Onset and symptoms of perimenopause: When should I see a doctor and other practices.

Perimenopause is the transitional phase into menopause. The median onset of perimenopause is 47 years. However, you may notice symptoms of perimenopause as early as your late 30s. Perimenopause lasts for a few years before menopause arrives. For some women, symptoms can carry on for decades.  

While some symptoms are manageable, many are significantly distressing affecting your daily functioning. Knowing when to meet your healthcare provider and simple ways to manage your symptoms at home can help with your transition to menopause.

Perimenopause (peri- meaning around), is the transitional phase to menopause, when your periods would have stopped completely. 

So one of your first signs that you might be in perimenopause is period irregularities. This can be coupled with classic symptoms such as hot flashes, vaginal dryness, or significant fluctuations in your mood.  

However, many of these signs may not be textbook versions of what you expect. Such as recently, actress Halle Berry spoke out about being misdiagnosed for herpes, when she was experiencing the burning sensation of vaginal dryness of perimenopause.  

The slow decline in estrogen is responsible for the fluctuation in such symptoms, and also its differing presentations among women.  

Similarly, some women may experience a burning sensation in the mouth, tinnitus (ringing in the ears), new skin reactions, heart palpitations, or recurrent UTIs as indicators for perimenopause.

Whenever you notice your first perimenopausal symptoms would be an ideal time to check in with your doctor. Your physician will assess whether your symptoms are because of declining estrogen of perimenopause or another underlying medical condition.  

An example of this possibility is the common hot flashes experienced by 85% of menopausal women. In some instances, hot flashes can be reported with certain cancers, thyroid disease, or certain medications you are taking. 

If your perimenopause symptoms affect your day-to-day functioning, your doctor can help you understand the reasons for it and suggest ways to manage your symptoms. While certain lifestyle changes can help, some women may need hormonal supplementation to assist with debilitating physical symptoms of perimenopause.  

Additionally, the erratic decline in estrogen during perimenopause may cause significant fluctuations in your mood. Perimenopausal women are two to four times more likely to experience a depressed mood than women who are not in perimenopause. This likelihood increases if you have had depression in the past.  

Any feelings or emotions you cannot cope with should prompt you to reach out for professional help. 

Community take:  I never had PMS mood changes. What women described as irritability, anger, and frustration before their periods just never happened to me. And then one day I was angry all the time. Even in situations I had no reason to be. I thought it was PMS, since I was still having my periods, even though it was not so regular. When it was starting to affect my interactions at home, I thought I’d see professional help. My doctor explained that all these changes (I was also having hot flashes which I ignored) were perimenopausal and related to my hormones. I talk to a therapist once a week, and that has helped provide a third person’s view to what I’m experiencing. If you feel different and are in your 40s, talk to a doctor. It is often not just in your head.

While you may not know exactly when you are going to transition to menopause, knowing the symptoms and how they might affect you can prepare you for perimenopause.  

In your 30s (not a bad idea to start in your 20s), optimize your nutrition and exercise regularly to encourage healthy aging. With the hustle of daily life, these are the first things to falter, causing the most damage to our physical and mental health. Additionally, routinely adding more strength training workouts, along with supplementing your diet with sources of iron, magnesium, and calcium is beneficial for reducing the severity of perimenopausal symptoms and long-term negative effects of declining estrogen levels. 

Another key is managing your stress levels during perimenopause. While the symptoms of perimenopause can be worrisome, added stress, and a consistently elevated cortisol level can worsen symptoms. Tackling your stress, through exercise, meditation and even regular therapy helps tremendously through perimenopause.

Perimenopause is a transitional phase in a woman’s life. Hallmark of perimenopause is the fluctuation in physical and mental health symptoms, which can worsen affecting daily functioning during this transitional phase. Consider checking in with your doctor for help, along with incorporating simple routine practices to favor healthy aging.