Could You Be Experiencing Perimenopause? What It Is and 10 Ways to Cope

Every day, women in their forties tell Dr. Lauren Streicher that they aren’t sleeping well, are feeling moodier than usual, and that they, along with their partners, are frustrated by their low libido. They want an explanation for what’s happening to their bodies, and she has one: perimenopause.

North American Menopause Society defines perimenopause as a “gradual transition between the reproductive years” that can last for several years and “can be associated with shorter menstrual intervals, irregular menses, night sweats, and other symptoms.” The word comes from “peri,” the Greek root meaning “around,” and “menopause,” meaning the time when a woman stops menstruating.

The average age at which a woman will experience perimenopause is between 47 and 48, but it’s completely normal for women as young as age 40 to experience symptoms, says Streicher, who is director of the newly opened Northwestern Medicine Center for Sexual Medicine and Menopause, author of “Sex Rx: Hormones, Health, and Your Best Sex Ever,” and associate clinical professor of Obstetrics and Gynecology at Feinberg School of Medicine at Northwestern University.

“It’s the perfect storm because everything is happening at once and none of it is good,” she says.

“Some women have many symptoms, some have no symptoms, and it lasts for a variable amount of time. It’s very individual for each woman,” says Dr. Barbara Soltes, director of the Midlife Center at Rush University Medical Center.

We asked experts who specialize in perimenopause and menopause for their top tips and tools to help women ease those symptoms and stay healthy and happy during their time of transition.

1. Wear comfortable shoes as much as possible.

Comfortable shoes make it much more enjoyable to walk and move, and doing both are key to feeling good during perimenopause.

“So many women become less active over time, and one reason is that when you’re wearing fabulous shoes, you’re more likely to drive and take the elevator than walk,” says Streicher. She urges women to carry comfy flats with them in their bag to help increase the number of steps they take each day.

Athletic shoes you can wear to exercise should also be in every perimenopausal woman’s closet, or preferably, on her feet and used for working out. A regular exercise regimen not only has important physical health benefits, but it also supports good mental health. “It may help keep mood swings in check,” says Dr. Dalia Davood, FACOG, a gynecologist at Advocate Health Care.

2. Sleep on good-quality sheets and wear lightweight cotton pajamas.

Sleep is a big issue for perimenopausal women. A recent study from the National Center for Health Statistics found that perimenopausal women were more likely than premenopausal and postmenopausal women to sleep less than 7 hours, on average, in a 24-hour period.

Often, hot flashes make sleep challenging. While many women don’t expect hot flashes to occur until menopause, it is possible to experience them in perimenopause. In fact, they are the most commonly reported symptom of perimenopause, according to Harvard Health.

To cope, Davood suggests keeping the bedroom temperature cool and wearing light clothing.

“I can’t say that this report surprises me given the physiologic changes that occur during perimenopause,” she says, though she cautions that there can be other factors contributing to sleep problems.

3. Make an appointment with your primary care physician.

Taking care of yourself is important at all stages of life, but especially so in perimenopause. One way to maintain your health is to have regular checkups.

“Make sure your blood pressure and weight are under control because that all plays a role during perimenopause,” says Soltes. She notes that getting both of those numbers where they should be is much harder in menopause, making it particularly important to address them during perimenopause.

4. Save the phone number of a physician specializing in menopause.

Some women do require medical treatment to cope with their perimenopause symptoms. Soltes says that when symptoms become severe enough that they start interfering with a woman’s day-to-day life or she is changing her lifestyle because of them, it’s time to seek medical help.

She recommends that women find a care provider who has knowledge of perimenopause and menopause, preferable a certified menopause practitioner, in addition to having a primary care physician.

Streicher agrees. “It’s important to have a team and to have a menopause expert on that team,” she says, cautioning that a woman’s gynecologist may not be an expert in menopause. “They may be an expert at delivering babies, but may not be an expert on perimenopause and menopause.”

The Menopause Society has a menopause practitioner locator here.

5. Load up on fruits and vegetables.

All the experts stressed that healthy eating is an important part of dealing with perimenopause.

“Diet is critical,” says Soltes. She recommends eating fewer refined carbohydrates and more vegetables and fruits.

“When it comes to fruits, stick with low glycemic fruits like berries, apples, and pears,” she suggests.

6. Keep an eye on the scale.

As we’ve already mentioned, weight becomes a big issue in perimenopause. Streicher recommends that women own and use a scale to weigh themselves regularly. “This is the time of life when women start putting on weight, for a variety of reasons, and it gets away from them. Women find themselves up 20 pounds before they know it. It’s gradual,” she explains.

7. Use a vibrator.

Many women at this stage find using a vibrator makes an “enormous difference” in their sex life, according to Streicher. “A lot of women who are peri or menopausal feel asexual, and women should continue to be self-sexual. Men are. Women may need more stimulation,” she explains.

8. Get the right lubricant.

Vaginal dryness is another common symptom of perimenopause, because declining estrogen levels result in vaginal tissue becoming thinner and drier. The good news is that help is readily available at the drug store in the form of a good lubricant. “No woman should have to have painful sex,” says Streicher. She recommends starting with a silicon-based product over one that is water-based. Replens Silky Smooth is one of her favorite brands. In some cases, even the best lubricant isn’t enough, but there are a number of safe, effective prescription options as well as laser treatments that will restore elasticity and lubrication.

9. Make sure you get enough calcium and vitamin D.

Women begin to lose bone during perimenopause, which makes the elements essential for bone health a priority. “I recommend making sure that they have enough calcium and vitamin D in their diets or encourage supplementation. Even taking a multivitamin daily is something that should be considered,” says Davood. (Here are more ways to keep your bones strong and avoid osteoporosis.)

10. Get access to good information.

All the physicians agree that knowledge is power, especially when it comes to a woman’s health. They recommended reading books like Streicher’s, pamphlets from the physician’s office, and reputable websites that offer science-based information about perimenopause. They help women know what to expect as well as demystify symptoms they may already have and suggest ways women can manage them.

“If you know what’s going on and what your options are, you are in control,” says Soltes.


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Shannan Younger

Shannan Younger is a writer living in the western suburbs of Chicago with her husband and teen daughter. Originally from Ohio, she received her undergraduate and law degrees from the University of Notre Dame. Her essays have been published in several anthologies and her work has been featured on a wide range of websites, from the Erma Bombeck Humor Writers Workshopto the BBC. She also blogs about parenting at Between Us Parents.

Shannan is the Illinois Champion Leader for [email protected], a campaign of the United Nations Foundation that supports vaccination efforts in developing countries to ensure life-saving vaccines reach the hardest to reach children. “Vaccines are one of the most effective ways to save the lives of children in developing countries and I’d love nothing more than to see diseases eradicated,” Shannan says. “We are so close to getting rid of polio for good!”