perimenopausal

Perimenopause is the transitional phase before menopause during which a person’s ovaries gradually produce fewer hormones, leading to hormonal fluctuations. This period is characterized by changes in menstrual cycles and a range of physical and emotional symptoms. It typically begins in the 40s but can start in the late 30s or early 50s, and lasts until menopause, which is reached after 12 consecutive months with no menstrual bleeding.

Common features of perimenopause include irregular or changing menstrual intervals, lighter or heavier periods, and a shorter or longer cycle. Vasomotor symptoms such as hot flashes and night sweats are common, as are sleep disturbances, fatigue, mood changes, headaches, and changes in sexual function. Vaginal dryness, urinary symptoms, and reduced libido may also occur. The intensity and combination of symptoms vary widely among individuals.

Hormonal changes during perimenopause involve fluctuating levels of estrogen and progesterone, often with rising follicle-stimulating hormone (FSH) as ovarian reserve declines. There is no single test to diagnose perimenopause; diagnosis is usually based on menstrual history and symptoms, with blood tests sometimes used to rule out other conditions.

Management focuses on relieving symptoms and supporting health. Lifestyle approaches include regular exercise, a balanced diet, adequate sleep, stress reduction, and smoking cessation. Treatments may involve non-hormonal therapies for vasomotor symptoms, vaginal moisturizers or lubricants, and calcium and vitamin D for bone health. Hormone therapy may be appropriate for some individuals with moderate to severe symptoms after a careful risk assessment. The perimenopausal period ends with menopause, defined as no menstrual bleeding for 12 consecutive months.