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Are you wondering if your irregular periods and hot flashes are a sign that your body is nearing its next chapter?
Perimenopause is the transitional phase before menopause. And it can be a rollercoaster of symptoms as your hormones fluctuate. While some perimenopause symptoms may subside, others may intensify.
This may have you wondering things like, “How do I know what stage of perimenopause I’m in?” Or, “What are the final periods before menopause like?”
Keep reading! We’ll break down the stages of perimenopause, the signs that you’re nearing the end, and also share what to expect during your final periods.
Key takeaways
- Perimenopause is the period of transition leading to menopause.
- Perimenopause can last anywhere from about 7 years up to 14 years. The length of time varies from person to person.
- The biggest indicator of perimenopause is irregular periods.
- Other common signs of perimenopause include hot flashes, night sweats, mood swings, vaginal dryness, sleep issues, and irregular periods.
- Signs perimenopause is ending include more frequent hot flashes, increased vaginal dryness, fewer mood swings, and fewer headaches.
- It is still possible to get pregnant during perimenopause, but less likely due to hormonal changes, declining egg quality, and irregular ovulation.
- You can manage perimenopause symptoms through lifestyle changes, hormone therapy, and medication.
- After perimenopause, you enter menopause. This officially happens when you haven’t had your period for 12 months.
What is perimenopause?
The word “peri” means “around.” So, “perimenopause” means “around menopause.”
And, perimenopause is the transitional phase before menopause begins.
This transition period can happen anywhere between the ages of 45 and 55, but this isn’t the case for everyone. Some people may experience it starting earlier or extending later.
This period isn’t super well-defined. Your period isn’t quite regular anymore, but it hasn’t completely ended yet, either.
But what is known is that perimenopause starts with the first signs of menstrual irregularity. And it ends with 1 year of amenorrhea (the absence of a period). 12 months without a period means you’ve officially entered menopause.
You can expect this transition between regular periods and menopause to last about seven years. However, some women may experience it for as long as 14 years.
Now let’s look at the different stages perimenopause takes you through.
What are the stages of perimenopause?
Perimenopause has two main stages: early and late.
Early perimenopause
This happens when your periods start to get irregular. You may notice the length of your menstrual cycle is changing and may vary by more than seven days. Sometimes your period may show up a few days early or a few days late.
Late perimenopause
During this time, your periods become even more irregular and infrequent. You may even experience more than 60 days between each period.
Eventually, these periods will stop completely. This is your sign that you’ve officially reached menopause
Signs that perimenopause is ending
The good news is that you don’t have to just guess when perimenopause is close to its end. There are signs perimenopause is ending.
Most often this involves a change in symptoms related to your body’s estrogen levels. Perimenopausal symptoms related to estrogen deficiency become more obvious. Meanwhile, symptoms related to hormonal changes become less intense.
Here are some of the symptoms you may experience during this time that serve as signs perimenopause is ending.
1. Infrequent periods
This is one of the biggest signs perimenopause is ending. In late perimenopause, your periods get further and further and further apart. The gap between periods becomes more than 60 days.
However, there is no way to know which period will be your last. You simply have to monitor the amount of time between periods. And eventually, the next period just won’t show up.
2. Hot flashes
You’ve likely heard about hot flashes — they are a common experience.
Most women experience them in the upper body — the face, neck, chest, and arms. These sudden bursts of heat followed by flushed skin and sweating are far from enjoyable. But they’re happening due to changes in your body.
During perimenopause, hot flashes happen because your hypothalamus (a.k.a. your body’s thermostat) gets confused by decreasing estrogen levels. It thinks you’re overheating, so it tries to cool you down. It does this by widening blood vessels and activating your sweat glands.
As you get closer and closer to menopause, hot flashes will become more frequent.
3. Sleep disturbances
Hot flashes and sleep disturbances go hand-in-hand. The more severe and frequent your hot flashes, the harder it is to sleep.
Additionally, a decline in estrogen and progesterone can also contribute to insomnia.
4. Vaginal dryness and irritation
This discomfort is due to low estrogen levels during perimenopause. This decrease in estrogen can cause dryness, irritation, and pain during sex and urination.
It’s important to note that this lack of lubrication can put you at higher risk of UTIs and vaginal infections. So take the necessary precautions to mitigate these risks.
5. Fewer headaches and mood changes
Headaches and mood swings are both common experiences during perimenopause. And they’re also thanks to hormone changes.
But, nearing the end of perimenopause means fewer hormone changes. And this means fewer headaches and a more stable mood.
6. Changes in sex drive
The low estrogen in your body, as you reach the end of perimenopause, means a lower sexual desire.
But, for others, decreased estrogen and progesterone levels can make the effects of testosterone more apparent. This can have the opposite effect and lead to an increased libido.
If any of these symptoms are affecting your daily life, talk to your healthcare provider.
Can you still get pregnant during perimenopause?
Yes — it is possible to get pregnant as you reach menopause. But, it’s less likely.
As long as you’re ovulating, you can get pregnant. And if you’re getting a regular menstrual period, you’re probably still ovulating.
But as you get deeper into perimenopause and your period becomes more irregular, so does ovulation.
To confirm whether you’re ovulating, use the Inito Fertility Monitor. It measures all four fertility hormone levels (LH, estrogen, PdG, and FSH) on one single test strip. PdG (urine metabolite of progesterone) helps confirm ovulation.
By knowing whether you’re ovulating, you can plan your pregnancy accordingly. If you find out you’re not ovulation for more than 3 cycles in a row, consult a fertility specialist to discuss your options.
How to manage perimenopause symptoms
Perimenopause brings with it a range of uncomfortable symptoms. But, there are ways you can manage them to help you feel your best.
Here are some tips:
Eat a healthy diet
Focusing on a diet that’s rich in phytoestrogens may help with symptoms of low estrogen. These foods include:
- Soy
- Flax seeds
- Sesame seeds
- Chickpeas
- Berries
- Cruciferous vegetables
Learn more: How to Increase Estrogen Naturally: 3 Simple Ways
Also make sure you’re eating a well-balanced diet that includes plenty of protein and focuses on whole, unprocessed foods.
Quit smoking
If you’re a smoker, now’s the perfect time to stop. Smoking can make perimenopause symptoms worse.
Exercise regularly
Studies show that regular exercise helps reduce hot flashes in particular. But it’s also great for managing other perimenopause symptoms.
Aim for 30 minutes of exercise at least 4 days a week.
Reduce stress
Stress can make perimenopause symptoms worse.
To manage stress, incorporate these things into your life:
- Breathwork
- Meditation
- Journaling
- Yoga
- Time in nature
Sleep well
Getting enough quality sleep is key during perimenopause.
To help improve your sleep, go to bed and wake up at the same time every day. Also, avoid screens and caffeine before bedtime. This creates a relaxing bedtime routine to help you wind down.
Hormone replacement therapy
If your symptoms are more severe and disrupting your day-to-day life, speak with your healthcare provider. They may suggest hormone therapy.
Hormone replacement therapy is effective in managing perimenopause symptoms like hot flashes, headaches, vaginal dryness, and mood swings.
This form of therapy can be a combination of estrogen and progesterone pills or a vaginal estrogen cream.
Talk to your healthcare provider about the best options for your unique situation.
What’s next after perimenopause?
Once you haven’t had a period for a full 12 months, you can say “goodbye” to perimenopause. You’ve officially entered menopause.
There’s no way to know which period will be your last. But, you’ll notice a shift in your hormone levels that will give you some signs.
At the end of perimenopause, your body isn’t able to respond to follicle-stimulating hormone and luteinizing hormone. And your ovaries gradually stop producing estrogen and progesterone.
Though menopause can come with its own range of menopausal symptoms, they tend to alleviate during the post-menopause phase. This is due to your hormone levels stabilizing. After the final drop in estrogen in late-stage menopause, your body starts to adjust to this new normal. This can mean fewer hot flashes, night sweats, and mood swings.
We understand this time can be challenging thanks to hormonal changes. But it’s also a natural part of life. And know that you’re not alone — every woman goes through this.
And, as you’ve learned from above, you can look out for signs perimenopause is ending and work to manage the symptoms so you can feel your best.
FAQs
During the final stages of perimenopause, periods become very irregular, with intervals of more than 60 days between cycles.
Your FSH and LH levels also increase, while estrogen and progesterone decrease
One of the biggest signs perimenopause is ending? More and more infrequent periods that come a couple of months apart.
You may also experience more hot flashes, sleep struggles, and vaginal dryness and irritation, but more stable moods and fewer headaches.
Early-stage perimenopause is characterized by menstrual cycles that are irregular. This means the menstrual cycle length varies by more than seven days.
Late-stage perimenopause is when your periods become even more irregular. You may experience more than 60 days between cycles.
Perimenopause symptoms may last anywhere from seven years to 14 years.
Each woman’s experience is different, however. Some only show symptoms part of that span of time, while others show them much longer.
Yes, you can spot as you reach the end of perimenopause. This is due to your hormone fluctuations.
Once perimenopause is over, menopause begins. They are different experiences, so it’s hard to say whether things get better. It depends on the person. But know that once your body adjusts to new hormone levels, things get better.
You may not be able to stop perimenopause symptoms, but there are ways to manage and alleviate them.
That includes lifestyle changes like eating a healthy diet, focusing on physical and mental health, and getting good sleep.
It can also include hormone therapy and medication to manage other side effects.
Perimenopause can be a challenging time due to the hormonal shifts happening in the body. Know that it is temporary.
And if the symptoms get too intense, talk to your healthcare provider about options.
Indicators that you’re entering premenopause include common symptoms like:
- Irregular periods
- Hot flashes
- Night sweats
- Mood swings
- Vaginal dryness
- Sleep issues
- Changes in hair and skin
Premenopause refers to the time when you are still in your reproductive years. You still have periods (whether regular or irregular) and there are no symptoms of perimenopause or menopause at this time.
Perimenopause, on the other hand, encompasses the transition period to menopause and can last from seven to 14 years. It is marked by hormonal changes and irregular periods.
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- Perimenopausal Bleeding and Bleeding After Menopause | ACOG
- Amenorrhea | NIH
- What Is Menopause? | NIH
- Management of the Perimenopause | PubMed Central
- Perimenopause: From Research to Practice | PubMed Central
- Perimenopausal conception | PubMed
- Physical Activity and Exercise for Hot Flashes: Trigger or Treatment? | PubMed Central
- Stress, depression, and anxiety: psychological complaints across menopausal stages | Frontiers
- Hormone Replacement Therapy | NIH
- Use of Antidepressants during Perimenopause | Sage Journals
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