5 Things All Women Need to Know About Perimenopause

The word ‘Perimenopause’ can evoke a lot of feelings for a woman – likely because 90% do not feel well-informed about perimenopause and 70% aren’t even sure what it is. While perimenopause can come with challenges, women who understand this stage find it easier to navigate the changes with confidence and  take proactive steps toward dealing with their symptoms. Here are five things every woman needs to know about perimenopause.

What even is perimenopause?

Perimenopause, often referred to as the “menopausal transition,” typically begins in a woman’s 40s but can start as early as the mid-30s. This phase marks the gradual decline of estrogen levels, leading to various physical and emotional symptoms. Unlike menopause, which is defined as the cessation of menstrual periods for 12 consecutive months, perimenopause can last several years. Understanding the onset and duration of perimenopause can help you recognize the symptoms early and get the right care.

What are the common symptoms of perimenopause?

Perimenopause symptoms vary among women because there are 34 recognized symptoms, all caused by fluctuating hormone levels.The most common symptoms include:

  • Irregular Periods: Menstrual cycles may become shorter, longer, heavier, or lighter.
  • Hot Flashes and Night Sweats: These sudden feelings of intense heat can be uncomfortable and disruptive to sleep and everyday life.
  • Mood Swings: Hormonal changes can lead to irritability, anxiety, or depression.
  • Sleep Disturbances: Difficulty sleeping or insomnia is a common complaint among women in perimenopause.
  • Vaginal Dryness: Lower estrogen levels can cause vaginal tissues to thin and dry, leading to discomfort during intercourse.

Understanding these symptoms can help you prepare and seek appropriate treatment options, such as hormone replacement therapy (HRT) or lifestyle changes, to manage them effectively.

How does perimenopause impact fertility?

While fertility naturally declines with age, it’s important to note that pregnancy is still possible during perimenopause. The unpredictability of ovulation during this time can make conception challenging but not impossible. If you don’t want to get pregnant, it’s important to continue using contraception until you are confident you have reached menopause. But if you do want to try to conceive during perimenopause, it could be a good idea to explore fertility treatments, as age-related fertility decline can make conception more difficult.

How can hormone replacement therapy (HRT) help perimenopause symptoms?

Hormone replacement therapy (HRT) can be a powerful tool for managing perimenopause symptoms. HRT helps replenish declining hormone levels, alleviating symptoms like hot flashes, mood swings, and vaginal dryness. There are various forms of HRT, including estrogen-only and combined estrogen-progesterone therapy. Consulting a healthcare provider can help you determine if HRT is a good option for you. The experts at Evolve offer online perimenopause treatments as well as access to a physician who can guide you through your journey.

What lifestyle changes should you make during perimenopause?

Adopting a healthy lifestyle can significantly impact how you experience perimenopause. Here are some habits to integrate into your routine that can help you find relief from perimenopause symptoms:

  • A balanced diet rich in fruits, vegetables, whole grains, and lean proteins can help manage weight, support bone health, and stabilize mood.
  • Regular physical activity, including strength training, cardio, and flexibility exercises, can boost energy levels, improve mood, and reduce the risk of osteoporosis.
  • Practices like yoga, meditation, and deep breathing exercises can help manage stress and promote emotional balance.
  • Establishing a regular sleep routine and creating a comfortable sleep environment can improve sleep quality and reduce nighttime disruptions.

While you may already be practicing some of these habits on a regular basis, setting up more healthy routines can improve your mental and physical health during perimenopause.


Perimenopause is a natural stage in a woman’s life that comes with its own set of challenges, as well as opportunities to better understand your body. Whether through lifestyle changes or medical interventions like hormone replacement therapy, there are many ways to support your overall health and embrace this new phase of life.

Curious about your treatment options for perimenopause? Request a free online consultation with an Evolve patient care coordinator 

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