What is perimenopause?
The transitional phase before menopause. Begins when ovaries produce less estrogen and progesterone β usually in your 40s. Cycles become unpredictable. Menopause is officially diagnosed when 12 months have passed without a period (average age 51).
Hormonal changes
Estrogen swings dramatically β sometimes higher than ever, sometimes very low. Progesterone declines steadily as ovulation becomes less frequent. The hormonal chaos is the message.
Common symptoms
- Cycle changes: shorter, then longer, then skipped
- Hot flashes & night sweats
- Sleep issues
- Mood changes: irritability, anxiety
- Brain fog, joint aches, vaginal dryness
Should I test my hormones?
Routine testing usually NOT recommended β levels swing too much. Diagnosis is clinical: age + cycle changes + symptoms. Testing useful before age 40 (premature ovarian insufficiency) or for fertility planning.
Hormone replacement therapy (HRT)
HRT is the most effective treatment for moderate-to-severe symptoms. Modern HRT, started within 10 years of menopause, has a favorable risk-benefit profile for most healthy women. Discuss with a menopause-trained doctor.
Lifestyle that helps
Evidence-based supplements
Vitamin D + calcium: bone health. Magnesium glycinate 200-400mg: sleep + mood. Black cohosh: hot flashes. Phytoestrogens: mild symptoms. Omega-3: mood + cardiovascular.
When to see a doctor
- Symptoms severely disrupt your life
- Bleeding very heavy or longer than 7 days
- Bleeding after 12+ months without a period
- Symptoms before age 40
- Mood changes affect relationships or work