Perimenopause: The Basics

September is Perimenopause Awareness month. Let’s discuss the basic details today.

Perimenopause can start at age 35 and is a time of hormonal fluctuations of estrogen and progesterone that cause menopausal like symptoms while still having a period. Symptoms include night sweats, irritability, anxiousness, depression, poor sleep, skin and hair changes, night sweats, hot flashes, fatigue, low libido, vaginal dryness, brain fog, and difficulty losing weight.

The hormonal fluctuations cannot be captured by bloodwork so the diagnosis is clinical and based on age and symptoms. Of course you want to rule out other potential causes like thyroid disease, low iron, low vitamin D, insulin resistance, and low vitamin B12 to name a few so bloodwork is still useful.

Treatment can include starting non-hormonal supplements like primrose oil, black cohosh, flaxseeds, or maca or begin bioidentical hormone therapy and remain on it as you transition into menopause.

In perimenopause, you can still get pregnant so if you need contraception, then that needs to be addressed as the aforementioned options do not provide contraception.

We will address diagnosis/labs, treatment, and lifestyle modifications in depth in the following blogs.