How to Know if You've Entered Perimenopause

How to Know if You've Entered Perimenopause

Every year, more than 2 million American women enter menopause — roughly 6,000 each day. But before your periods completely end, you go through perimenopause, when your body begins slowing down estrogen production and undergoing lots of other related changes.

Perimenopause can begin in your 30s or 40s, causing symptoms that can range from mild and subtle to annoying and disruptive. 

Knowing what those symptoms are can help you get a head start on menopause care and learn about treatments and screenings that can keep you comfortable and healthy.

Rafael J. Perez, MD, FACOG, helps women at the Center for Urogynecology and Advanced Laparoscopic Surgery manage perimenopause and its symptoms with custom treatment plans tailored to their needs. In this post, we review a dozen common perimenopause signs and symptoms you should look for.

Changes in your periods

Irregularities in their menstrual cycles are among the most common symptoms women experience during the years and months leading up to menopause. You may notice your periods don’t occur as regularly as they once did, or your periods may be shorter, longer, lighter, or much heavier than usual. 

Hot flashes

Hot flashes are another common symptom during perimenopause, happening when fluctuations in estrogen trigger body temperature changes. Along with intense feelings of warmth, hot flashes can cause excessive sweating and skin flushing, especially in your face.

Night sweats

Hot flashes don’t just happen during the day — they can happen at night during your sleep, too. You might wake up hot or sweaty and have trouble getting back to sleep as a result.

Vaginal dryness or itching

Estrogen plays a big role in vaginal health. As levels of the hormone decline, your vagina may become dry and irritated, leading to discomfort or itching. Symptoms can be especially noticeable before or after sexual intercourse.

Changes in concentration (brain fog)

Most people think of estrogen in terms of its role in sexual health, but it plays lots of other roles, too. Many women find that declining hormone levels lead to problems focusing and concentrating, a common symptom often referred to as “brain fog.” 

You might have issues with memory, too.


Moodiness around menstruation is common for many women, but as you get closer to menopause, you may notice an increase in moodiness. You might feel irritable, anxious, or depressed, feelings that can worsen if you also suffer from the next item on the list: sleep problems.

Sleep difficulties

Night sweats are one possible cause of sleep disturbances and daytime fatigue. But hormonal fluctuations can have an effect on your sleep in other ways, leading to difficulty falling asleep or staying asleep, along with lower quality sleep.

Weight gain

Declines in hormone levels can lead to weight gain, especially around your belly. You might notice it’s harder to drop those extra pounds, too.

Changes in sexual desire

Since estrogen plays a key role in sexual health, it’s no surprise that when hormone levels decline, your desire for sex can drop. Vaginal dryness, sleep problems, and moodiness can also contribute to low sexual desire.

Breast itchiness or tenderness

During perimenopause, you might notice that your breasts are especially tender or itchy, or you might find unexpected lumps in your breast tissue. These lumps are typically benign, but you should never ignore them, and it’s also important to have regular mammograms.

Increased urinary tract infections

In addition to vaginal irritation, some women experience irritation that extends to their urethra. Dryness and inflammation can cause burning sensations during urination and increase your risk of urinary tract infections.

Dry skin

Estrogen helps your skin retain moisture and promotes natural oil production that keeps skin healthy and comfortable. As estrogen production declines, your skin can become dry, itchy, and more brittle.

While perimenopause is one cause of these symptoms, other medical problems (including some cancers) can cause similar symptoms. If you have any of these symptoms, schedule an evaluation to ensure you get the treatment and medical screenings you need to stay healthy. 

To schedule your evaluation or to learn more about perimenopause therapies, call us today at 305-240-6047 to request an appointment with Dr. Perez and our team at Center for Urogynecology and Advanced Laparoscopic Surgery in South Miami, Florida.

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