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Published in on Jun 10th 2025

Understanding Perimenopause: The Overlooked Phase of Women’s Health

When we talk about menopause, the conversation often skips over an important transitional stage: perimenopause. This natural phase begins several months, or even years, before menopause, as the body gradually reduces its production of estrogen and progesterone. For many women, perimenopause brings noticeable physical and emotional changes, while for others, it may pass with minimal symptoms. Either way, understanding this stage can help you feel more in control of your health and well-being.

What Is Perimenopause, and How Is It Different from Menopause?

Perimenopause, meaning “around menopause,” is the time leading up to menopause when hormone levels, especially estrogen, begin to fluctuate. Menopause itself is defined as going 12 consecutive months without a menstrual period. In contrast, perimenopause is marked by irregular periods and a range of symptoms caused by shifting hormone levels. It typically begins in a woman’s 40s, but it can start earlier or later depending on individual factors.

Common Signs and Symptoms

Every woman’s experience is different, but some of the most common symptoms of perimenopause include:

• Hot flashes and night sweats
• Irregular menstrual cycles (longer, shorter, heavier, or lighter)
• Missed periods
• Sleep disturbances or insomnia
• Mood swings, irritability, or increased anxiety
• Depression or feelings of sadness
• Vaginal dryness or discomfort during sex
• Difficulty concentrating or memory lapses
• Unexplained weight gain
• Changes in cholesterol levels, potentially affecting heart health

While these symptoms are part of the body’s natural transition, they can still interfere with your daily life and deserve thoughtful attention and care.

When to Talk to Your OB-GYN

If you’re noticing changes in your cycle or experiencing uncomfortable symptoms, it’s a good time to check in with your OB-GYN. There’s no way to “stop” perimenopause, but there are effective treatments and lifestyle strategies to help you manage the transition.

Your provider may recommend:

• Lifestyle changes like diet, exercise, and stress management
• Birth control pills to regulate cycles and reduce hot flashes
• Hormone therapy (HT or HRT) to restore estrogen and progesterone levels
• Antidepressants to support mood stability
• Gabapentin or oxybutynin, which can help reduce hot flashes

Every treatment plan is unique. Your provider will help you decide what options best fit your needs, goals, and medical history.

Staying Healthy Through the Transition

As estrogen levels decline, your risk for conditions like osteoporosis and heart disease increases. That’s why it’s important to focus on preventive care and long-term health during perimenopause. Here are some helpful strategies:

Support Bone and Heart Health:

• Eat calcium-rich foods or take supplements if recommended
• Get enough vitamin D through diet, supplements, or safe sun exposure
• Engage in weight-bearing exercises like walking, dancing, or lifting weights

Ease Hot Flashes and Night Sweats:

• Avoid known triggers like spicy foods, alcohol, hot drinks, and warm rooms
• Dress in layers and use fans or air conditioning when needed

Improve Sleep and Emotional Wellbeing:

• Stick to a regular bedtime routine
• Avoid screens and stimulants like caffeine before bed
• Talk to your provider if you’re experiencing depression or anxiety

Care for Vaginal Health:

• Use vaginal moisturizers
• Talk openly with your provider about any discomfort during intimacy

Supporting Your Health at Every Stage

Perimenopause is a normal and significant stage of life, but it doesn’t have to be a struggle. With the right information, supportive care, and proactive choices, you can navigate the transition with confidence.

At Pacific Women’s OB/GYN, we’re here to listen, guide, and support you through every phase of your reproductive health. If you’re experiencing symptoms of perimenopause or have questions about your care, don’t hesitate to reach out and schedule a consultation.