Women's Health Institute


Perimenopause: The Change No One Told You About

Just like during puberty, women’s bodies go through many hormonal changes as they get older. For some women, they can experience menopause-like symptoms in their mid-30’s to early 40’s while still getting their monthly period. From night sweats to mood swings, these symptoms could be a sign of perimenopause.

But what is Perimenopause? According to the Mayo Clinic, perimenopause is the time in a women’s life before menopause when your body produces uneven levels of hormones like estrogen. This is your hormone system shifting from a reproductive function to a maintenance function. Every woman is different, and each body will experience these changes in a different way. At Women’s Health Texas, we understand that these uncomfortable symptoms can get frustrating. But it is important to know that you are not alone, as many women experience symptoms of perimenopause. We hope that by providing more information, mapping out the symptoms, and offering suggestions on how to manage them, you will feel more comfortable. Our providers at Women’s Health TX are always here to provide support and answer your questions.

What are the earliest signs of Perimenopause?
Perimenopause begins when periods are still regular, but the cycle length is shortened slightly. According to the Mayo Clinic, this is due to the fluctuation of estrogen levels and low progesterone. On average, perimenopause can last from 4 to 6 years, but can also last for 10 years or more. There are two stages of perimenopause, early and late. Early perimenopause typically begins when a woman is 35 to 42 years old. Late perimenopause generally begins at 45 to 50 years of age. Perimenopause ends after a woman has gone 12 months without having her period (menopause).


How do I know if I am in perimenopause?
Since a woman’s hormones levels can fluctuate during perimenopause, it can be tricky for your doctor to make a diagnosis. Women’s Health Texas recommends tracking your cycle to figure out what hormonal changes you may be experiencing. Simply record the day on which your period starts and the total number of days between Day 1 of one cycle and Day 1 of the next cycle. There are apps available for storing your notes, or you can mark them in a calendar. You should note any symptoms you may be having, and share this information with your Women’s Health Texas provider.

Symptoms may include (not all women experience symptoms):

  • Heavy flow – higher estrogen levels can lead to a heavier flow
  • Disrupted sleep – middle of the night waking, having trouble falling asleep, waking early
  • Mood changes – new or increased feelings of anxiety, irritability or depression
  • Night sweats and hot flashes – a change in hormone levels can cause changes in our internal thermostat
  • Sore breasts – erratic estrogen levels can cause breast tenderness to occur
  • Headaches – premenstrual headaches can begin or increase during this time
  • Weight gain – the high estrogen of early perimenopause makes gaining weight more likely
  • Shorter cycles – slightly shorter cycles by an average of 27 days
  • Low libido – lack of interest in sex is common
  • Vaginal dryness – this can be caused by the decline in estrogen levels
  • Brain fog – memory issues or being forgetful


What to do next?
Your Women’s Health TX provider can work with you to recommend treatment options to help ease symptoms. Birth control pills, medications, vitamins, and herbal supplements are all common when trying to relieve perimenopause symptoms. However, there are also many lifestyle changes that women can try. This includes a healthier diet, consistent exercise, and the refraining from smoking and drinking alcohol. These all attribute to a healthier wellbeing as well as reducing the complications that come from perimenopause. It is also important to remember you are not alone, many women are most likely experiencing similar symptoms.

Our providers at Women’s Health TX are always here for support and to answer any questions you may have. To learn more about perimenopause and how to manage your symptoms, please do not hesitate to contact us.