Perimenopause symptoms

Overview

Perimenopause is the 4–10 year window before your final period. Estrogen fluctuates wildly — often causing worse symptoms than menopause itself. Diagnosis is clinical.

Symptoms to watch for

• Irregular or heavier periods
• New PMS or worsening PMS
• Hot flashes and night sweats
• Sleep disturbance
• Anxiety, low mood, or irritability
• Brain fog
• Vaginal dryness
• Weight gain

What else could this be?

• Thyroid dysfunction
• Depression
• Fibroids or endometriosis (heavy bleeding)

Treatment

Low-dose oral contraceptives can stabilize hormones and control bleeding. Progesterone at night helps sleep and heavy periods. SSRIs for mood. Hormone therapy once periods have stopped.