Are you experiencing changes in your body temperature that make you feel like you are standing in the middle of an erupting volcano? Are you finding yourself crying randomly without warning? Are you experiencing trouble falling or staying asleep at night? If you answered yes to any of these questions and you are a woman over the age of 40, you may be experiencing premenopausal symptoms. Today, you are going to get an in-depth look at what it means to be premenopausal, including signs and symptoms, and how this stage of development prepares you for menopause.
A Woman’s Life Continuum
As a woman, you go through many transitions throughout your life. These transitions bring about changes in the way you look, the way you feel, your mood, and your energy levels. For many women, experiencing these changes can be wrought with physical and psychological challenges that can negatively impact their functioning in many areas of life.
Starting with puberty which begins in late childhood, a woman goes through significant physical changes, experiences sexual maturation, and develops reproductive capabilities. Puberty marks the time when a woman can become pregnant. For anyone who has experienced puberty, you may have felt self-conscious, inadequate, and anxious about the changes that were occurring within your body.
The perinatal period is another stage of transition for women. The perinatal period refers to the pregnancy period and up to one year postpartum. If you have ever experienced the perinatal period of life, you understand that this period comes with significant physical, social, and psychological changes. Your capabilities are reduced from the foods you eat to the activities of daily living you can perform. Have you ever tried to tie your shoes in the third trimester of pregnancy? If so, you know normal tasks of daily living increase in difficulty during the pregnancy phase.
During the postpartum period, you are thrust into a world that you don’t recognize and are completely responsible for the wellbeing and survival of another life—all while trying to get a couple of hours of sleep each day, eat enough to be able to sustain your own life and wipe the tears from your eyes after you had your third crying spell of the day. Fortunately, this stage doesn’t last forever, and eventually, you find some remnants of the woman you were before you brought your beautiful little bundle of joy into the world.
During menopause, your body experiences significant hormonal and reproductive changes; menopause marks the transition into infertility. You may have heard from other women about the physiological and psychological changes they experienced during this phase. Research shows that as many as 90% of women seek assistance from a medical professional to help cope with the symptoms of menopause.
Common symptoms that occur during menopause include:
- Poor sleep quality
- Hot flashes
- Increased anxiety
- An increase in depression symptoms
- Vaginal dryness
The Premenopausal Period
Perimenopause (also referred to as being premenopausal) is categorized as the period immediately before you enter menopause and it represents the final years of a female’s reproductive phase of life. During this time, hormonal and biological changes occur. For this piece, perimenopause and premenopausal are going to be used interchangeably to refer to the phase of life before entering menopause.
Perimenopause represents the shift from having reproductive abilities to no longer being able to reproduce. The length of perimenopause is different for each person, however it usually lasts 4-5 years and this stage of transition usually begins in your mid-to-late 40s. The perimenopausal period is considered over when you have not had a menstrual cycle in 12 months.
Signs and Symptoms of the Premenopausal Period
Each person’s experience of perimenopause is unique, and not everyone who transitions into the premenopausal phase is going to experience the same symptoms. Symptoms will also fluctuate in terms of severity and duration from person to person. This period of life is comprised of two parts: early perimenopause, which is categorized as having fairly regular menstrual cycles with very few and/or mild symptoms, and the end phase of perimenopause, which refers to a reduction in menstrual cycles (every 60 days) to the eventual cessation of menses.
Symptoms of Perimenopause
It’s important to note that during your 40s and 50s when perimenopause begins, a lot of social and relationship stressors can occur that can exacerbate symptoms. Some women during this phase are raising younger children while other women may be taking care of their elderly parents. Some women may be going through or recently went through a divorce or separation from their partner while others are juggling a demanding career along with the stressors of a full home life. Some women may be sending children away to college while others may be single mothers trying to make ends meet financially. All of these factors can influence the experience of perimenopausal symptoms.
Premenopausal symptoms can significantly impact your quality of life and they can include psychological and physical symptoms. Common symptoms of perimenopause include:
- Decreased or low energy
- Feelings of irritability
- Difficulty concentrating
- Experiencing crying spells or frequently tearing up
- Experience mood swings that can range in severity
- Experiencing feelings of anxiety, constant worry
- Muscle tension
- Feelings of hopelessness, depression, or anhedonia (loss of interest in once pleasurable activities)
What the Science Says
Research has found that:
- From 30% to 70% of premenopausal women experience hot flashes during the perimenopause phase. (Hot flashes during this phase are more mild than when they occur during menopause).
- Women of greater body mass report more severe hot flashes during the perimenopausal phase than women who have lower body mass.
- Sleep problems usually begin in women in their 40s and worsen as they age.
- There is a correlation between hot flashes and sleep problems. The more intense the hot flashes are, the more a woman experiences difficulty sleeping.
- Although depression and anxiety symptoms can present during the perimenopause phase, they are more likely to occur during menopause or late menopause.
Additionally, about 40% of women during the perimenopausal phase experience symptoms that are akin to PMS symptoms.
Getting Help for Your Perimenopause Symptoms
If you are one of the many women experiencing symptoms of perimenopause, you are not alone. While you can’t stop this phase from occurring as perimenopause is a normal part of your biological development, you can take steps to help mitigate the symptoms and maintain a high quality of life for yourself during this phase of life. It is important to assess the impact that these symptoms have had on your overall functioning, well-being, and quality of life. If you notice an impairment in any area of life, it is time to talk to a medical professional.
Talk to your doctor and/or OBGYN about the symptoms you are experiencing. You and your doctor can create a treatment plan that is based on your unique symptoms, needs, and health goals. Your doctor may prescribe you medication to help treat the physical or psychological symptoms you may be experiencing. Your doctor may also refer you to a counselor or therapist to address mood and psychological challenges via behavioral therapy. Additionally, hormone therapy is often used to help mitigate symptoms.
Lifestyle changes that focus on improving sleep and reducing your vulnerability to anxiety and depression can also help. As you may or may not know, sleep is a major contributor to many mental and emotional problems such as depression, anxiety, poor concentration, poor judgment, and impaired decision-making. To improve sleep, professionals recommend:
- Avoiding eating heavy meals close to your bedtime
- Developing a routine and sticking with it (getting up around the same time every day and going to bed around the same time every evening)
- Putting down your electronics (phone, television, iPad, tablet) at least an hour before you want to go to sleep
- Avoiding caffeine consumption in the afternoon because you can feel the effects of caffeine up to 8 hours after you last consume it
- Creating a comfortable, cool, and dark space in your bedroom for a restful night’s sleep
Other lifestyle changes that can help improve your perimenopausal symptoms by improving your mental health include:
- Regularly exercising
- Quitting smoking
- Reducing/eliminating consumption of mind-altering substances like alcohol and/or drugs
- Developing healthy emotional outlets such as journaling
- Identifying and engaging in hobbies that bring you joy (crafting, reading, yoga)
- Engaging in regular self-care practices such as eating healthy, taking your medication as prescribed, and staying hydrated
Medications that replace the hormone estrogen can help reduce your symptoms as well as medication that addresses symptoms of anxiety and depression. If you are having trouble paying for your prescription medication, ScriptSave WellRx can help you save money on the cost of your medications. Some people who take advantage of the ScriptSave WellRx prescription savings card save 80% on their medications. Stop paying too much for your prescriptions. Let ScriptSave WellRx help save you money today.
Jacquelyn Buffo began writing at the age of 10 when she won a county-wide essay contest explaining why her mother is worth her weight in gold. Since that time, she has written for several newspapers and a health and wellness blog. Her education and experience is in mental health and addiction. She is a licensed counselor and currently provides therapeutic services on an outpatient basis. Her counseling and substance abuse experience includes inpatient residential, in-home, and early recovery counseling. She is a certified addiction specialist and is working on obtaining her certification in Dialectical Behavioral Therapy. She also specializes in working with pregnant and post-partum women and has received advanced training on women's health.
- Falconi, A. & Hoyt, L.T. (2015). Puberty and perimenopause: Reproductive transitions and their implications for women’s health. Social Science & Medicine, 132, p.103-112.
- Garcia, E.R. & Yim, I.S. (2017). A systematic review of concepts related to women’s empowerment in the perinatal period and their associations with perinatal depressive symptoms and premature birth. BMC Pregnancy and Childbirth, 17(347).
- Santoro, N. (2016). Perimenopause: From research to practice. Journal of Women’s Health, 25(4), p.332-339.
- The American College of Obstetrics and Gynecology. (2023). Mood changes during perimenopause are real: Here’s what to know.