Perimenopause: The transition phase before menopause

Hot flashes, mood shifts and menstrual changes can all be signs that your body is getting ready for menopause. Learn how to ease the discomfort.


It’s one of the facts of life. Women go through menopause. But did you know that there’s also a transition phase before it called perimenopause that can include similar symptoms like hot flashes, menstrual changes, loss of libido and mood shifts? Although you may be cringing at the thought of prolonged discomfort, it’s Mother Nature’s way of easing you into a new phase of life. And, rest assured, it won’t last forever.

The perimenopause stage

The transitional phase of perimenopause signals the start of hormonal, biological and physical changes and can start about three to five years before menopause.

Perimenopause usually begins in your 40s or even late 30s as you start to notice changes in your menstrual cycle due to reduced amounts of estrogen. Once you’ve gone 12 months without a period, menopause will begin. Although you may be nearing the end of your reproductive years, you can still become pregnant during this time. Really!

Symptoms of the menopausal transition

No two women will have the same experience. For some, an occasional hot flash might be the worst symptom. For others, it will feel like summertime heat year-round. While hot flashes and night sweats are common, other symptoms can be just as challenging to manage and tend to stem from lack of restful sleep.

Sleep. Changing hormones can affect sleep patterns and cause you to wake more often.

Mood changes and low libido. These can occur for several reasons and most notably are a result of poor sleep and hormone changes.

Hot flashes and night sweats. Sudden feelings of being hot and uncomfortable, especially in the face, neck and chest can last for seconds up to minutes. These can vary in intensity and frequency. Most sleep problems are due to night sweats.

Weight gain. Hormone changes and aging both can affect weight. Because muscle mass reduces as we age, it slows metabolism making it more difficult to burn fat and maintain a healthy weight.

Headaches. The dips in hormone levels – estrogen and progesterone – may make headaches worse.

Bone loss. Low hormone levels, such as low estrogen, can lead to bone loss and the development of osteoporosis.


Easing the discomfort

To help manage the uncomfortable symptoms of menopause, focus on your diet, exercise and lifestyle changes. You can also talk to your doctor about medications that may help or hormone replacement therapy. According to the North American Menopause Society, there are things you can do to help prevent and decrease those pesky hot flashes.

  • Limit alcohol, caffeine and spicy foods – these can be hot flash triggers
  • Stay cool – keep your body temperature cool by dressing in layers and drinking cold water during the day
  • Keep your body weight at a healthy number – choose plant-based, whole foods over processed, high-fat foods
  • Don’t smoke – it increases the risk of osteoporosis, heart attack and stroke
  • Engage in plenty of routine exercises – it can relieve hot flashes and reduce the risk of fractures

Take the time to initiate a conversation about how you’re feeling with your doctor. Don’t worry about discussing sensitive topics – your doctor has heard them before and can offer you the resources you need to help manage your symptoms.

Find a doctor

To find a gynecology specialist experienced in treating menopause conditions visit our provider directory. Or, you can search for a gynecologist in your area.






Are menopausal hot flashes interfering with your life? Take the steps you need to start feeling better. #menopause #perimenopause #hotflashes #midlife @psjh 


Time for a change? Know the signs of menopause

Hot flashes in menopause? Ask your doctor about hormone therapy

Know the pros and cons of common osteoporosis medications

The North American Menopause Society

International Society for the Study of Women's Sexual Health

International Society for Sexual Medicine

The American College of Obstetricians and Gynecologists

This information is not intended as a substitute for professional medical care. Always follow your healthcare professional's instructions.


About the Author

The Providence Women's Health team is committed to providing useful and actionable insights, tips and advice to ensure women of all types can live their healthiest lives.

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