What is perimenopause?

Perimenopause is the period of time, usually lasting for several years, during which a woman’s body makes the transition to menopause. A woman is regarded as having reached menopause – the end of her reproductive years – when she had not had a menstrual period for twelve months.

During perimenopause, the levels of estrogen in the body rise and fall erratically. This results in irregular menstrual periods, mood changes, hot flashes and vaginal discomfort. These symptoms vary throughout the perimenopausal period, which can last for up to ten years.



The symptoms of perimenopause vary greatly from person to person. Some women experience a lot of discomfort, while others breeze through it with little or no difficulty. The primary symptoms of perimenopause include the following:

  • Irregular periods: As the estrogen levels start to fluctuate more, ovulation becomes irregular. Women may find themselves having an unusually long menstrual cycle followed by a relatively short one. The periods themselves can start to vary in terms of how long they are and how heavy the flow is. Although the woman’s ability to conceive starts to decline during perimenopause, pregnancy is still possible.
  • Vaginal discomfort: Falling estrogen levels are associated with the gradual decline in vaginal elasticity and lubrication. Women may experience discomfort or pain during and after intercourse, and they may become more prone to bladder infections and urinary incontinence.
  • Hot flashes: Most perimenopausal women experience periodic hot flashes that vary in intensity and frequency. The resulting discomfort can be severe enough to cause sleep disturbances.
  • Mood swings: Women who are in perimenopause often experience unpredictability in their moods. This may be due to a number of factors, including the changing estrogen levels and the sleep disturbances.
  • Fragile bones: One of the hallmarks of perimenopause is declining bone density. This makes women in this phase more susceptible to fractures and osteoporosis.
  • Changes in sexual desire: Women in perimenopause may experience a temporary change in their sexual desire and arousal. This may fluctuate throughout perimenopause, and usually stabilizes by the time the woman has reached menopause.


When does perimenopause happen?

Most women start going through perimenopause when they are in their forties, but this varies greatly from one individual to the next. Women may have an increased likelihood of experiencing perimenopause earlier in life if:

  • They are regular smokers
  • They have a family history of early menopause
  • They have had a full or partial hysterectomy
  • They have had chemotherapy or pelvic radiation therapy

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