10 Commonly asked questions about perimenopause

Perimenopause is a natural stage of life, but the changes that come with it can raise plenty of questions. From irregular periods and hot flashes to sleep changes, mood changes and more, symptoms can look different for every woman. Understanding what’s happening in your body and what options are available can make this transition easier to navigate. Here are answers to 10 common questions about perimenopause.

1. What is perimenopause?
Perimenopause is also known as premenopause. It is a time is a woman’s life when hormones begin to decline and become chaotic. Symptoms typically start in your 40’s and can last 10 years leading up to your final menstrual period.

2. What are the symptoms?
Insomnia, mood changes, fatigue, hot flashes, weight gain, low libido, brain fog, change in menstrual flow and frequency. These are only a few of the most common complaints.

3. Can lab work tell me if I am in perimenopause?
Having your hormones checked during perimenopause is not usually helpful. Hormone levels rise and fall erratically during perimenopause. There is no single blood, urine or saliva test to confirm perimenopause. However, there are other labs that can be checked to rule out other health issues that can mimic symptoms of perimenopause.

4. Why are my periods so crazy?
As our ovaries age, we often have months where we have anovulatory cycles, which is when you do not release an egg. Cycles will often become longer or shorter in duration. We often skip months. This is a sign of losing our ovarian reserve, and ovaries will eventually stop working altogether.

5. How is perimenopause treated?
There is not a one size fits all approach to treating perimenopause. We often use birth control pills to fix those irregular cycles and to keep the hormones from fluctuating so wildly. We often use hormones in various ways if a woman does not want to take oral contraception.

6. How do I know if I am in perimenopause or menopause?
It is not always easy to know. The definition is the absence of a period for 12 months. However, many women can not go by their cycles. Some women have had endometrial ablations, use continuous birth control, or use long term birth control such as IUD, Nexplanon or Depo Provera injections.

7. Do I have to be fully menopausal to use menopausal hormone therapy?
No, menopausal hormone therapy can be started in perimenopause.

8. Can I use over the counter supplements to treat perimenopause?
There are some supplements that may improve perimenopausal symptoms, but the results are mixed. Over the counter supplements are not regulated by the FDA, so we do not always know where they are made. Buyer beware.

9. Can I still get pregnant if I am menopausal?
Yes, if you are still menstruating, pregnancy can occur. Miscarriages are more common during menopause due to declining egg quality.

10. Isn’t the perimenopause/menopause transition a natural process?
Perimenopause and menopause will happen to 100% of women if we are fortunate to live long enough. We are living longer thanks to modern medicine; therefore, we are outliving our ovaries. We do not have to suffer through the transition period. We have FDA approved hormone therapies that are body identical to what our ovaries were making.