What to Expect During Perimenopause (And How to Feel Better)

Perimenopause — a popular term that’s lent itself to TikToks, memes, and reels in recent years.  But what is it, exactly? When does it occur? What are the symptoms? For starters, it’s real. You’re not imagining it. Simply put, if menopause is the main event (one year without a period), perimenopause is the chaotic opening act — complete with irregular cycles, unpredictable moods, and yes, the occasional hot flash.

The bad news? If you have ovaries, you will go through it. The good news? Where symptoms can often be misunderstood, misattributed, or worse (ignored), here at Beaches OBGYN, we believe that knowledge is power — especially when your hormones seem to have a mind of their own. So, let’s talk about what perimenopause is, what to expect, and how to manage those symptoms.

What Is Perimenopause, Anyway?

The word perimenopause literally means “around menopause,” and it’s the transitional period of time (pun intended) when hormone production changes —  specifically a decline in progesterone and estrogen — before your menstrual cycles stop completely. The vagueness of the whole “around” phrasing can feel frustrating, and the timeframe has a wide range. Perimenopause usually starts in your mid-40s, but it can begin as early as the mid-30s or as late as the mid-50s. This transitional time lasts an average of 4 years (but can run as long as 10!). Note that the average age of menopause is 51, which means the average age of perimenopause is 47 — but, of course, every woman is different.

Common Symptoms of Perimenopause

Every woman experiences it a little differently, but the easiest telltale sign that you’re in perimenopause is having irregular periods. Read: One month your cycle is on time, the next month it ghosts you, and then suddenly you’re dealing with two in one month. Have you gone 60 days without a period? Trust that you’re in it. Not fun. Here are some additional signs of perimenopause:

• Other menstrual changes, such as heavier or lighter periods
• Hot flashes and night sweats
• Mood swings, irritability, or anxiety beyond your usual PMS
• Sleep disturbances
• Vaginal dryness or discomfort
• Decreased libido
• Brain fog or memory issues

If you’re nodding along to any of this, you’re not alone — and no, you’re not going crazy.

What You Can Do About It

You don’t have to suffer through perimenopause alone. There are plenty of ways to manage symptoms and feel more like yourself:

• Talk to your doctor. Your provider can help determine what’s going on and offer options like hormone therapy, non-hormonal treatments, low-dose antidepressants, or lifestyle changes to ease your symptoms. We can also order a blood test to check hormone levels, which will provide additional insight.
• Prioritize sleep and stress relief. Establish a consistent sleep schedule and create a relaxing bedtime routine to improve sleep quality. Meditation, yoga, or deep-breathing exercises can also help with irritability and mood swings.
• Stay active. Regular movement and strength training can help with mood, weight management, and sleep.
• Maintain your support system. Fostering social connections and engaging in activities you enjoy can help support your emotional well-being. 
• Eat to support your hormones. Think a balanced diet rich in fruits, vegetables, and whole grains. Limit processed foods and sugar, and consider increasing calcium and vitamin D for optimal bone health (as a decline in estrogen can make bones less dense and more fragile). Stay hydrated and limit alcohol and caffeine, which can disturb sleep and worsen hot flashes.
• Try a vaginal lubricant. Water-based vaginal lubricants can help relieve vaginal dryness and discomfort during intercourse. 

READ: Managing Menopause Symptoms: How We Can Help You Find Relief

Perimenopause is a shared experience, even if it feels a little isolating. We’re here to guide you through this transitional phase with compassion and expertise. Whether you need symptom relief, guidance, or just a safe space to talk, we’re here for you.