By Mache Seibel, MD

5-Symptoms-of-peri-MenopausAm I in perimenopause? When does it happen? How will I know? How long will it last?


These are questions I’m asked all the time by women who can’t imagine it’s possible. Not now! Not at my age! Or am I already in menopause?

You may know the mean age of menopause in the United States is 51 years. But did you know that 1 in 10,000 women go into menopause before age 20; 1 in 1000 go into menopause before age 30; 1 in 100 before age 40 and 1 in 10 before age 45? Perimenopause is that up to 10-year window of transition when symptoms begin to occur.

Just like the word perimeter means around an area, perimenopause means the timeframe around menopause. If you think back to puberty, there was a transition when menstrual cycles were irregular, mood swings were common, sleep was a challenge, and your body began to go through changes that made you wonder if it was still you.

Similar types of things happen in perimenopause. Both mind and body change, at first gradually and eventually at a much faster and more noticeable rate. Here are 5 of the symptoms you are likely to notice and a little bit about them:

1.  Irregular cycles – cycle length can get pretty unpredictable and the time between cycles can get either shorter or longer, and flow can get either heavier or lighter. This also makes fertility a little bit lower the closer you get to menopause.

2.  Hot flashes – Hot flashes can begin as much as 10 years before menopause. Remember, the definition of menopause is one year after the last natural period and symptoms of menopause can begin up to a decade before the final menstrual period. If you are one of the ten percent of women who go through menopause before age 45, you could begin having hot flashes in your 30s.

3.  Breast tenderness – the tremendous hormonal fluctuations that occur in perimenopause cause your breasts to be tender and sensitive, and that can be very challenging. For some women, several weeks out of every month will be a window of breast tenderness and pain. It can be helpful to keep the calendar for a few weeks to see if you can find the pattern. Ultrasounds may reveal cysts that sometimes cannot be felt. The walls of the cysts can expand with hormonal fluctuation and that can stretch nerve fibers, causing pain.

4.  Lower sex drive – it’s not uncommon for women in perimenopause to experience a decreased sex drive. Women who are satisfied with intimacy before menopause typically are satisfied with intimacy in menopause and beyond.

5.  Mood Changes – widely fluctuating hormones can wreak havoc on mood and memory. And the poor sleep that often accompanies perimenopause doesn’t help. Anxiety and depression commonly get worse in perimenopause.

Are you wondering if you are in perimenopause, menopause or postmenopause? If so, take this 1-minute quiz and find out now. Click now and get your answer and some free quick explanation.


Mache Seibel, MD
Editor, My Menopause Magazine
Author of The Estrogen Window
Due April 2016 from Rodale Press

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