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Perimenopause

Home > Understanding Menopause > Stages of Menopause > Perimenopause

• What is Perimenopause?
• Signs and Symptoms
• Pregnancy and Perimenopause
• Sexual Health and Perimenopause
• Additional Resources

What is Perimenopause?

Perimenopause marks the time when your body begins the transition to menopause. It includes the years leading up to menopause — anywhere from two to eight years — plus the first year after your final period. There is no way to tell in advance how long it will last OR how long it will take you to go through it. It's a natural part of aging that signals the ending of your reproductive years.

Signs and Symptoms

Perimenopause causes changes in your body that you may or may not notice. For most women, the discomforts associated with perimenopause are minimal and manageable. Some things you might experience in the perimenopause years include:

• Changes in your menstrual cycle (longer or shorter periods, heavier or lighter periods, or missed periods)
• Hot flashes (sudden rush of heat from your chest to your head)
• Night sweats (hot flashes that happen while you sleep)
• Vaginal dryness
• Sleep problems
• Mood changes (mood swings, sadness, or irritability)
• Pain during sex
• More urinary infections
• Urinary incontinence
• Less interest in sex
• Increase in body fat around your waist
• Problems with concentration and memory

You can’t always tell if physical or emotional changes are related to menopause, the normal aging process, or something else. But by monitoring your menstrual cycle and recording your signs and symptoms for several months, you'll gain a better understanding of the changes occurring during this time. You will also have valuable information to discuss with your doctor should you have a concern.

Oral contraceptives (birth control pills) are often the treatment of choice to relieve perimenopausal symptoms — even if you don't need them for birth control. Today's low-dose pills regulate periods and stop or reduce hot flashes, vaginal dryness, and premenstrual syndrome.

Making lifestyle changes may help ease the discomfort of your symptoms and keep you healthy in the long run.

• Good nutrition. Because your risk of osteoporosis (bone disease) and heart disease increases at this time, a healthy eating plan is more important than ever. Adopt a low-fat, high-fiber eating plan that is rich in fruits, vegetables, and whole grains. Add calcium-rich foods or take a calcium supplement. Limit alcohol or caffeine, which can affect sleep. If you smoke, try to quit.

• Regular exercise. Regular physical activity helps keep your weight down, improves your sleep, strengthens your bones, and elevates your mood. Try to exercise for 30 minutes or more on most days of the week.

• Stress reduction. Practiced regularly, stress reduction techniques such as meditation or yoga can help you relax and tolerate your symptoms more easily. The "Stress and Your Health" FAQ can be a good resource as well.

Pregnancy and Perimenopause

If you're still having periods, even if they are not regular, you can get pregnant. Talk to your doctor about your options for birth control. Keep in mind that some methods of birth control, like birth control pills, shots, implants, or diaphragms will not protect you from sexually transmitted infections (STIs), including HIV.

Sexual Health and Perimenopause

Many aging women enjoy an active sex life. Yet, many women are not aware of their risk of getting sexually transmitted infections (STIs), including HIV. If you have more than one sexual partner or have started a new sexual relationship, talk with your partner about using condoms before having sex. Latex condoms used correctly and every time you have any type of sexual contact offer the best protection against STIs. Dental dams (used for oral sex) and female condoms also can help protect you from some STIs.

Additional Resources on Perimenopause:

Publications

1.   Frequently Asked Questions - Perimenopause - This fact sheet discusses perimenopause, the time leading up to menopause when you start to notice menopause-related changes. It provides information on what to expect, how long it will last, what the symptoms and treatments are, and when to talk to your doctor.

   http://www.womenshealth.gov/faq/perimenopause.htm

2. Menopause Guidebook (Copyright © NAMS) - This guidebook explains the emotional and physical changes that often accompany menopause. It also explains what to expect and how to take care of yourself after menopause.

   http://www.menopause.org/edumaterials/guidebook/guidebook.aspx

3. Midlife Transitions: A Guide to Approaching Menopause (Copyright © ACOG) - This brochure explains the different physical and emotional changes you may experience as you approach menopause. It provides information on treatment and coping strategies that can help you relieve the different symptoms.

   http://www.acog.org/publications/patient_education/ab013.cfm

4. Perimenopausal Women and the Use of Very-Low-Dose Birth Control Pills (Copyright © AAFP) - This publication provides information on very-low dose birth control pills, why someone would use these during perimenopause, who shouldn't take these pills, and how to know when menopause starts.

   http://familydoctor.org/online/famdocen/home/women/reproductive/menopause/326.html...

5. Perimenopause (Copyright © MFMER) - This publication explains what perimenopause is, what the signs are, and what factors may cause you to enter perimenopause early. It also discusses how you can care for yourself during this time of transition.

   http://www.mayoclinic.com/health/perimenopause/DS00554

6.   Perimenopause: Beginning of Menopause (Copyright © JAMA) - This publication explains the menopause transition known as perimenopause. It discusses the symptoms that often occur with perimenopause and the ways to ease them. It also raises awareness of health concerns that face women during menopause and beyond.

   http://jama.ama-assn.org/cgi/reprint/289/7/940.pdf

7. Perimenopause: Pathways to Change (Copyright © ARHP) - This on-line publication is designed to help you understand what perimenopause is and what physical and emotional changes you may notice. It also highlights some important issues such as birth control, sexually transmitted diseases, nutrition, and exercise.

   http://72.3.159.179/Publications-and-Resources/Patient-Resources/printed-materials/pathways...

Organizations

1.   National Institute on Aging, NIH, HHS
2. The Hormone Foundation
3. The North American Menopause Society (NAMS)

= Indicates Federal Resources

Content last updated May 29, 2008.