Perimenopause is the time before menopause when hormone levels shift and periods start to change. It usually begins in a woman's mid to late 40s and lasts about four years on average, though it can last up to ten. Symptoms like irregular periods, hot flashes and poor sleep can often be treated, and pregnancy is still possible.
Perimenopause means "around menopause." During these years, the ovaries make estrogen and progesterone less steadily. Levels can rise and fall from month to month, and even day to day. That is why symptoms can come and go, and why one month can feel very different from the next.
Many people search for "premenopausal" when they mean the same thing. Doctors usually use "perimenopause" for the transition itself.
Every woman's experience is different. Common signs include:
Some symptoms can have other causes, such as thyroid problems, anemia or pregnancy. Very heavy bleeding, bleeding between periods or bleeding after sex should always be checked by a clinician. These are not signs to wait out.
Most women enter perimenopause in their mid to late 40s. It lasts about four years on average, and can last up to ten. Smoking and some medical treatments can bring it on earlier. If your periods stop before age 40, that is a different condition (early or premature menopause) and needs its own evaluation.
In many cases, the diagnosis is based on your age, your period history and your symptoms. Because hormone levels change so much during perimenopause, a single blood test often can't confirm it. Your clinician may still order tests to rule out other causes, such as thyroid disease, anemia or pregnancy.
A simple way to prepare is to track your periods and symptoms for two or three months before your visit. Our perimenopause symptoms checklist can help.
Treatment depends on which symptoms bother you most, your health history and whether you still need birth control. Options your clinician may discuss include:
Every medicine has risks as well as benefits. Your clinician will go through them with you before you decide.
Yes, if you don't want to get pregnant. Ovulation can still happen even when periods are irregular. Many clinicians advise using birth control until you have gone a full year without a period, or as your clinician advises based on your age and method.
Your first visit is a conversation about your cycle, symptoms, health history and goals. Leticia Vargas, MD, OB/GYN, may recommend an exam or lab tests to rule out other causes. You leave with a plan you have agreed on. Some follow-up visits can be done by telehealth if you are located in Texas at the time of the visit.
Can perimenopause start at 40? Yes. Most women start in their mid to late 40s, but some notice changes in their late 30s or early 40s. Periods stopping before 40 needs a separate evaluation.
Can I get pregnant during perimenopause? Yes. You can get pregnant during perimenopause, even if you skip periods. Use birth control if you don't want to become pregnant.
Is HRT used for perimenopause? It can be. Hormone therapy may help hot flashes and night sweats in perimenopause for some women. Whether it's right for you depends on your symptoms, health history and need for birth control.
Is a blood test enough to know if I'm in perimenopause? Usually not on its own. Hormone levels change from day to day during this time, so diagnosis is mainly based on age, period changes and symptoms.
Talk with Leticia Vargas, MD, OB/GYN, about perimenopause. Call (210) 903-1030 or book a visit. In-clinic in San Antonio • Telehealth for women located in Texas Yaso Wellness Health Clinic, 1907 Goliad Rd, San Antonio, TX 78223
About the clinician: Leticia Vargas, MD, OB/GYN, founder of Yaso Wellness Health Clinic. About Dr. Vargas
Education only, not medical advice or a diagnosis. In an emergency, call 911.
