Dr. Lori Gore-Green | Women's Health Professional

Dr. Lori Gore-Green's Portfolio of Experience as a Women's Health Professional

Understanding Perimenopause: What Every Woman Should Know

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Women’s health goes through remarkable transitions across a lifetime, but one phase that often catches many by surprise is perimenopause. Unlike menopause — which is defined as the point when a woman has gone 12 consecutive months without a menstrual period — perimenopause is the transitional period leading up to it. This stage can last anywhere from a few months to several years and often begins in a woman’s 40s, though for some it can start earlier.

Perimenopause is driven by fluctuating estrogen and progesterone levels as the ovaries gradually produce less of these hormones. This hormonal shift can lead to a range of symptoms that vary greatly between individuals. Common signs include irregular periods, hot flashes, night sweats, sleep disturbances, mood swings, and changes in libido. Some women may also notice weight gain, vaginal dryness, or difficulty concentrating.

Because the experience is so personal and unpredictable, it’s important for women to pay attention to changes in their bodies and seek guidance from a healthcare provider when symptoms interfere with daily life. Tracking menstrual cycles and symptoms can help both patient and provider understand what’s happening and rule out other conditions.

While perimenopause is a natural part of aging, its symptoms can significantly affect quality of life. Lifestyle adjustments — such as maintaining a healthy diet, exercising regularly, practicing stress-reduction techniques, and getting enough sleep — can help ease some discomforts. For more troublesome symptoms, doctors may recommend medical options such as hormone therapy, low-dose antidepressants, or other medications tailored to individual needs and medical history.

It’s also an ideal time to have broader health discussions with a provider. Bone density decreases as estrogen declines, so focusing on calcium, vitamin D, and weight-bearing exercise can help maintain strong bones. Heart health is another consideration, as cardiovascular risk rises after menopause.

Most importantly, women should know they don’t have to navigate this transition alone. Talking openly with healthcare professionals and with other women experiencing similar changes can provide valuable support and practical tips.

Perimenopause is not an illness but rather a phase that can be managed with awareness, healthy habits, and personalized care. By understanding what to expect, women can feel empowered to advocate for their well-being and continue living fully through every stage of life.

Perimenopause and Periods

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Perimenopause is a period of time that occurs just before actual menopause when you cease menstruating. During this time, you’ll notice changes in your monthly cycle as estrogen and progesterone levels begin to fluctuate. Some months, your period may come sooner than normal. Others, you might be late. While every woman’s experience is different, knowing what to expect with perimenopause and periods can help you to navigate through this new stage in life.

Prepare for Heavier Periods

Many women struggle with heavy periods at various points in their life, but perimenopause can bring flooding. Technically, a heavy period is one that involves losing 80 mL of menstrual blood. You may suspect that this is happening to you if you consistently run through multiple tampons or pads within a short period of time. Heavy periods put you at risk for serious problems such as anemia, which means you’ll want to reach out to your doctor for help.

Get Ready for Spotting

You may have spotted in the past from various reasons such as changing birth control pills. However, spotting during perimenopause is caused by your body being confused by changing hormone levels. If spotting is new to you, then you’ll want to schedule an appointment to make sure that it isn’t from other causes. If you’ve noticed other changes in your period, then it is likely perimenopause.

Watch for Changes In the Color

Dark or brown blood may become more prevalent during this stage of your life. This is because your body’s hormone levels can disrupt how the blood leaves your uterus. Blood that sticks around in the uterus for too long oxidizes, which is why you see this color. Most likely, you’ll notice this more at the beginning and end of your periods. It can also occur with spotting.

 

Dealing with spotting, heavy periods and even the surprise missed start date can get frustrating. Make sure to talk to your doctor about any changes that you notice with your cycle. They’ll help to rule out other health problems and suggest ways to make this transition easier. Taking care of yourself can go a long way toward helping to minimize some of these symptoms. Perimenopause doesn’t last forever, but having the right types of support can make it more manageable until your periods eventually end.

The Symptoms of Perimenopause

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Perimenopause, also known as menopause transitions, often begins a few years before menopause. This is the period during which the ovaries start making less estrogen. The symptoms can start when a woman is in her 40s; however, some women experience Perimenopause in their 30s.

Symptoms of Perimenopause
Throughout the menopause transition, most people may notice some changes in their bodies. Below are some of these changes:

1. Sleeping problems and hot flashes
While hot flashes are expected during the menopause transition, their length, frequency, and intensity vary. Sleep problems will be due to night sweets and hot flashes. However, sleep can sometimes become unpredictable even without the hot flashes and night sweats.

2. Changes in moods
One may experience irritability and mood swings during Perimenopause. There is also an increased risk of depression, often due to the disruption of sleep associated with hot flashes.

3. Bladder and virginal problems
With diminishing estrogen levels, the virginal tissues lose elasticity and lubrication, making penetration during intercourse painful. Low levels of estrogen also increase the risk of virginal and urinary tract infections. Loss of virginal tissue tone also contributes to urinary inconsistencies.

4. Changes in cholesterol levels
Reduced estrogen levels contribute to unfavorable changes in individual blood cholesterol levels, including increased bad cholesterol, also known as low-density lipoprotein.

5. Irregular menstruation periods
During Perimenopause, ovulation becomes irregular and unpredictable. The time between one’s periods becomes shorter or longer. The flow may also become heavier or lighter while skipping some months.

6. Reduced sex drive
Changes in sexual desire and arousal are common during Perimenopause. However, for those who have satisfactory and pleasurable sexual experiences before the Perimenopause period, this is likely to continue beyond Perimenopause.

When to See a Doctor
While some women may see a doctor when they experience severe Perimenopause symptoms, others don’t experience severe enough symptoms to warrant medical attention. Since the signs are often subtle, most women don’t realize they are all connected to the rising and falling of estrogen and progesterone levels. One should seek medical help if they experience any of the below:

  • Extremely heavy periods with blood clots
  • Periods that last several days longer than normal
  • Spotting between periods
  • Periods happening closer together
  • Spotting after having intercourse

The perimenopause period lasts until menopause. With the rise and fall of progesterone and estrogen levels, most women experience the above changes. If any of the symptoms interfere with your health and daily activities, ensure you seek medical assistance.