Perimenopause FAQs


Perimenopause is the period that precedes menopause, characterized by the reduced secretion of estrogen by the ovaries. Typically, perimenopause begins when the woman hits 40 years old. However, some women may develop menopause in their late 30s.

The symptoms of perimenopause last until the woman reaches menopause. The latter refers to the complete depletion of ova (plural of ovum). Note that the last year or two that precede menopause will present with more severe symptoms.

In this article, we will cover the signs and symptoms of perimenopause, as well as how to diagnose it. We will also discuss some therapeutic options and frequently asked questions (FAQs) about this condition.

How Long Does Perimenopause last?

Typically, perimenopause lasts an average of 4 years. However, the duration varies greatly. For instance, some women only experience the symptoms of perimenopause for a few months, while others deal with this condition 6-7 years prior to menopause.

Signs and Symptoms of Perimenopause

The exact symptoms of perimenopause vary from one woman to another. In general, they all experience at least one vasomotor symptom.

Here is a list of some perimenopause signs and symptoms:

  • Hot flashes
  • Breast tenderness
  • Worse premenstrual syndrome
  • Decreased libido
  • Unexplained fatigue
  • Disturbed cycle
  • Dyspareunia (i.e., feeling pain during sex)
  • Vaginal dryness
  • Sudden urges to pee
  • Mood swings
  • Insomnia

Which symptoms should I be concerned about?

The most annoying symptom you may experience during perimenopause is irregular menstrual cycle. This can lead to severe bleeding and disturb your efforts to conceive a baby.

Women may experience the following:

  • Heavy bleeding and formation of blood clots
  • Periods lasting longer than usual
  • Vaginal dryness – causes painful sex
  • Irregular spotting (e.g., after sex, in between periods)
  • Shortening of the duration between periods

Aside from perimenopause, other causes of abnormal vaginal bleeding include pregnancy, fibroids, hemostatic disorders, birth control pills, endocrine disorders, and cancer.

Diagnosis of Perimenopause

The diagnosis of perimenopause is usually clinical. In other words, your doctor will be able to diagnose the condition based on your presenting symptoms.

Moreover, hormone tests can help confirm the diagnosis. Ideally, multiple tests are conducted since estrogen and progesterone levels vary greatly in one menstrual cycle.

Pregnant during Perimenopause?

Conceiving a baby during perimenopause is possible. While you will have reduced fertility, you can become pregnant. Therefore, if you don’t plan to have kids, make sure to use contraceptive methods, even during perimenopause.

On the other hand, if your goal is to become pregnant, you should consult with your physician to increase your chances.

Perimenopause Treatment

Hormone replacement therapy, or HRT, is an effective treatment for the symptoms of perimenopause and menopause. This therapy consists of low-dose birth control pills for a short time. Alternatively, you could use progesterone injections, skin patches, and vaginal rings.

Aside from pharmacological treatments, some lifestyle modifications that may help with perimenopause symptoms include:

  • Regular exercise
  • Smoking cessation
  • Drink less alcohol
  • Optimize your sleep hygiene
  • Lose weight
  • Include more calcium-rich foods in your diet
  • Take a multivitamin for cervical health

Speak with your doctor if decreased libido is a prominent symptom. Seeing a therapist in this situation may be recommended by your doctor. You can also use vaginal lubricants to improve your sex life.

Mood swings and other mental trouble can be treated with lifestyle changes and antidepressants. The latter may also help with hot flushes.

In summary, speak with your primary care physician or gynecologist about the specific symptoms you are dealing with. This will guide your doctor into prescribing a specific drug for your case.