Perimenopause Explained Cedars-Sinai Skip to content Close Select your preferred language English عربى 简体中文 繁體中文 فارسي עִברִית 日本語 한국어 Русский Español Tagalog Menu Close Call 1-800-CEDARS-1 toggle search form Close Share Email Print CS Magazine Cedars-Sinai Magazine Perimenopause Explained Jul 06, 2022 Carrie St. Michel Share Tweet Post Perimenopause is having a moment. It’s appeared on the covers of more than a dozen recently published books, and perimenopause-branded products—from hot-flash-cooling mists to mood-swing supplements—are turning up on store shelves. Every woman eventually goes through perimenopause, yet many have never heard the word before or do not understand the full scope of this reproductive rite of passage. In a 2021 survey of American women ages 45 to 60, nearly half were unfamiliar with the term. Perimenopause is the extended time of transition leading to menopause, which is reached when a woman hasn’t had a period for one year. Perimenopause can start as early as the mid-30s and lasts an average of four years, but it also can span more than a decade. It is punctuated by fluctuating hormones, irregular periods, sleep disturbances, vaginal dryness and a laundry list of other significant physical, cognitive and emotional symptoms. Perimenopause and menopause are not interchangeable terms, and women need to know and discuss the distinction, say Cedars-Sinai OB-GYNs Alyssa Quimby, MD, and Sara Twogood, MD. Here, they help demystify perimenopause and share how physicians can change “the change” conversation to better prepare women for this universal transition. Alyssa M Quimby MD Obstetrics & Gynecology Alyssa M Quimby MD Obstetrics & Gynecology Accepting New Patients In-person Visits 310-423-1224 Accepting New Patients Call to Schedule Why is perimenopause not on most women s radar Alyssa Quimby: Part of the problem is perimenopause isn’t easy to explain. Menopause has a straightforward definition, but perimenopause is a complex process, and no two women experience it in the same way. Another part of the problem is there’s little focus on perimenopause and menopause in medical school. Sara Twogood: The reproductive transition can be confusing because a woman doesn’t stop menstruating overnight. It’s a gradual and often unpredictable process. Even when you haven’t had a period for 12 months and are officially menopausal, the symptoms you experienced during perimenopause can continue. Some patients in their 70s and 80s have lingering symptoms that started when they were perimenopausal. People probably find it easier to use “menopause” as an umbrella term, even when they actually are in perimenopause. A lot of women aren’t aware that perimenopausal symptoms can start in their early 40s or even earlier. They also often are surprised by the range and severity of some symptoms, including trouble sleeping and changes to mood and sex drive.” —Sara Twogood, MD Sara B Twogood MD Obstetrics & Gynecology Sara B Twogood MD Obstetrics & Gynecology Accepting New Patients In-person Visits 310-423-1224 Accepting New Patients Call to Schedule What are the signs and symptoms of perimenopause AQ: Changes in menstruation are a hallmark of perimenopause—a shorter cycle, a longer cycle, a heavier period, or a lighter period than is usual for a particular woman. Many women are unaware of perimenopause, so they assume a medical condition, such as fibroids, is to blame when they experience changes in their periods. We evaluate every patient for their concerns, but often what they’re experiencing are normal perimenopausal symptoms. ST: A lot of women aren’t aware that perimenopausal symptoms can start in their early 40s or even earlier. They also often are surprised by the range and severity of some symptoms, including trouble sleeping and changes to mood and sex drive. In Discoveries: Menopause Matters When a woman has perimenopausal symptoms what should she share with her doctor AQ: It’s a good idea to track your cycle and symptoms. There are many apps women can use, or they simply can log their symptoms in a notebook, including when symptoms occur and how long they last, the start and end dates of each period and whether it’s heavy or light, and anything else they notice. This information tells your doctor what’s happening with your hormones and how your symptoms are impacting you. What treatments are available for perimenopause symptoms ST: We tailor therapies to each patient’s situation, but there are several established methods for managing symptoms. For irregular bleeding, we often recommend birth control pills because they make periods more predictable, lighter and less painful. We consider hormone replacement therapy for women whose common symptoms—such as hot flashes, mood swings or vaginal dryness—have become intolerable. Antidepressants also can alleviate hot flashes, mood swings, sleep disturbances and night sweats. Read: Menopause Q&A with Dr. Erica Wang What can clinicians do to better prepare women for perimenopause AQ: We see firsthand the knowledge gaps around important women’s health topics. Clinicians in the women’s health space need to help fill those gaps by educating women about their bodies and reproductive medicine. Knowledge is empowering, and we want women to enter this new chapter of their lives with confidence. ST: We saw that factual, accessible information wasn’t reaching enough women, so, in 2020, we created Female Health Education, an online platform offering courses on important subjects for every stage of a female’s life—from puberty to menopause. We’re particularly passionate about increasing awareness of perimenopause because it’s universal and its symptoms can be debilitating and protracted. We want women to view perimenopause as the natural transition it is. Tags Women's Health Gynecology magazine Summer 2022 Share Tweet Post Blog & Magazines catalyst Blog & Magazines Home CS-Blog Blog CS Magazine Cedars-Sinai Magazine discoveries magazine Discoveries Magazine Embracing our Community Embracing Our Community Blog & Magazines catalyst Blog & Magazines Home CS-Blog Blog Embracing our Community Embracing Our Community CS Magazine Cedars-Sinai Magazine discoveries magazine Discoveries Magazine Popular Topics Patient Stories Health Tips Doctor Profiles At-A-Glance Meds and Tests Make an Appointment Find a Doctor Schedule a Callback Call us 24 hours a day 1-800-CEDARS-1 Support Cedars-Sinai MAKE A GIFT VOLUNTEER Share Email Print Please ensure Javascript is enabled for purposes of website accessibility