- Perimenopause, the time of life when a menstruating person’s cycles become disrupted as that person enters menopause, can take people by surprise.
- While information and education about menopause and how it can manifest are becoming more widespread, the start of perimenopause can be harder to identify correctly.
- Board-certified obstetrician-gynecologist Sheryl Ross explains how to figure out whether or not perimenopause has started, and what to do to minimize its impact, including making different dietary and other lifestyle choices.
In perimenopause, the female body begins its transition into menopause, which signals the end of fertility and the beginning of a new stage of life.
Recently, there has been increased awareness of the symptoms of menopause, particularly hot flashes, mood changes, night sweats, vaginal dryness, and brain fog.
However, the start of perimenopause can be hard to pinpoint, though it is generally characterized by more irregular periods and changes in the blood flow at menstruation. Perimenopause can also cause symptoms like vaginal dryness and mood changes.
According to data cited by the
“Perimenopause happens when your ovaries stop functioning consistently, upsetting the normal hormonal rhythm. Symptoms and hormonal changes of this transitional phase usually happen within 10 years of menopause. The 40s can be a time of hormonal unrest and chaos,” Sheryl Ross, MD, board certified OB-GYN and Women’s Health Expert at Providence Saint John’s Health Center in Santa Monica, CA, told Medical News Today.
Ross shared her medical experience and top tips on how to figure out when perimenopause has started, and what lifestyle changes to adopt for a smooth transition into this next stage of life.
“Perimenopause refers to those years in the reproductive life cycle where the ovarian function becomes irregular,” Ross explained.
“Estrogen production from the ovaries is erratic and unpredictable causing a number of menopausal symptoms. Perimenopause is the transitional phase of hormonal changes that occurs before menopause officially happens. There may be months or years of overlapping symptoms. When estrogen stops being produced by the ovaries and you lose your period for 1 year, you are now in menopause and no longer have reproductive capabilities.”
— Sheryl Ross, MD
“It is an unpredictable and individualized natural hormonal cycle,” the OB-GYN noted.
Because of this, “it can be challenging to know the difference between these two normal hormonal cycles —perimenopause and menopause,” Ross told us.
According to her, the first step is to be aware of the symptoms associated with it, which are caused by fluctuations in estrogen levels.
These can include:
- irregular, erratic, and heavy periods
- night sweats and hot flashes
- sleep disturbances
- sudden changes in mood with depression and anxiety symptoms
- short-term memory loss and trouble focusing
- vaginal dryness
- low sex drive (low libido).
“Hot flashes and night sweats are known as ‘vasomotor’ symptoms and occur as a result of fluctuating estrogen levels,” Ross told us. “They can occur with the same vengeance and disruption in both perimenopause and menopause.”
According to her, “having hot flashes and night sweats only suggests fluctuating or declining estrogen levels and does not differentiate between perimenopause and menopause.”
Still, she said, “the conversation starts with knowing your symptoms and getting blood tests, including your FSH [follicle-stimulating hormone] and estradiol levels.”
Ross emphasized that perimenopause symptoms can be disruptive and that they can seriously impact a person’s quality of life on a day-to-day basis.
Still, she noted that “simple lifestyle modifications, medications specifically treating each symptom, and hormone therapy” can all help keep any bothersome symptoms in check.
First and foremost, “consulting with a healthcare provider who treats perimenopause and menopause is recommended to be given personalized care and safe treatment options,” she advised.
At the same time, she said: “A healthy lifestyle goes a long way at any time in your life, but especially in this later chapter of life. […] There are simple adjustments you can start to make as soon as you notice hormonal changes in perimenopause.”
According to Ross, dietary changes can be key to staying at the top of one’s game during perimenopause:
“A diet focused on fresh fruits, vegetables, whole grains and fish, with limited alcohol intake and little red meat — similar to the Mediterranean diet — not only benefits your heart, it improves cognitive function. The Mediterranean diet is associated with the
highest life expectancy and lowest heart disease rate and is proven to helpperimenopausal symptoms .”
On the same note, she emphasized, this is the time to “ditch the fast food,” explaining that “the saturated fats and excessive sodium in fast food give you no ‘value’ whatsoever; in fact, depression is more common in those who eat fast food regularly.”
“Within weeks of removing this food, you will show a decrease in cholesterol levels and even a decrease in weight gain,” Ross suggested.
She also advised that: “Removing or decreasing sweets in your diet will not only limit your calorie intake; it will often reduce your intake of fat. A reduction of sugary foods will immediately reduce blood sugar, which will help in decreasing the bloating and water retention so common in perimenopausal women.”
While having a glass of wine here and there may feel like a good idea to help you relax, Ross strongly advised against making it a habit.
“Alcohol increases your risk of heart disease, liver disease, high blood pressure, diabetes, colorectal and breast cancer, and worsens hot flashes,” she stressed.
“It’s recommended that you consume no more than 3 to 4 servings of alcohol a week. Removing alcohol, even 1 or 2 drinks a few times a week, has immediate effects on blood sugar levels, water retention, blood pressure, weight loss, energy level, emotional stability, sleep changes, and pulse rate,” Ross told us.
Ross also noted that staying physically active regularly can make a significant difference in how a person feels throughout perimenopause.
“Regular exercise improves metabolism, breathing, energy, and emotional stability. Exercise makes you feel more confident and helps ease the stress of perimenopausal symptoms. It strengthens your heart and improves your sleep patterns,” she explained.
Conversely, “lack of exercise not only puts you at risk for heart disease, high blood pressure, and other chronic health problems, it also leads to weight gain, obesity, fatigue, insomnia, and depression, all of which worsen the transition into perimenopause,” Ross said.
“Exercising as little as 30 minutes, 3 days a week can show immediate health benefits,” she advised.
Finally, achieving better-quality sleep may be more difficult to improve, but Ross stressed that regularly getting a good night’s rest is key to maintaining a sense of wellness throughout perimenopause and later in life.
“Sleep is necessary for your mental and physical Health,” she said, advising at least 7 hours of sleep per night, ideally.
For those struggling to maintain good sleep hygiene, Ross reiterated that having an exercise routine can help.
If you are too busy or too tired to exercise because of life’s demands, here are some expert tips on how to stay on track with workouts.
And here is what you can do instead of exercise in order to stay active and healthy.
