What is perimenopause: Symptoms, signs, age and everything you need to know

Stressed sad tired exhausted caucasian middle-aged perimenopause mature businesswoman freelancer relaxing on the couch sofa, thinking about family marriage work problems at work office
What is perimenopause? Read on to learn the signs, symptoms and need-to-know information. (Photo via Getty Images)

This article is for informational purposes only and is not a substitute for professional medical advice, diagnosis or treatment. Contact a qualified medical professional before engaging in any physical activity, or making any changes to your diet, medication or lifestyle.

Most women know about menopause, but what about the stages surrounding this transitional time?

Perimenopause is the phase that comes prior to menopause. During this time, one’s estrogen levels begin to decline significantly. Perimenopause also comes with symptoms similar to menopause, such as hot flashes, mood swings and infertility.

So, what exactly is perimenopause? Read on to learn the signs, symptoms and need-to-know information.

What is perimenopause?

Perimenopause refers to a period of time leading up to menopause. This stage lasts anywhere from one to 10 years.

During this stage, women show symptoms like hot flashes, mood swings, insomnia, vaginal dryness and night sweats. One of the main signs of perimenopause is irregular menstrual periods, though many women may also experience regular periods and have other associated symptoms.

Perimenopause is a natural stage of aging that is caused by the decline in the quality and number of one’s eggs. With the decline in eggs, hormone levels fluctuate, and one’s menstrual period becomes more irregular. The perimenopausal stage continues until one’s menstrual cycle stops completely, and the menopausal stage commences.

Middle aged woman sitting by a fan to recover from a hot flash from perimenopause
Perimenopause refers to a period of time leading up to menopause. (Photo via Getty Images)

How is perimenopause different from menopause?

Menopause is the stage that follows perimenopause.

While women may experience irregular menstrual periods during perimenopause, menopause marks the time when one’s menstrual period has ended. The average age for starting menopause in Canada is 51.5 years.

During menopause, the associated symptoms may increase in frequency, with 80 per cent of women experiencing one or more symptoms.

However, once hormone levels lower, the symptoms of menopause typically improve or go away entirely.

At what age does perimenopause start?

Some women show signs of perimenopause as early as their late 30s. For other women, perimenopause can start as late as their early 50s. On average in Canada, perimenopause begins four years before one’s last period, or around age 47.

While every woman is different, some cases of early perimenopause are due to lifestyle choices or medical treatments. Radiation therapy and chemotherapy are two medical treatments associated with early menopause.

Additionally, smoking, low body fat and genetic or autoimmune diseases are linked to early menopause. After an oophorectomy procedure in which both ovaries are removed, sudden menopause also begins.

middle aged woman with perimenopause doing a yoga stretch on the ground
On average in Canada, perimenopause begins four years before one’s last period, or around age 47. (Photo via Getty Images)

What are the symptoms of perimenopause?

Perimenopause shares many of the same symptoms as menopause. Some of the symptoms of perimenopause include:

  • Irregular menstrual cycle

  • Hot flashes, flushes or power surges

  • Fluctuating estrogen levels

  • Night sweats

  • Vaginal dryness

  • Urinary tract infections

  • Mood swings

  • Increase in premenstrual syndrome (PMS) symptoms

  • Urinary incontinence

  • Osteoporosis or bone loss

  • Increase in heart rate

  • Insomnia

  • Changes in skin elasticity

Some women may also experience depression during perimenopause or menopause. Those who experienced postpartum depression are more likely to also experience depression at this time.

The symptoms of perimenopause range from mild to severe, with some women needing medical treatment to navigate their symptoms. These treatments include hormone replacement treatments, antidepressants and medications that target specific symptoms like hot flashes.

Make sure to consult with a healthcare professional prior to starting any new medication, and to learn whether one of these treatments may be right for you.

Lifestyle changes can also mitigate the severity of perimenopausal symptoms. Changes to consider include quitting smoking, managing stress, eating a balanced diet and exercising regularly.

Close-up portrait of pretty mature woman fanning from a perimenopause hot flash
Hot flashes are a common sign of perimenopause. (Photo via Getty Images)

When to call a doctor

More severe symptoms may need a doctor’s attention. Contact your doctor if you are experiencing any of the following:

  • Unusually heavy, irregular or prolonged menstrual periods

  • Bleeding between menstrual periods

  • Bleeding after having no periods for over six months

  • Bleeding while on hormones

  • Severe insomnia, hot flashes or mood swings that are interfering with your daily life

  • Vaginal pain or dryness

  • Signs of a urinary tract infection

The bottom line

Perimenopause is a natural stage in a woman’s life, and it should not be feared. While the symptoms of perimenopause and menopause can be uncomfortable, it's not forever.

If you are experiencing symptoms of perimenopause, talk to your doctor to decide if any treatments might be right for you to help you navigate these changes.

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