Perimenopause: All You Need to Know

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”—so, yes, this is the time around menopause.

In other words, perimenopause is the time leading up to when your body stops ovulating.

The exact point of menopause itself is 12 months after you’ve had your last period. But rather than a single, isolated moment, menopause is a journey that takes place in different phases over a space of time.

Over this transition, 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.

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 at 35 and 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 signs of menopause

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 perimenopause

The second phase is the chapter before hitting menopause. 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:

Let’s name and reclaim that stuff.

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 is the common stuff:

• Hot stuff. 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. Sometimes the flash goes quickly to a chill in one sweeping motion. And then there are also night sweats. They’re fun. Through all of this, keep hydrated. Keep loving yourself. (And license to scream when you need to.)

• Vagina stuff. Vaginal atrophy is the term that is used—but we’re not so crazy about that, tbh. You’re not withering or wasted. Your estrogen has just dropped. Which is supposed to happen. This drop can cause vaginal dryness and burning, and it can also cause the wall of your vagina to thin. This may impact how you feel about sex. Moisturizers and lubes can help.

• 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.

• Bone stuff. Toward the end of perimenopause, you might start losing bone mass at quite a rapid rate. This is normal. Ensuring that you have the right amount of calcium and vitamin D in your diet can help strengthen your bones.

• Food stuff. 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. Pelvic floor exercises can help.

• Heart stuff. Pounding and palpitations are normal at this time because of changing hormone levels—but if you’re worried about anything that feels irregular, chat to your doctor.

• Muscle stuff. Cramps, spasms, tingles. You don’t have to just live through this. Talk to your doctor about meds that can help.

• 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. You finally do and then you wake up moments later. You have nightmares. You have sweats. Things that help? Yoga, meditation, exercise. And if you need meds, talk to your doctor.

• Mood stuff. 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.

And there’s also something else that shouldn’t just be shoved into one big Oh it’s hormones pile:

• Mental health stuff. This time of life can be a whole lot for your emotions to take. 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. 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. Counseling really 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.

📚 More on menopause:
Introducing, Peanut Menopause
What Happens During Menopause?
How to Deal With Menopause
When Does Menopause Start?
Painful Sex After Menopause? What to Know
Hot Flashes: Causes, Symptoms, and What to Do
What to Know About Menopause Joint Pain
Unusual Menopause Symptoms You Might Not Know
Why Are My Breasts Getting Bigger After Menopause?
Menopause and Sleep: What’s the Link?
Menopause and Constipation: What’s the Link?
What are the 34 Symptoms of Menopause?
What are the Signs Perimenopause is Ending?