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Navigating Perimenopause: A Friendly Guide to Understanding Perimenopause

art drawing of woman in perimenopause

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Perimenopause is the phase leading up to menopause, the point at which a woman’s menstrual cycle comes to an end. This transitional period can last anywhere from 2 to 10 years and is characterized by a variety of physical and emotional symptoms. During perimenopause, your body:

  • Ovulates less frequently
  • Produces lower amounts of estrogen and other hormones
  • Becomes less fertile
  • Experiences shorter and more irregular menstrual cycles

The Reason Behind Perimenopause

Perimenopause is a natural occurrence that takes place when your ovaries gradually cease functioning. Ovulation may become inconsistent and eventually stop altogether. Your menstrual cycle will lengthen, and the flow may become irregular leading up to your final period.

The symptoms of perimenopause are caused by fluctuating hormone levels within the body. When estrogen levels are high, you might experience PMS-like symptoms, while lower estrogen levels can lead to hot flashes and night sweats. These hormonal fluctuations may coincide with your regular cycles.

Common Perimenopause Symptoms

Each woman’s experience with perimenopause is unique. However, the most frequently reported symptoms include:

  • Mood fluctuations
  • Changes in libido
  • Difficulty concentrating
  • Headaches
  • Night sweats
  • Hot flashes
  • Vaginal dryness
  • Sleep disturbances
  • Joint and muscle pain
  • Profuse sweating
  • Frequent urination
  • PMS-like symptoms

It’s important to consult your healthcare provider for an accurate diagnosis, as perimenopause symptoms can resemble those of other conditions.

Diagnosing Perimenopause

Determining whether you’re experiencing perimenopause can be challenging. Your healthcare provider may consider your symptoms, medical history, age, and a physical examination to help with the diagnosis. Blood tests to measure hormone levels might also be recommended.

Decoding Hormonal Changes: FSH and AMH Levels

The science of gauging one’s closeness to menopause is rooted in hormonal testing. Two significant hormones play pivotal roles in this assessment:

Follicle Stimulating Hormone (FSH): This hormone’s level is a key indicator of menopause. A test for FSH is usually conducted on day three of the menstrual cycle if menstruating, or any day if menstruation has ceased. An FSH level above 25 suggests that menopause could commence within one to three years.

Anti-Müllerian Hormone (AMH): AMH levels inversely correlate with FSH levels. An AMH level under one, coupled with an FSH level above 25, strongly indicates a close approach to menopause.

It’s advisable to have more than one reading of FSH levels as they can fluctuate monthly, providing a clearer picture of the hormonal landscape.

Perimenopause Treatment Options

Perimenopause doesn’t require treatment unless the symptoms are causing discomfort. Possible treatments include:

  • Hormone therapy with estrogen or a combination of estrogen and progestins to balance hormone levels
  • Antidepressants to manage mood fluctuations

Your healthcare provider may also recommend lifestyle adjustments:

  • Consume a balanced diet rich in fruits, vegetables, and whole grains
  • Aim for 1,000-1,200 mg of calcium daily from food or supplements
  • Exercise regularly
  • Identify and avoid hot flash triggers (e.g., alcohol, coffee, tea) by keeping a journal
  • Consult with your healthcare provider about alternative treatments for symptom relief

While some herbal supplements claim to help manage hot flashes, it’s important to remember that the FDA does not regulate these products. They haven’t undergone the same testing as conventional medications to establish their effectiveness and safety. Always consult your healthcare provider before using any herbal supplements.

Perimenopause: Key Takeaways

  • Perimenopause is a natural transition leading up to menopause, during which your ovaries gradually stop functioning
  • This phase can cause physical and emotional symptoms
  • Treatment is not necessary but can help alleviate symptoms
  • Treatment options include hormones, antidepressants, and lifestyle changes

Maximizing Your Healthcare Provider Visit

To get the most out of your healthcare provider visit, consider the following tips:

  • Know the purpose of your visit and your desired outcome
  • Write down questions you’d like answered beforehand
  • Bring a companion to help with asking questions and remembering information
  • Take notes during the appointment, including new diagnoses, medications, treatments, or tests, as well as any instructions provided
  • Understand the reasons for new medications or treatments and their potential side effects
  • Inquire about alternative treatment options
  • Know the rationale behind recommended tests or procedures and what the results may indicate
  • Understand the implications if you choose not to take prescribed medication or undergo the suggested test or procedure
  • Note the date, time, and purpose of any follow-up appointments
  • Make sure you know how to contact your provider if you have further questions

Taking Control of Perimenopause Symptoms

If you find that perimenopause symptoms are significantly impacting your daily life, Bioidentical Hormone Replacement Therapy (BHRT) might be a solution worth considering. BHRT can help alleviate symptoms by stabilizing your hormone levels, making this phase more manageable.  Remember, you have the power to take control of your perimenopause journey and improve your quality of life.

Get started with BHRT

Experience the power of BHRT and start living your best life as you transition into menopause.

Video: Dr. Alexis deep dive on Perimenopause

If you’re interested in learning more about perimenopause and how to navigate this important phase of life, you won’t want to miss this video below. Dr. Alexis takes you through everything you need to know about perimenopause, including the hormonal changes that occur, the symptoms you might experience, the most effective strategies for managing these symptoms and more. Drawing on her extensive experience in women’s health, Dr. Alexis provides practical tips and advice for staying healthy and thriving.


Summary and Key Takeaways of the Video