Perimenopause Symptoms, Test, Treatment and Remedies

Perimenopause is known as the transitional phase that begins in the years before the final menstrual period, or menopause. During this phase, women begin to experience the physical changes that go along with menopause, which typically last from 4 to 8 years. Perimenopause manifests as the ovaries gradually begin to produce less estrogen, and this transitional phase persists up until the time of menopause, when the ovaries finally stop releasing eggs. During the last 1 to 2 years of perimenopause, the drop in estrogen production rapidly speeds up, triggering menopause symptoms.

Perimenopause is a normal occurrence that typically begins in a woman’s 40s, although it is possible for it to start in her 30s or earlier. Perimenopause progresses differently for every woman, but the first indication of early menopause symptoms begin with the changes in the length of time between menstrual periods and officially ending one year after the final menstrual period.

Symptoms of perimenopause

Symptoms that occur during the perimenopause phase range from subtle to obvious changes in the body. Some women do not report any physical changes besides irregular menstrual periods, while other women report symptoms of hot flashes, night sweats, and drying vaginal tissue.

Irregular menstruation

Irregular menstrual periods are the primary beginning symptom of perimenopause, and it begins with the varying changes in the length of time between periods. The menstrual flow may be lighter or heavier than normal, and periods may be skipped. Persistent changes and irregularities in menstruation of seven days or more in length are usually an indicator of early perimenopause phase.

Toward the end of the perimenopause stage, the space between period lengths can be up to 60 days or more.

Hot flashes

A lot of women also experience hot flashes with varying intensity, length, and frequency. Hot flashes may cause difficulty sleeping.

Mood swings

Some women also experience mood changes during perimenopause, including irritability and an increased risk of depression.

Vaginal issues

Diminishing estrogen levels may cause the drying or thinning of the vaginal tissues due to loss of lubrication and elasticity, which may make sex more painful. Low estrogen levels can also cause an increased risk of urinary or vaginal infections.

Other symptoms, such as breast tenderness, worsening premenstrual syndrome, low sex drive, fatigue, urine leakage, and urinary urgency may be experienced. Heavy periods, clotting, spotting, and spotting after sex can also indicate perimenopause.


Perimenopause is a natural process and a gradual transition. There is no definitive test to determine if you’ve entered the perimenopause transition phase, although doctors may take a look at information such as your age, medical menstrual history, and symptoms to determine if you may have entered this stage. Some doctors may conduct tests to check hormone levels, although this is rarely needed to evaluate perimenopause.


Treatments used to alleviate perimenopause symptoms include drug therapy.

Hormone therapy: Systemic estrogen therapy is a common drug therapy, often coming in a pill, gel, or cream form, that is used to relieve perimenopause and menopausal symptoms such as hot flashes and night sweats.

Vaginal estrogen: Estrogen can be used to treat vaginal dryness by being administered directly to the vagina in the form of a vaginal tablet ring or cream. This treatment releases enough estrogen to combat vaginal dryness and intercourse discomfort.

Clonidine: This high blood pressure medicine can help alleviate the number and severity of hot flashes.

Antidepressants: Antidepressants are often used to manage hot flashes and mediate severe mood shifts in women.

Gabapentin (Neurontin): Most often used to treat seizures, it has also been proven to alleviate hot flashes and is a good substitute for estrogen therapy.

Many women typically use hormone medicines such as birth control pills, progestin pills, vaginal estrogen, hormone therapy, and estrogen therapy to relieve symptoms until menopause. These medications can be taken in the short-term for up to 4 to 5 years, which works effectively for women going through the perimenopause phase who want to alleviate their symptoms until menopause.


Making healthy lifestyle choices is a good way to remedy the unpleasant symptoms of perimenopause and menopause. Eating a healthy diet, for instance, such as adopting a low-fat, high-fiber intake that’s rich in fruits and vegetables, can help mediate some of the common symptoms of perimenopause. Avoiding caffeine and alcohol is also a sure way to lessen hot flashes.

Exercising regularly and maintaining a physically active lifestyle can also help prevent the abnormal weight gain, mediate sleep problems, and relieve mood changes commonly associated with perimenopause.

Also, making sure you keep a consistent sleep schedule is important to ensuring that your body is running smoothly and healthily.

There are also over-the-counter water-based vaginal lubricants you can use to help relieve vaginal dryness and make sex less painful for you. Doing regular Kegel exercises can help improve vaginal problems as well.

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  1. Honeylane Hernandez September 2, 2016
    • Sue September 2, 2016

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