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Menopause isn't an on-off switch. Women don't just wake up one day in menopause. Rather, there's a slow, progressive transition, known as perimenopause.

What is Perimenopause?

Perimenopause, or menopause transition, begins several years before menopause. It's the time when the ovaries gradually begin to make less estrogen. It usually starts in women's 40s but can start in their 30s or even earlier.

Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last 1 to 2 years of perimenopause, this drop in estrogen speeds up. At this stage, many women have menopause symptoms.

How long does it last?

The hallmark symptom of perimenopause is changes to the menstrual cycle. It's hard to say how long this phase lasts because early signs can be gradual or easy to ignore. When a woman is busy juggling her many responsibilities, she might not notice a slightly different period or a few extra days on a menstrual cycle here and there.

Exactly when this phase occurs varies widely. It can depend on many factors:

  • Genetics (age of onset of menopause is determined by genes)
  • Overall health
  • Reproductive history
  • Body composition (e.g., levels of body fat that can change the hormonal environment)
  • Stress
  • Lifestyle factors (e.g., smoking, alcohol use)

The average length of perimenopause is 4 years, but for some women, this stage may last only a few months or continue for 10 years. Perimenopause ends when women have gone 12 months without having their period.

What Happens During Perimenopause?

During perimenopause, the hormonal landscape of a woman's body undergoes significant shifts. Here's a glimpse into some of the changes that take place:

  1. Fluctuating Hormones: Estrogen and progesterone, the primary female sex hormones, experience erratic fluctuations. These hormonal imbalances can lead to irregular menstrual cycles, varying from shorter to longer intervals.
  2. Symptom Manifestations: Perimenopause often brings about a variety of symptoms, such as hot flashes, night sweats, mood swings, irritability, sleep disturbances, vaginal dryness, and decreased libido.
  3. Ovulation Variability: Ovulation becomes unpredictable, impacting fertility. This is a crucial aspect for women who still wish to conceive during this time.
  4. Bone Health: There may be a decline in bone density, increasing the risk of osteoporosis. Adequate calcium and vitamin D intake, along with weight-bearing exercises, become vital.
  5. Metabolism and Weight: Many women notice changes in metabolism and body composition. It might become slightly easier to gain weight and harder to lose it.

Are There Treatments That Can Ease the Symptoms of Perimenopause?

Many women get relief from hot flashes and night sweats, or VMS (Vasomotor symptoms), after taking low-dose birth control pills for a short time. Other options that may control hot flashes include the birth control skin patch, vaginal ring, and progesterone injections. Certain women should not use birth control hormones, so talk to your doctor to see if they are right for you.

You may also feel better if you do things that enhance your general well-being, such as:

  • Exercise
  • Stop smoking
  • Get more sleep and try going to sleep and waking up at the same time each day
  • Drink less alcohol
  • Get to a healthy weight and stay there
  • Get enough calcium in your diet
  • Ask your doctor if you should take a multivitamin

Can I Get Pregnant If I Am Perimenopausal?

Yes. Despite a decline in fertility during the perimenopause stage, you can still become pregnant. If you do not want to become pregnant, you should use some form of birth control until you reach menopause (you have gone 12 months without having your period).

Why Understanding Perimenopause Matters?

  1. Empowerment through Knowledge: Knowledge is your greatest ally. Understanding perimenopause arms you with the ability to identify and manage the changes happening in your body. This empowers you to make informed decisions about your health and well-being.
  2. Health Management: Awareness of perimenopause allows you to take proactive steps to manage symptoms and reduce potential health risks. Regular exercise, a balanced diet, stress reduction techniques, and open communication with healthcare providers become essential tools.
  3. Lifestyle Adjustments: Embracing perimenopause involves adapting to new needs and priorities. By understanding this stage, you can fine-tune your lifestyle, focusing on self-care practices that promote mental, emotional, and physical well-being.
  4. Future Planning: For those who wish to have children, knowing when fertility might decline significantly is crucial for family planning decisions.


Perimenopause is a transformative journey that every woman will traverse. Understanding this stage grants you the opportunity to embrace the changes with grace and confidence. As a Menopause Specialist Coach, I am here to support and guide you through this significant phase, helping you navigate the challenges and harness the empowerment it can bring. Remember, with knowledge comes the power to navigate perimenopause on your terms.