Perimenopause – What the Heck is Happening to My Body?

Perimenopause is the time leading up to your final menstrual period and can last up to several years.  During this time,menstrual cycles may be heavier or lighter than usual, and may come at shorter or longer intervals.

Behind the scenes, your hormone levels are all over the place.  They can swing dramatically and shoot higher (and dip lower) than they did during your reproductive years.  These swings can explain some of the bothersome symptoms that women experience, including mood swings, heightened anxiety, irritability, trouble concentrating, “brain fog” and difficulty sleeping, as well as the more familiar symptoms of hot flashes and night sweats.

If you’ve noticed changes in your waistline, you’re not alone.  Weight gain and weight redistribution- especially around the middle- can also be problematic and is influenced by several factors including aging, changes in hormones, activity level, and diet.  Vaginal dryness can start even before menopause and can lead to discomfort with sexual activity.

Journalists: Sound bites with Dr. Faubion are available in the downloads.

 What can you do to minimize the impact of these changes?

  • Maintain a healthy weight-the rules of your body have changed, and you need to figure out the new balance. Try recording or journaling the calories you consume and the calories you burn to help you make adjustments as needed
  • Regular exercise-will help you maintain your weight, relieve stress, and improve your overall health, though studies are mixed on whether exercise reduces hot flashes and night sweats
  • Stress management-try a yoga or tai chi class, meditation, acupuncture or a massage to lower your stress level
  • Cultivate a positive attitude-work on staying in the present moment, being mindful and resilient
  • Avoid triggers for hot flashes such as caffeine, warm beverages, alcohol, and tobacco. Dressing in layers and using a fan can help keep you cool
  • Use a vaginal lubricant as needed for sexual activity.

When should you seek advice from your medical provider?

  • If you have heavy or irregular menstrual bleeding
  • If you are experiencing significant and persistent problems with your mood
  • If hot flashes and night sweats are particularly disruptive
  • If you have pain with sexual activity

While the changes associated with perimenopause can catch you off guard, you can take steps to make this natural transition into menopause as smooth as possible.

Author: Stephanie Faubion M.D.Director, Mayo Clinic Women’s Health Clinic and Office of Women’s Health