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Understanding and managing your perimenopause symptoms

First and foremost, it’s important to understand that perimenopause is a natural stage of life for women, and it’s important to take care of their physical and emotional health.

menopause icon in flat style. maternity symbol for your web site

Perimenopause is the period of time leading up to menopause when a woman’s body experiences hormonal changes and the production of eggs decreases. It typically begins when a woman enters her 40s, although it can start earlier or later, and lasts until menopause, which is defined as the end of menstrual periods. For some women, symptoms can start as early as 35 years of age and others can last into their mid 50’s. 

During perimenopause, women may experience a range of symptoms due to fluctuations in hormones, including hot flashes, night sweats, irregular periods, mood swings, difficulty sleeping, and decreased sex drive. These symptoms can be mild for some women and severe for others.  I often liken this period to a rollercoaster ride with the high levels of hormones suddenly diving into low and then we go back up again. 

The signs of perimenopause can vary from woman to woman, but some common signs include:

  • Irregular periods: The length of time between periods may become longer or shorter, and periods may be lighter or heavier.
  • Hot flashes: Sudden feelings of warmth and sweating are common during perimenopause.
  • Night sweats: Some women may experience sweating at night, especially during hot flashes.
  • Mood swings: Changes in hormone levels can affect a woman’s mood and cause irritability, anxiety, or depression.
  • Trouble sleeping: Insomnia or difficulty sleeping through the night can be a sign of perimenopause.
  • Decreased sex drive: Changes in hormone levels can reduce a woman’s libido.
  • Vaginal dryness: Hormonal changes can cause the tissues of the vagina to become dry and uncomfortable.
  • Bone density loss: Perimenopause is associated with a decline in bone density, which can increase the risk of osteoporosis.

Below are some lesser known signs and symptoms of perimenopause:

  • Increased joint or body pain 
  • Brain fog: The classic walking into a room and forgetting why you are there gets worse. 
  • Increased fatigue: This is the common and most dreaded one because so many women are already exhausted before entering this new transition phase.  Who needs more? 
  • It’s important to note that not all women will experience all of these symptoms, and the severity of symptoms can also vary. It’s always best to consult a doctor to determine if you are experiencing perimenopause and what steps you can take to manage it.

Here are some of the top lifestyle factors to support perimenopause:

mid section of woman applying hormone patch on belly
Could hormone replacement therapy be right for you? Talk to your doctor!
  1. Exercise regularly: Get your sweat on with a good workout. Your body will thank you and so will your mood! Research shows that specifically getting outside (more on that below) for exercise has improved benefits for reducing stress and improving mental health. 
  2. Eat a balanced diet: It’s important to feed your body right during perimenopause, so pile your plate high with fruits, veggies, and whole grains. Who knows, you might even start to feel like a superhero!
  3. Get enough sleep: Get some quality shut-eye and catch those Z’s, because a well-rested body is a happy body. Trust us, you don’t want to be the grumpiest person in the room during a hot flash!
  4. Manage stress: Take a deep breath and relax! Meditation, yoga, and other stress-management techniques can help you find your zen during perimenopause. My favorite is Binaural Beats. I think of this as an easy way to trick my brain into meditation.  Insight Timer is a great app that can give you a wide range of Binaural Beat meditations.  
  5. Quit smoking: Lung health and 2nd hand smoke aren’t the only reasons to kick the habit. Studies show that smokers have a worse time with menopause symptoms like hot flashes and sleep quality.
  6. Limit alcohol and avoid late, large dinners: Enjoy a glass of wine with dinner, but don’t go overboard. You don’t want to end up with a wine headache on top of hot flashes! Eat your dinner at least 3 hours before your bedtime.  Late meals and alcohol will have your body busy processing what you’ve consumed, on top of processing and making your needed hormones. That’s some intense multitasking for any body.
  7. Consider hormone therapy: Talk to your doctor about hormone therapy, because sometimes a little extra help can go a long way. Supporting women in this transition for the last 20+ years, I’ve learned that the key factors are
    1. using bio-identical hormones, 
    2. making sure that you are not taking oral estrogen (patches and creams are all better options) and 
    3. getting your progesterone levels regularly checked as this is the most common deficiency during this phase of life.  
  8. Practice self-care: Treat yourself to some TLC and do things that bring you joy and relaxation. Read a good book, spend time with friends and family, or pursue a hobby. Life is too short, so have fun!

I often get asked “what type of exercise should I start to support my body during this transition?” 

Some of the best exercises for building and maintaining strong bones while reducing stress hormones are:

  1. Weight lifting: Resistance exercises using weights or resistance bands can help build and maintain bone density, particularly in the hips, spine, and arms.
  2. High-impact aerobics: High-impact activities like jumping, running, and jumping jacks can help increase bone density.
  3. Dancing: Dancing is a fun way to combine weight-bearing and resistance exercise, and it can help improve balance, coordination, and overall fitness. Dancing is also very good for brain health and research shows it can help prevent dementia. 
  4. Stair climbing: Climbing stairs is a weight-bearing exercise that can help increase bone density in the legs, hips, and spine.
  5. Get outside to do any of your chosen activities. Exercising outside, most simply put, amplifies the benefits of working out.
    1. Exercise will get those endorphins going but doing it outside, in the sun, will release more serotonin as well as increase Vitamin D intake (which helps with mood regulation). 
    2. Being outside is also a natural stress reliever – the Japanese have a name for this: Shinrin-yoku, in english, known as Forest Bathing.
    3. Exercising outdoors, challenges the body in a way exercising in the gym doesn’t. For example, walking or jogging on a treadmill is not the same as walking or jogging in a park – there are twists and turns and the terrain is uneven – meaning you have to be alert and your body is using smaller muscles that wouldn’t be activated on the treadmill.
    4. You constantly get fresh air! Even if you live in a city, studies have shown that outdoor air is cleaner than indoor air.

Research shows that it’s important to note that these exercises should be done regularly, at least three times a week, to see a benefit for bone health. Consult a doctor or physical therapist before starting a new exercise program, especially if you have any pre-existing health conditions.