Wondering if it’s perimenopause? You’re not alone.

Jill McLeod, MD

Obstetrics and Gynecology

The average age of menopause, which is one year without a period, is 51. Perimenopause, which can begin a decade before menopause, is marked by a drop in estrogen levels as your body prepares to stop ovulating and, therefore, stop having periods. While some women may have symptoms in their 30s, the early to mid-40s is the most typical age range.

Struggling with strange and unexplained symptoms and wondering if it’s perimenopause? OB/GYN Jill McLeod, MD, explained what symptoms of perimenopause to watch for and what treatments are available to help.

What are the most common symptoms of perimenopause?

“The single most common symptom of perimenopause is new irregularity in your period,” said Dr. McLeod. “Think skipping periods, having them much closer together than usual, longer or shorter periods than normal or changes in whether they are heavy or light.”

Other common symptoms of perimenopause include:

• Hot flashes and night sweats
• Insomnia or sleep disruptions, such as falling asleep normally but waking multiple times in a night
• Low libido
• Vaginal dryness or painful sex
• Brain fog and confusion
• Increased irritability and anxiety

Can a hormone test diagnose perimenopause?

“Perimenopause and menopause are generally diagnosed clinically, based on your symptoms,” said Dr. McLeod. “Checking your hormone levels isn’t typically very helpful, since hormone levels fluctuate drastically throughout your cycle and results wouldn’t change how we manage those symptoms.”

How are symptoms of perimenopause treated?

Estrogen based hormone therapy is the most effective treatment for most symptoms. Dr. McLeod noted that symptoms of hot flashes and sweats are generally reduced by about 75%.

For most patients, the benefits of hormone replacement outweigh the risk. Of course, this should be discussed with your provider, because every woman’s experience is unique.

“Another option is non-hormonal medication, such as an SSRI, a type of antidepressant,” said Dr. McLeod. “This can be especially helpful when it comes to anxiety symptoms. Finally, there are options like gabapentin and a new class of medications that target specific neurons in the brain that trigger those night sweats and hot flashes.”

Speak with your doctor if you are struggling with any or all of these symptoms. Just because a process is natural does not mean you have to suffer. Treatment can help you continue enjoying quality of life as your hormones change and you head toward menopause.