Perimenopause – Symptoms, causes & risk factors


The term perimenopause is used for “around menopause” and it refers to the time during which your body is making the natural transition to menopause which marks the end of the reproductive years. Also, the perimenopause is known as menopausal transition. It is noticed that women start perimenopause at different ages. You can notice signs of progression toward menopause, such as menstrual irregularity, sometimes in your 40s. There are some cases when women start noticing changes in their mid – 30s. The main female hormone is estrogen.

It is known that the level of estrogen rises and falls unevenly during perimenopause. The menstrual cycle can be lengthen or shorten. Also, you can begin to have menstrual cycles in which your ovaries do not release an egg (to ovulate). Also, you can experience menopause – like symptoms, like vaginal dryness, sleep problems and hot flashes. There are some treatments which can help to ease these symptoms. When you have gone through 12 consecutive months without a menstrual period, then you have officially reached menopause and the perimenopause period is over.


Here are some symptoms which you can experience through your perimenopause period.


Changing cholesterol levels: When the estrogen levels are declining, then it can lead to changes in your blood cholesterol levels, including the increase of bad cholesterol (LDL) which is increasing the risk of diseases. Also, the HDL (good cholesterol) decreases as women get older so this is increasing the risk for heart disease.

Loss of bone: When estrogen levels are declining, then women start to lose bone more quickly that you replace it which is increasing your risk of osteoporosis, which is a disease that causes fragile bones.

Changes in sexual function: When you are in the perimenopause, then the sexual arousal and desire can change. But if you had satisfactory sexual intimacy before the menopause, then the chances are big for this to continue through perimenopause and beyond.

Decreasing fertility: When your ovulation becomes irregular, then the ability to conceive decreases. But as long as you have periods, pregnancy is possible. If you want to avoid pregnancy, then you should use birth control pills until you have had no periods for twelve months.

Vaginal and bladder problems: When your estrogen levels diminish, then your vaginal tissues can lose lubrication and elasticity which will make the sexual intercourse painful. The low estrogen levels can leave you more vulnerable to vaginal or urinary infections. The loss of tissue tone can contribute to the urinary incontinences.

Mood changes: During perimenopause, you have increased risk of depression, irritability and mood swings. The cause for the mentioned conditions can be sleep disruptions that are associated with hot flashes. Also, mood changes can be caused by factors which are not related to the hormonal changes of perimenopause.

Hot flashes and sleep problems: During perimenopause is very common to have hot flashes. The frequency, length and intensity of hot flashes can vary. There are many cases when sleep problems are caused by night sweats or hot flashes but there are some cases when sleep becomes unpredictable even without them.

Irregular periods: When the ovulation becomes more unpredictable, then the length of the time between periods can be longer or shorter, your flow can be light to heavy and you can skip some periods. You may be in early perimenopause if you have a persistent change of seven days or more in the length of your menstrual cycle. You are in the late perimenopause if you have a space of 60 days or more between your periods.


When you are going through the menopausal transition, then your body’s production of estrogen and progesterone rises and falls. There are many changes which you can experience during perimenopause that are result of decreasing estrogen.

Risk factors

It is normal part of woman’s life to have menopause. But it can happen in some women earlier than in others. There are some factors which increase your risk of having perimenopause at an earlier age, such as

  • Hysterectomy
  • Cancer treatment
  • Family history
  • Smoking


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