Perimenopause (also known as the menopause transition) is the time when the body begins to prepare for menopause. The ovaries begin producing fewer hormones during this shift, making the menstrual cycle inconsistent or irregular. The body is nearing the end of its reproductive years at this point.

Perimenopause can start as early as the mid-30s and last until the mid-50s. Some women only experience perimenopause for a brief time; however, for many people, it lasts four to eight years. Perimenopause refers to the period when the menstrual periods are no longer predictable.

As the body adjusts to different hormone levels, individuals may experience other physical changes and symptoms. Although their fertility declines during perimenopause, women can still become pregnant. Perimenopause symptoms, when it begins, and how long they last differ between women. Once you've gone 12 months without a monthly period, you're out of perimenopause and into menopause.


Some subtle and not-so-subtle changes in the body may occur during the menopausal transition. One may experience:

Hot flashes and sleep problems

Perimenopausal hot flashes are common. The strength, length, and frequency vary. Sleep issues are frequently caused by hot flashess or night sweats.

Irregular periods

Irregular periods: Because ovulation is becoming more variable, the duration between periods may get longer or shorter, the flow may vary from light to heavy, and women may miss some periods. If the menstrual cycle duration changes for seven days or more, women may be in early perimenopause. If women get a period every 60 days or more, they are likely in late perimenopause.

Mood changes

Mood swings, impatience, and an increased risk of depression are all possible during perimenopause. Sleep interruption caused by hot flashes could cause these symptoms. Mood swings can also be induced by factors unrelated to perimenopausal hormone changes.

Vaginal and bladder problems

When estrogen levels fall, the vaginal tissues may lose lubrication and suppleness, making physical intercourse painful. Low estrogen levels may also make women more prone to urinary or vaginal infections. Tissue tone loss may contribute to urine incontinence.

Decreasing fertility

The ability to conceive decreases as ovulation gets irregular. However, as long as women are having periods, pregnancy is still feasible. Use birth control measures until you haven't had a period in 12 months if you want to avoid getting pregnant.

Changes in sexual function

Sexual arousal and desire may fluctuate during perimenopause. However, if the sexual relationship was adequate prior to menopause, it will probably remain so into perimenopause and beyond.

Changing cholesterol levels

The blood cholesterol levels could vary negatively due to declining estrogen levels. One of them is an increase in low-density lipoprotein (LDL) cholesterol, the "bad" cholesterol that raises the risk of heart disease. In addition, as women age, their levels of high-density lipoprotein (HDL), or "good" cholesterol, fall, which raises their chance of developing heart disease.

Loss of bone

As estrogen levels decrease, women begin to lose bone density more quickly than they can replace it, raising the risk of osteoporosis, a condition that causes brittle bones.

When should you see a doctor?

Consult the doctor if you are nearing perimenopause and experience symptoms like mood swings, hot flashes, or changes in sexual function that affect your life or well-being.


The body's production of progesterone and estrogen, two important female hormones, fluctuates while you go through perimenopause. The many changes you undergo during perimenopause are brought on by a drop in estrogen.

Risk factors

Menopause is a typical life stage. However, some women could experience it earlier than others. The risk factors are:

  • Smoking: Menopause begins for smokers 1–2 years earlier than for non-smokers.
  • Cancer treatment: Chemotherapy or pelvic radiation therapy for cancer has been associated with early menopause.


Perimenopause is a process characterized by a gradual transition. No single test or indication will tell you if you are in perimenopause. The doctor considers many factors, including age, menstruation history, and the symptoms or body changes you're experiencing.

Some doctors may order hormone tests to evaluate individual hormonal levels. Hormone testing, aside from examining thyroid function, is essential in assessing perimenopause.


Perimenopausal symptoms are frequently treated with medications.

Hormone therapy

The most successful treatment option for perimenopausal and menopausal is systemic estrogen therapy, which comes in pill, skin patch, spray, gel, or cream form. In order to relieve the symptoms, the doctor may suggest the lowest amount of estrogen possible based on the individual and family medical histories. If you still have your uterus, progestin will be required in addition to estrogen. Systemic estrogen can help in the prevention of bone loss.

Vaginal estrogen

Estrogen can be delivered directly to the vagina using a vaginal pill, ring, or lotion. Only a very small amount of estrogen is produced by this medication, and it is absorbed by the vaginal tissue. It can help with urinary issues, vaginal dryness, and discomfort during intercourse.


Certain antidepressants, such as selective serotonin reuptake inhibitors (SSRIs), have been shown to lessen menopausal hot flashes. An antidepressant for hot flashes may be beneficial for women unable to take estrogen due to medical reasons or for women who require an antidepressant for a mood problem.

Gabapentin (Neurontin)

Gabapentin is licensed for seizure treatment, but it has also been demonstrated to help with hot flashes. This medication benefits women who cannot utilize estrogen therapy for medical reasons and those who suffer from migraines.
Before deciding on a course of therapy, consult the doctor about the options and the risks and benefits of each. The alternatives should be reviewed yearly because the needs and treatment options may change.

Perimenopause Dos and Don’ts

Making these healthy lifestyle choices may help alleviate certain perimenopausal symptoms and promote good health as you age. To control or lessen its symptoms, follow its do's and don'ts.

Get enough sleepSmoke
Regular exerciseConsume alcohol
Eat healthily and maintain weightGet exposed to triggering factors that cause hot flashes (e.g. coffee, tea, alcohol, etc.)
Practice stress-reduction techniques like meditation and yogaAvoid doctor consultations if you experience symptoms
Have citrus fruits (limes, oranges, lemons, grapefruit, citrons, kumquats)Take highly refined carbs and sugar, saturated and trans - fats

Perimenopause Care at Medicover

Menopause and perimenopause are just two of the many disorders that the Department of Gynecology at Medicover Hospitals treats with clinical and surgical procedures. With our superb state-of-the-art facilities, cutting-edge instruments, and technology for treating various gynecological disorders, we are regarded as one of the most reliable hospitals in India.

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