Perimenopause: Stages, Symptoms, and Support

Entering perimenopause can feel like going on a trip to a foreign land without a map.

But don’t worry. You don’t have to just fend for yourself.

This transition is a totally normal life phase—and while no two experiences of it are identical, we do have a lot to learn from each other.

Let’s start at the beginning.

In this article: 📝

What is perimenopause?

The peri in perimenopause means “around”— as in the time around menopause—and is basically the period leading up to when your body stops ovulating.

Another name for it? The menopausal transition.

The exact point of menopause itself is 12 months after you’ve had your last period.

So, technically, menopause lasts only one day that comes after 12 consecutive months without a period— after that day, you’re in the post-menopause era.

Over the menopausal transition or perimenopause, your hormones—most notably estrogen and progesterone—start to fluctuate.

When they do, you may experience all sorts of interesting changes.

Some people have loads of intense symptoms. Some people have none.

But knowing the signs of perimenopause can make the whole journey just that much easier to navigate.

What is the average age for perimenopause?

So when does perimenopause start?

Although it’s often spoken about as something that only hits you in your late 40s and early 50s, perimenopause can span a far greater stretch.

It can start younger than you think—you may notice its first signs in your 30s already.

And it may take you all the way to your late 50s

What are the stages of perimenopause?

Roughly speaking, perimenopause can be divided into two stages—early and late.

But these are by no means neat little boxes.

No two experiences of perimenopause are alike.

Signs and symptoms vary both in terms of when they occur and what happens when they do.

Early stage of perimenopause

Thou shalt (often) know it by changes to thy period (not always, but commonly.)

Things can get more irregular in terms of how much and how often.

You can experience surges of estrogen which may make you feel all sorts of things, from tender breasts to bloating to mood swings to headaches.

This phase usually starts in your 40s but can start in your 30s.

Late stage of perimenopause

The second phase is the chapter before hitting menopause.

The late stage of perimenopause usually occurs when a woman is in her late 40s or early 50s.

For some women, this time can bring with it a host of uncomfortable symptoms—often made worse by the fact that we just don’t talk about any of this.

Basically, there’s just way too much What is this thing happening to my body?? going on.

Symptoms of perimenopause

Conversations around perimenopause are often brought to an early close with the phrase I’m just going through some stuff.

We want you to know that your stuff matters.

So:

Ready?

Before we get going, an important reminder about stuff—not everyone goes through the same stuff or in the same way.

Your stuff is your stuff, but here are the most common:

Hot stuff aka hot flashes 🥵

Ah, the infamous hot flash.

All of a sudden, there’s this surge of heat from who knows where, cascading through your face, neck, and sometimes your whole torso.

Sometimes you go a delectable shade of pink. Sometimes you sweat. And other times, the flash goes quickly to a chill in one sweeping motion.

And then there’s also night sweats. They’re fun.

“A hot flash is by far the most typical symptom during perimenopause,” explains registered nurse Nancy Mitchell, “affecting 75% of women.”

‘While some experience hot flashes for only one or two years, others can live with them for ten years or even longer.

And for one-third of women, it becomes moderately or severely problematic.”

Through all of this, keep hydrated. Keep loving yourself. (And just know you have license to scream when you need to.)

Period stuff 🩸

Some periods like to go out with quite an impressive final act.

They might get irregular. They might be more intense. They might be longer.

“Heavy or prolonged bleeding is common during perimenopause,” explains Mitchell.

“According to a study by the University of Michigan, 91% of women in the menopausal transition had instances of bleeding that lasted 10+ days.”

Bone stuff aka loss of bone mass 🦴

Toward the end of perimenopause, you might start losing bone mass at quite a rapid rate.

This is normal.

“About 25% of perimenopausal women are ‘fast bone losers’,” says Mitchell, “meaning they are prone to a particularly rapid loss of the mineral density of bones.”

Ensuring that you have the right amount of calcium and vitamin D in your diet can help strengthen your bones.

Muscle stuff 💪

Cramps, spasms, muscle tension, and tingles. You don’t have to just live through this.

Talk to your doctor about meds that can help.

Heart stuff ❤️‍🩹

Pounding and palpitations are normal at this time because of changing hormone levels.

Around 42% of women in perimenopause report having palpitations.

But if you’re worried about anything that feels irregular, chat with your doctor.

What are some uncommon symptoms of perimenopause?

And then there’s the stuff less frequently experienced by women during perimenopause.

“Only 5% of women notice the triad of perimenopause symptoms such as interrupted sleep, sexual problems, and depression,” explains Mitchell.

Let’s take a look at some of them:

Sleep stuff 🥱

Getting rest can feel like something you just cannot seem to tick off your To-Do list.

You can’t get to sleep. And once you finally do, you wake up moments later.

You have nightmares. You have sweats.

Things that help? Yoga, meditation, exercise.

Vagina stuff aka vaginal atrophy 🏜

About 15% of women experience vaginal atrophy before they reach menopause.

And while vaginal atrophy is the term that is used—we’re not so crazy about it, tbh.

You’re not withering or wasted. Your estrogen has just dropped.

Which is supposed to happen.

And this drop in estrogen can cause vaginal dryness and burning.

It can also cause the wall of your vagina to thin.

All of this may impact how you feel about sex after menopause, but moisturizers and lubes can help.

Food stuff aka changing appetite 🧁

You might be craving all things sweet or all things salty.

Or you just have no interest in any food whatsoever.

Nothing is appetizing.

Either way, self-care sometimes means taking the time to make yourself a nice meal and sitting down to eat it.

Bladder stuff 💦

Let’s just say the pee ‘n sneeze is not a myth.

But pelvic floor exercises can help.

Mood stuff 😶‍🌫️

Don’t get scared when your mood goes on a swing: from extreme lows to extreme highs.

The change in hormones can cause your mood to fluctuate.

Estrogen can surge during menopause and then plummet.

Progesterone also takes a dive.

So, yes, this can leave you feeling all over the place.

Besides, there’s so much that can take a toll on your mental health—fears about getting older, career stress, serious family responsibilities… It’s a lot.

This time of life can be a whole lot for your emotions to take.

Added to this, if you wanted to have children and weren’t able to (for the myriad reasons out there), this time can be one of real loss.

But counseling does help.

As does chatting to a community of people going through the same things you’re going through.

You just don’t have to go through this alone.

Find out more: 40 perimenopause symptoms.

You’ve got this.

And when you don’t feel like you have, reach out.

The Peanut community have you.