Perimenopause can begin with changes that are easy to explain away. Your periods may become less predictable. You may suddenly struggle to sleep, feel warmer than usual at night, or notice changes in your mood or energy.
These can all be perimenopause symptoms, but they can also have other causes. Understanding what perimenopause is, what changes to look for, and when to talk to your doctor can help you make informed decisions about your health.
What Is Perimenopause and How Is It Different From Menopause?
Perimenopause is the transition leading up to menopause. During this time, levels of hormones such as estrogen and progesterone fluctuate, which can affect your menstrual cycle and cause a wide range of physical and emotional symptoms.
Menopause is different. You reach menopause when you’ve gone 12 consecutive months without a menstrual period and there is no other medical reason for your periods to have stopped.
What Are the First Signs of Perimenopause?
For many women, one of the first signs of perimenopause is a change in their menstrual cycle. Your periods might come closer together or further apart. They may become heavier, lighter, longer, or shorter.
Other early symptoms can include hot flashes, night sweats, difficulty sleeping, mood changes, breast tenderness, headaches, or changes in sexual desire.
There’s no single pattern that every woman follows. You may notice several symptoms or very few.
How Long Does Perimenopause Last?
Perimenopause usually lasts for several years, although its length varies considerably from one woman to another. Maybe a few months, maybe several years, but the average is around four years.
Symptoms can also change during that time. Something that causes problems for a few months may improve, while a different symptom appears later.
This variation is one reason it can be helpful to discuss changes with your doctor rather than trying to determine your stage of menopause yourself.
And the stage is a little less important on a day-to-day basis than recognizing and understanding symptoms so you can manage them well.
What Symptoms Can Perimenopause Cause?
Changes in hormone levels can affect many parts of your body. Some of the most common perimenopause and menopause symptoms include:
- irregular periods
- hot flashes
- night sweats
- sleep problems
- mood changes
- vaginal dryness
- discomfort during sex
- changes in libido
- problems with concentration or memory
You may also notice changes in headaches, joint or muscle discomfort, or urinary symptoms.
These symptoms vary greatly in severity.
For one woman, perimenopause may be a relatively minor change. For another, symptoms can interfere with sleep, relationships, work, and everyday life.
It’s also important not to assume every change is caused by a hormone imbalance. Thyroid conditions, anemia, pregnancy, medication, and other health issues can cause symptoms that overlap with perimenopause.
When Should I See My Doctor for Perimenopause?
You don’t have to wait until perimenopause symptoms become severe before talking to your doctor.
Consider making an appointment if symptoms are affecting your sleep, mood, relationships, work, or quality of life.
You should also seek medical advice if you develop possible early menopause symptoms. Around 5% of women go through a natural menopause earlier. So it’s worth asking.
Changes in bleeding deserve particular attention.
Talk to your healthcare provider about very heavy bleeding, bleeding between periods, bleeding after sex, periods that last much longer than usual, or any other irregular bleeding pattern that concerns you.
You should also seek medical advice if you develop possible menopause symptoms at an unusually young age. Your doctor can assess whether another condition could be involved and whether further investigation is appropriate.
How Can Your Doctor Assess Perimenopause?
There isn’t one test that can tell you whether you’re in perimenopause.
Your doctor will usually start by asking about your menstrual cycle, symptoms, medical history, medications, and any changes you have noticed. Your age and overall health also help build the picture.
Hormone levels naturally rise and fall during perimenopause, so a blood test taken on one particular day may not provide a straightforward answer. However, testing can sometimes be useful, particularly if your symptoms or age suggest another cause should be considered.
This broader assessment can help your doctor decide whether your symptoms are consistent with perimenopause and whether any other health conditions need attention.
What Are the Treatment Options for Perimenopause?
You don’t necessarily need treatment simply because you’re going through perimenopause. If symptoms are mild, practical changes may be enough to help you feel well.
If symptoms are disrupting your life, there are treatment options for perimenopause. The right choice depends on the symptoms you’re experiencing, your health history, your preferences, and whether you still need contraception.
Lifestyle and Symptom Management
Regular physical activity, good sleep habits, and a balanced diet – yes, we’ve said it before but they can all help you during perimenopause. It can also be useful to identify and limit your personal triggers for hot flashes.
Vaginal moisturizers or lubricants can help with vaginal dryness and discomfort.
Your doctor can also discuss treatments aimed at particular symptoms, including nonhormonal options when appropriate.
Hormone Therapy for Perimenopause
Hormone therapy can be an option for some women with troublesome symptoms. You may also hear this called hormone replacement therapy or HRT.
There are different types, doses, and methods of taking hormone therapy. What’s appropriate for you depends on factors including your symptoms, whether you have a uterus, your medical and family history, and your individual health risks.
Your healthcare provider can discuss the potential benefits and risks with you and determine whether hormone therapy for perimenopause is appropriate.
What About BioTE Hormone Therapy?
BioTE hormone therapy uses hormone pellets placed beneath the skin to release hormones gradually over time. Stella Mattina offers BioTE as one of the options that may be considered for some patients.
It isn’t automatically the right choice for everyone experiencing perimenopause symptoms. Your provider will consider your symptoms, medical history, individual needs, and the available alternatives before recommending a treatment approach.
The aim is to find an appropriate way to manage your symptoms and support your health, whether that involves BioTE, a different hormone therapy option, nonhormonal treatment, or lifestyle changes.
Get Support for Your Hormone Health With Stella Mattina
Perimenopause is a normal stage of life. But that doesn’t mean you have to put up with symptoms that are affecting how you feel or function.
If you’ve noticed changes in your periods, sleep, mood, or other aspects of your health, you can come to your usual Stella Mattina clinic and talk to your provider.
We can help you understand what may be causing your symptoms, look at your wider women’s hormone health, and discuss treatment options that fit your individual needs.
We have same-day appointments to suit your lifestyle, so take advantage of this and get your questions answered. Call 214-942-3100 today.
Dr. Gonzalo Venegas
Gonzalo Venegas, MD is the Medical Director of Stella Mattina Health and a respected obstetrician-gynecologist with over four decades of service in the Dallas medical community. He has led the Department of Obstetrics and Gynecology at Methodist Dallas Medical Center and contributed to community health through his role on the Parkland Health & Hospital System Board. A dedicated mentor at UT Southwestern, Dr. Venegas is known for his leadership, compassion, and commitment to advancing women’s health and medical education.