity;
  • Eat a great amount of nutrient-dense food;
  • Get enough sleep;
  • Clear your mind of stress;
  • Try mindful eating.



Sheri Goddard

Expert on menopause. Woman Consultant at Menopause Coach.
I will help you look at menopause in a "new light", and empower you to make healthy, alternative choices rather than thinking you MUST use unsafe traditional methods as you make your transition to menopause and beyond.

Related topics