Perimenopause Symptoms: Why You Don’t Have to Wait Until Menopause for Support
One of the most common misconceptions I’ve learned about from my ladies in the clinic is the idea that they can’t start hormone therapy until they are officially in menopause. This is a big and unfortunate misunderstanding that has left many women struggling for years, grasping for that menopause diagnosis before feeling like they can ask for the care they need.
If you prefer video format, I’ve uploaded a video recording of this topic too:
The reality is, many women begin experiencing symptoms several years before menopause, during the transition phase called perimenopause.
It’s interesting, really, that menopause itself is a retrospective diagnosis. It’s defined as 12 consecutive months without a menstrual period. So basically, once you don’t bleed for a full year (assuming there’s no other medical cause), congrats, you’ve earned the diagnosis of menopause! But symptoms don’t magically just appear at that 1 year milestone, they are experienced in real time, often long before menopause is “official.”
Perimenopause can begin in a woman’s late 30s, but typically in their mid-40s, and is marked by erratically fluctuating hormone levels — particularly estrogen and progesterone. These hormonal shifts can feel unpredictable and, for many women, disruptive. Remember the years of what seemed like daily mood swings, changes to your body you’ve never experienced before, and just simply feeling “hormonal” in your early teens when you were going through puberty? Well, you can think of perimenopause as that process in reverse, except that your body is now learning to live with drastically lower levels of the hormones that she had become reliant on over the past ~30 years.
It breaks my heart when women don’t open up about their symptoms, think they are crazy, or worse yet, are told it’s “all in their head.” In reality, these erratic fluctuations in hormones causes very real, and serious symptoms, that should always be prioritized.
Some of these common symptoms during perimenopause may include:
Hot flashes or night sweats
Sleep disruption or insomnia
Mood changes: depression, anxiety, or irritability (this population is at great risk for mental health challenges)
Brain fog or difficulty concentrating
Changes in menstrual cycle length, flow, or regularity
New joint aches and pains
Many other symptoms, the list goes on, and depends on the individual
Often, because cycles may still be occurring in perimenopause, many women are told they are “not menopausal yet,” or that their labs are “normal.” This can leave women feeling dismissed or confused, despite very real and distressing symptoms.
The truth is: you do not need to wait until you’ve gone a full year without a period to talk about symptom relief with your trusted doctor.
For many women, hormone therapy is a safe, and life-changing option during perimenopause. While hormone therapy is actually very safe for most women when prescribed by a physician with proper training, still not everyone is a candidate for hormone therapy. If you are in the group that has a real contraindication (there is a lot of fear and misinformation out there, so find a doctor comfortable with hormone therapy, not fearful of it), there are other alternatives to hormone therapy that your doctor can offer to support you during this time too!
Some of my most rewarding experiences in residency thus far have been supporting my patients as they transition through perimenopause to menopause. So, from the bottom of my heart, if your perimenopause symptoms are affecting your quality of life, you don’t have to wait until menopause to get the care and support you deserve.
If you are interested in learning more, you can schedule an Individualized Educational Consultation with me here, or join my waitlist here to be one of the first to be notified about openings when I open my practice in 2027!
*Of course, this is educational content only. Not a substitute for medical care. Views are my own and separate from my institution and employer. Always discuss individual health concerns with your personal healthcare provider.