what are the symptoms of perimenopause

What Are the Symptoms of Perimenopause? Understanding Your Experiences and the Possibilities of Treatment

by Charlotte

As we age, we’re often left trying to understand what is going on when our bodies start to undergo natural transitions, and the transition to menopause is often one of the most puzzling. Women often understand what to expect from menopause itself, but many aren’t as informed regarding the changes that they undergo in the years leading up to it, also known as perimenopause.

Perimenopause is a transitional period when shifting hormones cause your menstruation to become rarer and more irregular, culminating in the cessation of your menstrual cycle. These changes are primarily driven by declining estrogen levels, which can have a profound impact on both your physical and emotional wellness years before the onset of menopause. Most women have entered perimenopause by the time are in their upper 40’s, though for some women start in their 30’s .

While some women experience perimenopause without problematic symptoms, the disruption of hormonal patterns often causes significant distress. By exploring the symptoms of perimenopause, you can better understand what you are experiencing and how treatment can help you regain balance.

Taking A Closer Look at the Symptoms of Perimenopause

On average, the perimenopausal transition takes several years, but it can last for over ten years for some women. During this time, you may experience a number of symptoms as the result of the body’s changing hormone levels, including:

  • Irregular periods
  • Hot flashes
  • Insomnia
  • Changes in sexual desire and function

The duration and severity of these symptoms vary from person to person, ranging from mild and fleeting to persistent and troublesome.

Irregular Periods, Irregular Cycles, And Irregular Flow

Irregular timing of periods, irregular length of menstrual cycles and periods, and irregular flow during periods are all defining symptoms of perimenopause. You may notice that your menstrual cycle is becoming dramatically longer or shorter than you’re used to, or your cycle may be completely unpredictable. Your periods may also be heavier or lighter than normal. The duration of menstruation may also be shorter or longer than normal, and you may experience spotting. Eventually, the irregular periods of perimenopause give way to the lack of periods which characterize menopause itself.

While these changes are expected parts of perimenopause, they can also be uncomfortable and disruptive. If you experience heavy bleeding or something else which concerns you, consult your doctor—they’ll be able to tell you whether it’s something you should be concerned about and talk to you about how to alleviate your symptoms.

Hot Flashes

While hot flashes are typically associated with being in menopause or having a hormonal imbalance, many women experience them in perimenopause as well. That’s because hot flashes are caused by dropping estrogen levels, which can make your body think it is feeling hot when there’s no external heat source.

Hot flashes can be uncomfortable, embarrassing, and distruptive experiences. Having a hot flash while you’re sleeping may also cause night sweats, which can disrupt your quality of sleep and leave you feeling exhausted and soaked when you awaken. Sometimes a decline in progesterone levels causes night sweats even before estrogen levels drop, so this often is the first sign of perimenopause before daytime hot flashes appear.


Whether as a result of hormonal changes themselves or because of the hot flashes that hormonal changes can cause, one of the most common and noticeable symptoms of perimenopause is insomnia. Significantly, this symptom tends to worsen with time; the closer you are to menopause, the more likely you are to suffer from insomnia. While many women turn to sleep aids to address their insomnia, you may find that hormone replacement therapy is a safer and more effective choice to address perimenopausal insomnia at the root.

Changes in Sexual Desire and Function

If you’re experiencing low sex drive, decreased levels of arousal, pain during sex, and vaginal dryness, perimenopause may be to blame. Aside from being uncomfortable, these symptoms can have a profound impact on your emotional health, your sense of self, and your relationships. You may not have to accept altered sexual desire and function caused by perimenopause, provided that you find the right treatment, and addressing these symptoms can be critical to supporting your overall quality of life.

You Don’t Have to Live With the Symptoms of Perimenopause

Because perimenopause is a natural change, you may believe that your symptoms are inevitable. But you aren’t necessarily powerless in the face of perimenopause; there are treatments that you can consider to help you alleviate discomfort and restore your sense of wellness.

For many women, bioidentical hormone replacement therapy (BHRT) is an ideal way to address perimenopausal symptoms. BHRT compensates for your diminishing supply of estrogen and progesterone using hormones that are biochemically identical to the ones your body makes naturally. By replenishing your hormone levels, your perimenopausal symptoms can be minimized or even eliminated altogether. Because BHRT is customized to your individual body chemistry, you can be sure that the treatment you receive is uniquely suited to your needs.

Working with a practitioner who has received specialized training in BHRT and understands the challenges women face in perimenopause is critical to ensuring the best possible treatment experience. Practitioners such as those within the BodyLogicMD network have the knowledge and insight necessary to create a comprehensive treatment plan designed to restore your body to a comfortable hormonal environment and enhance your overall health. With the right supports, you can enter this new phase of life knowing you have the resources to feel your best.

BodyLogicMD can help you address your symptoms of perimenopause with expert care from a highly-trained practitioner who specializes in bioidentical hormone replacement therapy and integrative medicine. The practitioners within the BodyLogicMD network are among the top medical professionals in the nation and specially certified to help you address the symptoms of perimenopause so that you can achieve your health goals. To begin your journey contact a local practitioner to schedule your first appointment or take the BodyLogicMD Hormone Balance Quiz today.

Disclaimer: These statements have not been evaluated by the Food and Drug Administration. All content on this website is for informational purposes only. The content is not intended diagnose, treat, cure or prevent diseases.


  • Charlotte

    Charlotte is a patient care coordinator specializing in bioidentical hormone replacement therapy. She is committed to helping patients who struggle with the symptoms of hormonal change and imbalance explore their treatment options and develop effective strategies to optimize wellness.