Perimenopause can cause more than just wacky periods. It’s also common to experience symptoms like:
Everyone’s body is a little different, so it’s hard to pinpoint an exact time when you’ll enter perimenopause — and how long it will last before you reach menopause.
Perimenopause typically starts in your late 40s or early 50s. But it can sometimes come sooner, as early as your mid-to-late 30s. Again, an irregular menstrual cycle is usually the first sign that things are ramping up.
Some folks will only experience perimenopause symptoms for a few months before their periods fizzle out. But more often, you’ll be in it for the long haul — anywhere from 4 to 10 years.
As you reach the homestretch to menopause, you might notice that your symptoms intensify as your estrogen levels start dropping at a faster rate.
You’ll know you’re past perimenopause and have finally reached menopause once your periods have stopped for a full year. The average age for this momentous event? 51.
Treatments to ride out the hormone wave
Perimenopause symptoms can range from annoying (I definitely did not expect my period today) to straight-up miserable (I wake up drenched in sweat every night and trying to have sex hurts).
But no matter what hand you might be dealt, there are ways to help manage your discomfort and help you feel more yourself.
Hormone therapy
Hormone therapy involves taking estrogen and progestin — or just estrogen if you’ve undergone a hysterectomy.
Systemic hormone therapy, which is given as a pill or patch, is the best option for managing hot flashes and night sweats. If vaginal dryness is your only issue, you can use a local therapy like a vaginal ring, tablet, or cream.
The treatments come with some big risks, though. Hormone therapy can increase your chances for heart disease, breast cancer, endometrial cancer, blood clots, and gallstones, and they’re not recommended if you’ve recently undergone treatment for breast cancer.
Your doc can help you weigh your individual pros and cons and help you figure out the right move for you.
Other prescription drugs
If you have severe symptoms but want to avoid hormone therapy, you have other options. Hot flashes and sleep problems can also be managed with certain antidepressants, antiseizure meds, and blood pressure meds.
Selective estrogen receptor modulators (SERMs) can help with hot flashes and vaginal dryness.
Over-the-counter lubes
Vaginal dryness that isn’t super intense can often be managed with drugstore products. Water-based lubricants like Astroglide can be good if the dryness only bothers you during sex. You could even try coconut oil (just be aware that this can make latex condoms less effective).
FYI: Steer clear of any lubes or moisturisers with glycerin, which can sometimes cause itching or burning.
Lifestyle changes
Managing your daily routine might be enough to keep mild to moderate perimenopause symptoms in check — and these may be worth trying before moving on to prescription treatments. Try things like:
- Avoiding hot flash triggers. Notice that caffeine or spicy foods tend to bring on hot flashes? Steering clear or limiting your intake can make a difference. Wearing layers that are easy to remove, keeping your bedroom cool at night, and not smoking can also help keep hot flashes in check.
- Eating a plant-based diet. Soy-based foods, chickpeas, lentils, flaxseed, and whole grains contain phytoestrogens — plant estrogens that could potentially help ease symptoms.
- Exercising. It’ll help you sleep better and boost your mood. Aim for at least 30 minutes of moderate to vigorous movement every day. Yoga can be particularly helpful if you’ve got stress or anxiety.
- Managing your weight. Having a higher body mass index seems to make people more prone to hot flashes — but research shows that losing weight can help.
Natural remedies
One of the most popular supplements for perimenopause symptoms is the herbal extract black cohosh. But experts say there’s not enough quality evidence to recommend it, and it might potentially pose a risk to your liver. It could also be unsafe if you have or are at high risk for breast cancer.
Isoflavone supplements derived from soy or red clover are another possible option, but again, there’s not much proof that they’re useful, and they could potentially raise the risk for breast cancer.
The bottom line? Herbal supplements aren’t an automatic no, but they may not be the best option. If you’re thinking about taking an herbal supplement to wrangle your symptoms, talk with your doctor first.
Perimenopause is a completely normal part of life. If you’re able to handle the symptoms on your own, there’s no need to get medical attention.
But if issues like hot flashes, mood swings, sleep problems, or vaginal dryness are affecting your quality of life, you should absolutely loop your doctor in.
You should also give your OB-GYN a heads-up about significant changes to your periods. While some irregularity is normal during perimenopause, you should call a doctor if your periods:
- are extremely heavy
- go on for more than 7 days
- come with spotting in between them
- are fewer than 21 days apart
