{"id":11418,"date":"2020-05-13T09:00:59","date_gmt":"2020-05-13T13:00:59","guid":{"rendered":"https:\/\/www.singlecare.com\/blog\/?p=11418"},"modified":"2025-11-29T09:54:51","modified_gmt":"2025-11-29T14:54:51","slug":"what-is-perimenopause","status":"publish","type":"post","link":"https:\/\/www.singlecare.com\/blog\/what-is-perimenopause\/","title":{"rendered":"What is perimenopause?"},"content":{"rendered":"<p><span style=\"font-weight: 400;\">Many women think of menopause as something they \u201cgo through.\u201d <\/span><span style=\"font-weight: 400;\">Menopause<\/span><span style=\"font-weight: 400;\">, however, is actually a destination\u2014not a journey. You reach this destination when you have made it through a solid year without a menstrual period. The phase leading up to that point (you know, the one with all the annoying hot flashes, mood swings, and heavy periods) is actually called perimenopause, says<\/span> <span style=\"font-weight: 400;\">Leah Millheiser, MD a board certified gynecologist at Sutter Health in Dublin, California<\/span><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It is the result of fluctuating estrogen levels in the body. \u201cThis uneven up and down can wreak havoc on a woman\u2019s body,\u201d says Dr. Millheiser.\u00a0<\/span><\/p>\n<h2 id=\"perimenopause-symptoms\"><span style=\"font-weight: 400;\">Perimenopause symptoms\u00a0<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">You will have a pretty good idea that you are in the perimenopause phase because the symptoms are quite telling. When you\u2019re perimenopausal, common symptoms include:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Hot flashes and night sweats (also known as vasomotor symptoms)<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Irregular periods<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Heavy periods<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Vaginal dryness<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Breast tenderness<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Low sex drive<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Mood changes, feelings of anxiety or depression<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Bladder problems\/incontinence<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Insomnia or sleep disturbances<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Weight gain<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">\u201cThe majority of women will experience at least some of these symptoms,\u201d says <a href=\"https:\/\/www.sutterhealth.org\/find-provider\/dr-leah-s-millheiser-1078057689\">Dr. Millheiser<\/a>.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The severity of the symptoms will vary, and can even vary month by month, she says. One month, for example, you could have a totally normal period. The next, you might miss it altogether because that surge of estrogen prevents you from ovulating. Meanwhile, your uterine lining continues to build. The result? Your next period is a very heavy one.<\/span><\/p>\n<h2 id=\"how-long-does-perimenopause-last\"><span style=\"font-weight: 400;\">How long does <\/span><a href=\"https:\/\/www.acog.org\/patient-resources\/faqs\/womens-health\/the-menopause-years\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">perimenopause<\/span><\/a><span style=\"font-weight: 400;\"> last?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">These havoc-wreaking menopausal symptoms often start off mild and gradually, but they can also hit suddenly and with great intensity. They can last for a year, or they can last for five or 10 years. The average is 7.4 years, says<\/span> <a href=\"http:\/\/madameovary.com\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Mary Jane Minkin, MD<\/span><\/a><span style=\"font-weight: 400;\">, a clinical professor in the department of obstetrics, gynecology and reproductive science at Yale University School of Medicine. How long will they last for <\/span><i><span style=\"font-weight: 400;\">you<\/span><\/i><span style=\"font-weight: 400;\">? Unfortunately, there is no way to predict the answer to this question. You really just have to wait and see, Dr. Minkin says.<\/span><\/p>\n<h2 id=\"what-is-a-normal-age-for-perimenopause\"><span style=\"font-weight: 400;\">What is a normal age for perimenopause?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Just like it is impossible to predict how long perimenopause will last, it is also somewhat mysterious as to when exactly perimenopause will begin. If you are in your mid-40s, and are experiencing hot flashes and changes to your menstrual cycle, that could be a sign that hormone levels are changing and perimenopause is underway. However, it could also signify something else, so you\u2019ll want to speak to your doctor to rule out any health issues that need treatment.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Can older female relatives offer a gauge as to when perimenopause will begin and how long it will last? Sometimes, yes. \u201c[You can] talk to your mom and your aunt because there are familial tendencies,\u201d Dr. Minkin explains.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Be aware, though, that this is <\/span><i><span style=\"font-weight: 400;\">just<\/span><\/i><span style=\"font-weight: 400;\"> a gauge. Doctors don\u2019t really know how much of a role familial tendencies play because there isn\u2019t a lot of reliable data on the topic, says Dr. Millheiser. \u201cIt is different for every woman,\u201d she says.<\/span><\/p>\n<h3 id=\"what-s-a-normal-age-for-menopause\"><span style=\"font-weight: 400;\">What\u2019s a normal age for menopause?<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">As for actually <i>reaching<\/i> menopause, the average age is 52, according to the <a href=\"https:\/\/womenshealth.gov\/menopause\/menopause-basics\">Office on Women\u2019s Health<\/a>\u2014but it is normal for women to reach menopause anytime between the ages of 45 and 58. At this point, your ovaries are no longer releasing eggs and those fluctuating hormones should stabilize. Although some women experience hot flashes throughout menopause, says Dr. Minkin.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\t\t<div class=\"singlecare-dynamic-newsletter-wrapper sin-newsletter-wrapper\">\n\t\t\t<span class=\"heading\">Get our wellness newsletter<\/span>\n\t\t\t<form class=\"form-wrapper\" data-newsletter-form=\"1\" data-subsource=\"Wellness Newsletter\">\n\t\t\t\t<div class=\"input-wrapper\">\n\t\t\t\t\t<label for=\"dynamic-email\">Email<\/label>\n\t\t\t\t\t<input type=\"email\" id=\"dynamic-email\" class=\"email\" required>\n\t\t\t\t<\/div>\n\t\t\t\t<div class=\"input-wrapper\">\n\t\t\t\t\t<input class=\"submit-form-btn\" type=\"submit\" value=\"Click to sign up\">\n\t\t\t\t<\/div>\n\t\t\t<\/form>\n\t\t\t<p class=\"success-message\" aria-live=\"polite\"><\/p>\n\t\t<\/div>\n\t<\/span><\/p>\n<h2 id=\"how-is-perimenopause-diagnosed\"><span style=\"font-weight: 400;\">How is perimenopause diagnosed?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Perimenopause is a completely natural process, and diagnosis is symptom-based, Dr. Millheiser explains. There are no tests to verify perimenopause; only tests to rule out other conditions that have similar symptoms. For example, if your doctor is not certain your symptoms are the result of perimenopause, a pregnancy test, a blood test, a Pap smear, and\/or imaging might be ordered to check for other women\u2019s health problems like uterine fibroids, ovarian cancer, or certain thyroid conditions\u2014especially if you are on the younger side.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cIf a woman is having hot flashes or night sweats and is in her late 40s, I would say there is a pretty good chance she is in perimenopause,\u201d Dr. Millheiser says. \u201cBut if you are in your early 40s and are experiencing these symptoms in isolation, you might want to be checked for other conditions.\u201d<\/span><\/p>\n<p><span style=\"font-weight: 400;\">The best thing a woman nearing the age range of perimenopause can do, Dr. Millheiser says, is to simply learn to recognize the symptoms of perimenopause so she can face it head on. Treatment is available, and the symptoms can be managed.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cPreparation with knowledge is so important,\u201d she says, explaining that many women spend years suffering with symptoms of perimenopause simply because they don\u2019t realize exactly what is going on. \u201cIf these symptoms are starting to [disrupt] your quality of life, you really need to talk to your doctor about it.\u201d<\/span><\/p>\n<h2 id=\"perimenopause-treatment-options\"><span style=\"font-weight: 400;\">Perimenopause treatment options\u00a0<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">The treatments your doctor recommends will depend on the symptoms that are most bothersome to you, says Sally Rafie, Pharm.D., founder of<\/span> <a href=\"https:\/\/birthcontrolpharmacist.com\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Birth Control Pharmacist<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<h3 id=\"medication\"><span style=\"font-weight: 400;\">Medication<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">Some women, for example,<\/span> <a href=\"https:\/\/www.nia.nih.gov\/health\/hot-flashes-what-can-i-do\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">struggle most with hot flashes<\/span><\/a><span style=\"font-weight: 400;\"> and night sweats. In these cases, a low-dose birth control pill or patch, or some other type of hormone therapy (one that delivers estrogen locally), like a vaginal ring, a topical gel, or an insert\u2014such as <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/estriol-vs-estradiol\/\"><span style=\"font-weight: 400;\">estradiol<\/span><\/a><span style=\"font-weight: 400;\"> \u2014 is the gold standard. Hormone therapy may not be safe for everyone and you should discuss risks with your provider if you have:<\/span><\/p>\n<ul>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">A history of<\/span> <span style=\"font-weight: 400;\">heart disease<\/span><span style=\"font-weight: 400;\"> or risk factors, such as high cholesterol<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">A family or personal history of<\/span> <a href=\"http:\/\/www.womenshealth.gov\/breast-cancer\/index.html\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">breast cancer<\/span><\/a><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">High levels of triglycerides, a type of fat in your blood<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">A family history of gallbladder disease<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">Liver disease<\/span><\/li>\n<li style=\"font-weight: 400;\"><span style=\"font-weight: 400;\">A history of<\/span> <span style=\"font-weight: 400;\">stroke<\/span><span style=\"font-weight: 400;\"> or blood clots<\/span><\/li>\n<\/ul>\n<p><span style=\"font-weight: 400;\">You can find a list of approved hormone therapies <\/span><a href=\"https:\/\/www.fda.gov\/media\/87765\/download\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">here<\/span><\/a><span style=\"font-weight: 400;\">.\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Other options include antidepressants\u2014such as<\/span> <span style=\"font-weight: 400;\">a low dose selective serotonin uptake inhibitor (SSRI)\u2014for women who don\u2019t respond to hormone therapy.<\/span> <a href=\"https:\/\/www.singlecare.com\/prescription\/gabapentin\"><span style=\"font-weight: 400;\">Gabapentin<\/span><\/a><span style=\"font-weight: 400;\">, a medication normally used to treat seizures, is a potential option for women who are unable to use estrogen due to other health conditions (like migraine), Dr. Rafie says.<\/span><\/p>\n<p><b>RELATED: <\/b><a href=\"https:\/\/www.singlecare.com\/blog\/best-birth-control-pill-contraceptive-guide\/\"><b>The best birth control pill for you<\/b><\/a><\/p>\n<h3 id=\"over-the-counter-treatments\"><span style=\"font-weight: 400;\">Over-the-counter treatments<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">If<\/span> <a href=\"https:\/\/health.clevelandclinic.org\/best-fixes-vaginal-dryness-plus-natural-options\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">vaginal dryness<\/span><\/a><span style=\"font-weight: 400;\"> and\/or pain during sex is the primary concern, non-hormonal local therapies like vaginal moisturizers and lubricants, are a great place to start, says Dr. Rafie. Examples include Replens and Astroglide, which are available over the counter.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">And if <\/span><i><span style=\"font-weight: 400;\">everything<\/span><\/i><span style=\"font-weight: 400;\"> is bothering you? Yes, you can use these treatments in conjunction with one another. Side effects are minimal or nonexistent. However, if you choose to take low-dose birth control pills it is entirely possible you won\u2019t even recognize that perimenopause is happening.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cI think women need to realize that if they are on hormonal birth control pills it may mask symptoms of perimenopause,\u201d she says. \u201cThat could be a good thing, but [some women] really want to know what is going on [with their bodies].\u201d<\/span><\/p>\n<h3 id=\"alternative-therapies\"><span style=\"font-weight: 400;\">Alternative therapies\u00a0<\/span><\/h3>\n<p><span style=\"font-weight: 400;\">As for<\/span> <span style=\"font-weight: 400;\">natural and herbal therapies<\/span><span style=\"font-weight: 400;\"> (like red clover, black cohosh, or soy), Dr. Rafie urges women to discuss the use of such supplements with their healthcare providers because a) data is mixed and b) the industry is not regulated by the Food and Drug Administration, meaning that safety and effectiveness have not been proven. According to the National Institutes of Health Office of Dietary Supplements, some studies have indicated that<\/span> <a href=\"https:\/\/ods.od.nih.gov\/factsheets\/BlackCohosh-HealthProfessional\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">black cohosh, specifically, can actually worsen the frequency and severity of hot flashes<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cWith [alternative therapies] it is always a risk\/benefit analysis that every individual, with the help of their healthcare provider, should look at carefully [before using],\u201d Dr. Rafie says.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Simple lifestyle changes can be quite beneficial as well. Dr. Minkin recommends dressing in layers to alleviate the discomfort of vasomotor symptoms like hot flashes and night sweats. She also suggests paying attention to potential triggers. For example, some women find that red wine and\/or spicy foods increase the frequency and duration of hot flashes, so they eliminate (or reduce the consumption of) those items from their diets, she says.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">Dr. Minkin also emphasizes the importance of maintaining a healthy body weight during perimenopause and beyond because excess weight is a contraindication to a whole host of health problems.<\/span><span style=\"font-weight: 400;\">\u00a0<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cGood nutrition and exercise [will] help, there&#8217;s no question about it,\u201d she says, adding that it is typical for a woman to gain between 5-8 pounds during the perimenopause phase\u2014even with a healthy diet and plenty of exercise\u2014thanks again to those hormonal changes.<\/span><\/p>\n<h2 id=\"can-women-get-pregnant-during-perimenopause\"><span style=\"font-weight: 400;\">Can women get pregnant during perimenopause?<\/span><\/h2>\n<p><span style=\"font-weight: 400;\">Even if you don\u2019t need or want to take low-dose birth control pills to help with hot flashes, there may be one significant benefit to using them during perimenopause\u2014contraception.<\/span> <a href=\"https:\/\/www.menopause.org\/for-women\/sexual-health-menopause-online\/reminders-and-resources\/contraception-you-need-it-longer-than-you-may-think\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">Because, yes, you <\/span><i><span style=\"font-weight: 400;\">can<\/span><\/i><span style=\"font-weight: 400;\"> get pregnant during perimenopause<\/span><\/a><span style=\"font-weight: 400;\">.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">It all goes back to the unpredictable menstrual cycles that occur during this time, she says. In other words, you might not know exactly when, or if, <\/span><a href=\"https:\/\/www.singlecare.com\/blog\/ovulation-guide\/\"><span style=\"font-weight: 400;\">you are ovulating<\/span><\/a><span style=\"font-weight: 400;\">. The quality of the eggs, and therefore the odds of getting pregnant, are diminished, of course (<\/span><a href=\"https:\/\/www.reproductivefacts.org\/news-and-publications\/patient-fact-sheets-and-booklets\/documents\/fact-sheets-and-info-booklets\/age-and-fertility\/\" target=\"_blank\" rel=\"noopener noreferrer\"><span style=\"font-weight: 400;\">less than a 5% chance according to the American Society for Reproductive Medicine<\/span><\/a><span style=\"font-weight: 400;\">)\u2014but the possibility remains.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">\u201cPeople certainly aren\u2019t as fertile as they were when they were 22, but they still are fertile until they go that magic year without a period,\u201d Dr. Minkin explains.<\/span><\/p>\n<p><span style=\"font-weight: 400;\">And if oral contraceptives\u00a0 aren\u2019t for you? That\u2019s okay.<\/span> <span style=\"font-weight: 400;\">Just be sure to use some sort of contraception<\/span><span style=\"font-weight: 400;\">. \u201cI have personally delivered three babies to 47-year-old women,\u201d Dr. Minkin says.<\/span><\/p>\n","protected":false},"excerpt":{"rendered":"<p>Many women think of menopause as something they \u201cgo through.\u201d Menopause, however, is actually a destination\u2014not a journey. You reach this destination when you have made it through a solid year without a menstrual period. The phase leading up to that point (you know, the one with all the annoying hot flashes, mood swings, and [&hellip;]<\/p>\n","protected":false},"author":93,"featured_media":11435,"comment_status":"open","ping_status":"open","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"footnotes":""},"categories":[8029],"tags":[8670],"coauthors":[8369],"class_list":["post-11418","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-health-education","tag-womens-health","wpautop"],"acf":[],"yoast_head":"<!-- This site is optimized with the Yoast SEO Premium plugin v27.4 (Yoast SEO v27.4) - https:\/\/yoast.com\/product\/yoast-seo-premium-wordpress\/ -->\n<title>What is perimenopause? Symptoms and treatments<\/title>\n<meta name=\"description\" content=\"Perimenopause is the first stage of menopause marked by symptoms like hot flashes, mood swings, and vaginal dryness. 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