Perimenopause is what most women think of as “going through menopause.” It is defined as the period prior to menopause and the first year after the cessation of menses when endocrinologic, biologic, and chemical features of approaching menopause commence. The average age for onset of perimenopause is 47, and for most women it lasts approximately four years. Only about 10% of women cease menstruating abruptly and have no menstrual irregularity characteristic of the perimenopausal years. In essence, the normal balance or interaction of ovarian hormones, which has existed for 20+ years, is disturbed. Generally speaking, there is often a wide fluctuation in estrogen levels – sometimes low, often high or normal; Progesterone and Testosterone levels are usually declining or low, and may have been on a downward trend for many years prior to perimenopause. During perimenopause, the hormonal changes are quite varied and can lead to many different clinical symptoms, including:

  • Irregular menses- less or more frequent, heavier or lighter, longer or shorter
  • Mood changes
  • Weight gain or changes in weight distribution
  • Vasomotor symptoms – hot flashes, night sweats
  • Sleep disturbance
  • Vaginal dryness
  • Urinary incontinence, frequency, & urgency
  • Urinary tract infection
  • Depression & anxiety
  • Decreased cognitive function – memory, concentration
  • Decreased libido
  • Skin & hair changes