What is Perimenopause?

Women go through three major phases in their reproductive lives: perimenopause, menopause, and postmenopause. Today, let’s talk about perimenopause—the wild, unpredictable, and sometimes frustrating transition phase.

What is Perimenopause?

Think of perimenopause as puberty in reverse. Your ovaries start changing, and estrogen and progesterone fluctuate—sometimes dramatically, sometimes unpredictably. Most women start noticing these changes between ages 35-45. Some symptoms are subtle; others feel like a complete body and mind takeover.

Maybe your periods are showing up closer together or ghosting you for months at a time. Some are heavier than ever, while others are barely there. Your mood? One moment you’re fine, the next you’re in a full-blown rage, anxiety attack, or crying at a dog food commercial. You might gain weight, feel exhausted, lose your drive for things you once loved, or just not feel like yourself anymore.

Should You Get Bloodwork?

Hormonal testing can be done, but here’s the kicker—because hormones are fluctuating so much during this time, the results often look normal or are inconclusive. Think of it this way: we don’t run hormone tests on a 13-year-old girl with mood swings and acne because we know she’s going through puberty. The same concept applies to women in perimenopause. The symptoms often tell the story better than the labs do.

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Common Symptoms of Perimenopause

📌 Irregular periods
📌 Sleep disruption/insomnia
📌 Rage
📌 Depression/anxiety
📌 Hot flashes
📌 Lightheadedness
📌 Brain fog
📌 Feeling unloved
📌 Unusual tiredness
📌 Back, joint, or muscle pain
📌 Dry skin
📌 New facial hair (thanks, hormones 🙃)
📌 Crawling sensation under the skin
📌 Decreased sexual desire
📌 Pain with intercourse
📌 Vaginal dryness
📌 Urinary urgency or frequency
📌 Burning mouth sensation
📌 Ringing in the ears
📌 Itchy ears
📌 Breast pain
📌 Dry eyes

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What Can You Do?

Perimenopause isn’t fun, but you can take control by focusing on the 4 pillars of health:

✅ Nutrition: Fuel your body with whole, nutrient-dense foods.
✅ Sleep: Aim for 7-9 hours per night (yes, even with the 2 AM hot flashes).
✅ Exercise: Move your body 30 minutes a day, 5 days a week (150 min total per week).
✅ Stress Management: Whether it’s deep breathing, yoga, therapy, or rage-screaming into a pillow—find what helps.

Hormonal Options

If lifestyle adjustments aren’t enough, hormonal treatments can help balance those extreme ups and downs:

💊 Low-dose birth control pills can help smooth out the big hormone fluctuations, reducing many symptoms.
🌀 Hormonal IUDs may help control irregular bleeding.
🌙 Micronized progesterone is a great starting point—it plays a crucial role in stabilizing mood and optimizing sleep.

There are also non-hormonal options, and the best choice depends on your symptoms and needs. If you’re struggling, don’t suffer in silence. Let’s talk about options to help you feel like you again.

Stay strong, stay balanced, and be your own health advocate. 💜

Andrea
Women’s Health Nurse Practitioner

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