It's Not You, It's Perimenopause

Perimenopause comes with a host of hormonal changes and lasts anywhere from 6 to 10 years

You’re hot, you’re moody and you can’t remember the last time you got a good night’s sleep, let alone where you left your keys. Welcome to the club: you’re in perimenopause!

Wait? Aren’t those the symptoms of menopause? Nope. When most women think of the meaning of menopause, they really aren’t thinking of menopause at all. They are thinking about perimenopause, a time that can begin in your late 30s or early 40s and reach into your 50s. Perimenopause comes with a host of hormonal changes and lasts anywhere from 6 to 10 years — until you haven’t had your period for a full 12 months in a row. Then you have graduated to menopause! (Sorry, no cap and gown for this one.)

The first step to finding hormone happiness is to ID and track your symptoms. Each day, chart the frequency, duration and severity of your perimenopause symptoms. Talk them over with your perimenopause and menopause specialist to learn how to not just mask the symptoms, but treat their underlying cause.

Here are the main symptoms to be on the alert for during perimenopause:


Hot flashes, probably the most infamous of perimenopausal symptoms, strike about two-thirds of women during “the change.” During perimenopause and menopause, the levels and balance among estrogen, progesterone and testosterone begin to fluctuate. When your estrogen levels begin to decrease, they can trigger your body’s thermostat to send a signal that you are overheated. This causes your body to send out an all hands on deck alert: your heart pumps faster, the blood vessels in your skin dilate to circulate more blood in order to radiate heat and your sweat glands release sweat to cool you even more. Your body cools down when it otherwise wouldn’t, and you are left feeling miserable: soaking wet in the middle of a board meeting (like me) or in the middle of a good night’s sleep.

The fix: Regular exercise, healthy eating, acupuncture, herbal remedies, antidepressant medications and hormone therapy (HT) are some of the most common options to reduce and even rid your life of hot flashes. Which treatment (or combination of treatments) works for each woman varies. Talk with your specialist about these perimenopause coolers.


If you can’t see through the fog to find your thoughts, you’re not alone. Forgetfulness and other memory difficulties plague between one- and two-thirds of women during perimenopause. Many women even have trouble focusing and manipulating times, prices and other information in their head.

The fix: Your brain is the center of your health. Treat it right by first consulting your specialist to test your hormone levels and see if they need tweaking. Then, support the formation of new, healthy brain cells by eating omega-3 fatty acids and exercising regularly. Plus, simple meditation practices and even brain games like Cranium Crunches can help you tap your brain’s potential. Check out the best natural ways to break through brain fog.


Fluctuating estrogen and progesterone levels impact neurotransmitters (aka mood regulators) in the brain. While these highs and lows can take most women’s moods for a wild ride, some women — especially those who had severe PMS when they were younger — may be particularly susceptible to unpredictable and ever-changing dispositions during perimenopause.

The fix: Ditching refined sugar and upping your exercise routine can improve your blood sugar and insulin response to prevent the high-lows that send your family running for cover. If you find yourself in a constant low, hormone therapy (HT) or antidepressants, particularly SSRIs and SNRIs, are incredibly effective at easing depression in perimenopausal women.


Don’t remember the last time you woke up feeling rested? During perimenopause, levels of progesterone, nature’s Valium, can take a nosedive. Mix in sweat-soaked sheets and soaring stress levels, and what woman would wake up bright-eyed and bushy-tailed?

The fix: While natural progesterone treatments can help restore your body’s sleep-well chemicals to the right levels, good sleep habits — establishing a routine, keeping regular hours, only using your bed for sleep (and sex) — can also help. Following a Mediterranean diet rich in produce, whole grains and wine (yay!) has been linked to fewer night sweats, while yoga reduces symptoms of insomnia.


Sure, perimenopause is all about hormones. Problem is, so are most migraines. The silver lining: Two-thirds of female migraine sufferers either reduce or completely ditch their migraines when they have their last period, enter menopause and their hormones finally stop fluctuating.

The fix: Talk to your specialist about your symptoms and triggers, and explore your hormone replacement therapy options. When it comes to migraine and headache prevention, estradiol transdermal patches are generally your best bet. Learn more about how you can win the war on migraines.


Between hot flashes, mood swings and flat-out life as you know it, how could you not suffer perimenopausal stress? But as if stress weren’t bad enough all on its own, it turns out it can also exacerbate hot flashes, sleeplessness, migraines and even weight gain.

The fix: While your staple stress-busting tactics (think: bubble baths, exercise and meditating) can work miracles, you might also need to start saying “no” every now and again. You can’t take care of anyone else if you don’t put yourself on the top of your to-do list!


Estrogen is a major player in maintaining the structure of the vaginal wall, elasticity of the tissues around the vagina and production of vaginal fluid. So when your estrogen dries up, so can your nether region. Vaginal discomfort can have a negative impact on your relationship with your partner, your sexuality, and your quality of life and self-image.

The fix: When it comes to the vagina, thin is out — and silence is not golden! Vaginal atrophy is a chronic condition and requires ongoing treatment to remedy the underlying cause. Don’t wait! Call your specialist now.

When it comes to women’s health, misinformation abounds. Unfortunately, it’s women who are paying the price. So learn the truth about perimenopause so that you can get the help you need and deserve to lead a happy, healthy life.