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  • Writer's pictureDr. HyunJung (Katie) Oh

Am I in Perimenopause?

Perimenopause, often termed the menopause transition, is a natural phase in a woman's life that typically occurs in her 40s or early 50s. This transformative period involves significant hormonal and biological shifts as the body prepares for menopause. These changes can impact various aspects of health, leaving women in this transition feeling bewildered and overwhelmed by the evolving landscape within them.


As women approach their 40s, they may ponder whether they've entered perimenopause. Understanding the signs and stages of this transition is crucial for proactive healthcare, but pinpointing its exact onset isn't always straightforward.


The Challenge of Identifying Perimenopause

During perimenopause, hormone levels can vary considerably, not only between individuals but also within a person from one day to the next. Relying solely on hormone testing to determine perimenopausal stage can be misleading due to the erratic fluctuations of hormones during this time.


Tracking Your Perimenopausal Journey

The STRAW (Stages of Reproductive Aging Workshop) criteria offer a standardized approach to help women identify the stages of perimenopause and menopause based on changes in their menstrual cycle patterns. These stages provide valuable insights into the perimenopausal journey and the associated symptoms.

  • Late Reproductive Stage: Subtle changes in flow and cycle length indicate the body is preparing for the transition, though perimenopause has ‘technically’ not yet begun. Please note that some experts call this stage the ‘very early perimenopause stage’ because women with regular cycles may start noticing perimenopausal symptoms such as worsening PMS, irritability and sleep problems due to erratic hormone levels during this time.

  • Early Perimenopause Stage: Menstrual cycles varying by more than 7 days from the average cycle length indicate the early perimenopausal stage. Symptoms may arise from excess estrogen, including breast tenderness, heavy bleeding, and headaches, rather than the typical menopausal symptoms.

  • Late Perimenopause Stage: Cycle lengths extending beyond 60 days and skipped periods suggest declining hormone levels. Typical menopausal symptoms, such as hot flashes, insomnia, and mood swings, may manifest during this phase, especially when you are skipping your periods.

  • Menopause: Defined as one year without a menstrual period, characterized by low estrogen and progesterone levels. The 12 months of no period before officially entering menopause are considered to be the last stage of perimenopause. During this time, women may experience typical symptoms of menopause more consistently, such as hot flashes, night sweats, sleep disturbances, mood-related issues, brain fog, joint pain, and vaginal dryness.

Navigating Your Unique Perimenopausal Journey

Perimenopause is a unique journey for every individual, and it's a long journey. Many perimenopausal women become confused and frustrated with the changes happening in their bodies due to the ever-changing nature of their hormones during this transition. By tracking the changes in menstrual cycles and symptoms, you can better understand your unique journey, anticipate changes, and seek timely medical guidance and support—ensuring a fulfilling and healthy life during perimenopause and beyond.


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