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What is perimenopause?

Medically reviewed by Neka Miller, PhD on December 14, 2020. To give you technically accurate, evidence-based information, content published on the Everlywell blog is reviewed by credentialed professionals with expertise in medical and bioscience fields.


It’s natural for your body to change as you get older, and for many middle-aged women these changes include noticeable differences in the menstrual cycle. Everyone’s body is different and only you know what is considered to be a normal period for you. But if—after decades of having a regular cycle—you begin to notice changes in your period, this could be a sign that your body has entered perimenopause.

Now you may be left asking, “What is perimenopause and how can you tell if you’ve entered the perimenopause stage?”


Check hormone levels that may indicate menopause is approaching with the Everlywell at-home Perimenopause Test.


Here, we break down what perimenopause is and the common symptoms that can occur during this phase of a woman's life, so continue reading to learn more.

What does perimenopause mean?

Perimenopause is the menopausal transition stage when your body begins to experience fluctuations in estrogen levels and other hormone levels. This transition can begin as early as in your 30s and lasts for several years before you reach actual menopause, which is when you have not had a period for 12 consecutive months.

Perimenopause is different from menopause because ovulation still happens during this phase. This means that you still get your period and it is possible to get pregnant. But periods can be quite erratic during perimenopause due to fluctuating hormone levels. During late perimenopause, estrogen levels typically fall, often causing a flood of perimenopausal symptoms.

What to expect during perimenopause

How do you know if you've begun transitioning towards menopause? Many people associate hot flashes with menopause, but the signs of menopause you may experience during this transition can include more than that symptom alone. Knowing what these symptoms are in advance can help you recognize whether your body is starting to enter menopause.

The most commonly experienced perimenopause symptoms to look out for include the following:

  • Irregular periods
  • Periods with abnormal bleeding that can be heavier or lighter than usual
  • Hot flashes
  • Night sweats
  • Sleep disturbances or difficulty sleeping
  • Vaginal dryness
  • Weight gain
  • Headaches or migraines
  • Mood changes or more severe PMS symptoms
  • Changes in sex drive
  • Urinary tract infections
  • Urinary incontinence
  • Breast tenderness
  • Racing heart
  • Joint and muscle pain
  • Hair loss

You probably won’t have all of these symptoms during perimenopause, but it’s worth knowing many of the possible signs.


Experiencing symptoms like these and suspect you may be entering perimenopause? Take the at-home Perimenopause Test to check if your levels of key hormones (estradiol, follicle-stimulating hormone, and luteinizing hormone) fall within established normal ranges.


However, some of these symptoms are more commonly experienced than other symptoms. Hot flashes, also known as vasomotor symptoms, are among the most frequently experienced symptoms that usually start during late perimenopause. Hot flashes are caused by a sudden flow of blood to the face or neck, making you feel uncomfortably hot and sweaty. Hot flashes last for varying amounts of time for different people and can be triggered by certain factors such as hot weather, tight clothing, caffeine, smoking, spicy foods, and alcohol—according to research.

Vaginal symptoms, urinary tract infections, and headaches should be evaluated by your healthcare provider to ensure that they are not caused by other—more serious—health issues.

How long does perimenopause last?

Typically, perimenopause begins in your 40s, but some women may start transitioning towards menopause in their 30s. On average, perimenopause lasts about four years before the onset of menopause; however, in some women perimenopause can begin eight to ten years before menopause.

Perimenopause is different from premature menopause or early menopause. Menopause that occurs at an earlier age than 45 is called early menopause. Premature menopause refers to menopause that occurs in women before the age of 40. Only 5% of women are estimated to undergo early menopause, while 1% of women are estimated to undergo premature menopause.

Tips for navigating perimenopause

If you experience any unusual symptoms or are concerned about sudden changes to your cycle, be sure to speak with your healthcare provider. Natural menopause occurs without medical treatment or surgery, but other medical conditions can affect the perimenopause phase. Unusual symptoms like increased clotting during periods, spotting after periods, and longer or shorter periods, can also be due to other problems like a hormonal imbalance. Discussing signs and symptoms with your healthcare provider can help you figure out whether your symptoms are related to perimenopause or something else.

Additionally, certain medications or treatments may help relieve some symptoms of perimenopause; for example, hormone therapy may be recommended to reduce vasomotor symptoms or excessive menstrual bleeding. In some cases, women receive hormone replacement therapy to replace estrogen levels in the body during menopause.

Also, remember that it is possible to get pregnant during perimenopause—so if you are not planning for pregnancy, consider using some form of birth control even if you are perimenopausal.

Is there a test for perimenopause?

Determining whether you are perimenopausal can’t be done with just a lab test, since making this determination also requires an assessment of symptoms and medical history by a healthcare provider.

That being said, if you’ve started noticing changes in your menstrual cycle, or experiencing other possible perimenopause symptoms, there is an easy way to test whether they are accompanied by the hormonal changes that can be characteristic of perimenopause.

The Everlywell at-home Perimenopause Test lets you check if your hormone levels for 3 key hormones involved in the menopausal transition are within normal ranges—from the comfort and privacy of your home. Using just a few drops of blood that you can collect yourself with a simple finger prick, the test measures estradiol (a common form of estrogen in the body), luteinizing hormone (LH), and follicle-stimulating hormone (FSH).

For context, LH and FSH are hormones that are critical for the process of ovulation. During perimenopause, when quantities of eggs in the ovaries decrease, the levels of LH and FSH increase in the body. Estradiol regulates normal functioning of the sexual organs and levels normally decrease as menopause approaches.

After your sample is analyzed by the lab (a prepaid shipping label is included with the kit to easily send in your sample), your test results are reviewed by a board-certified physician and secure, easy to understand digital results are returned to you. From there, it can be a great idea to discuss your results with your healthcare provider.


What happens during menopause?

How long does menopause last?


References

1. Menopause. Mayo Clinic. URL. Accessed December 14, 2020.

2. Perimenopause. Mayo Clinic. URL. Accessed December 14, 2020.

3. Menopause, Perimenopause and Postmenopause. Cleveland Clinic. URL. Accessed December 14, 2020.

4. Thurston RC, Joffe H. Vasomotor symptoms and menopause: findings from the Study of Women's Health across the Nation. Obstet Gynecol Clin North Am. 2011;38(3):489-501. doi:10.1016/j.ogc.2011.05.006

5. Premature and Early Menopause. Cleveland Clinic. URL. Accessed December 14, 2020.