Perimenopause

Perimenopause is the stage in a woman’s life leading up to menopause. It’s when the ovaries stop releasing eggs, hormone production decreases and fluctuates, and women may experience a variety of symptoms that range from unpleasant to disruptive to quality of life. The perimenopausal stage ends with menopause: when you haven’t had a period for 12 consecutive months.

Perimenopause can last a few months to several years, leading out of childbearing years into menopause and the period after (postmenopause) when you can no longer become pregnant.

Yes. It’s possible to get pregnant during perimenopause. While your ovaries are producing less estrogen and progesterone, fertility and egg quality decline, and your periods may become irregular, you can still get pregnant. Even if you don’t have a period for several months in a row, it doesn’t mean that pregnancy will not occur. If you do not want to become pregnant, contraception is still necessary. Notably, perimenopause symptoms such as missed periods, fatigue, and mood swings, are often similar to early signs of pregnancy.

On average, perimenopause lasts about four years. However, some women experience perimenopause symptoms for just a few months, while others endure unpleasant symptoms that last up to 10 years. Typically, without addressing symptoms with hormone medications or therapies such as bioidentical hormone replacement therapy (BHRT), most women endure perimenopause symptoms for two to eight years before they reach menopause (12 consecutive months without a period).

Weight gain during perimenopause is common, especially around your midsection. This is usually the result of hormonal shifts, including decreased estrogen production, which can lead to fat storage around your belly. Sometimes known as “the menopausal middle,” this weight can be difficult to lose, but it is possible.

During perimenopause, your body often stores fat, burns fewer calories, and can become resistant to insulin. This complex chain of events can make you gain weight even when you don’t change anything about your diet or lifestyle. For perimenopausal women, it’s not typically just a matter of taking the “exercise more, eat less” approach.

Addressing the root cause of weight gain during perimenopause “hormonal deficiencies,” may help you lose weight. Bioidentical hormone replacement therapy (BHRT) is one way to optimize your hormones to help boost metabolism, regain muscle tone, and lose unwanted pounds. Personalized BHRT helps bring your hormones back to an ideal level and can therefore make it easier to prevent unwanted weight gain.

Many women aren’t aware of perimenopause, or that their experiences could be linked to hormonal imbalance. Being familiar with the signs and symptoms of perimenopause will help patients identify early and act. Symptoms can start years before the final menstrual period (FMP). Tracking menstrual cycles manually can be helpful, as is connecting with a healthcare provider if perimenopause is possible.

Perimenopause triggers a multitude of hormonal changes. When estrogen levels drop and androgen levels rise, an imbalance occurs. That imbalance causes the body to distribute fat differently, and there can be signs patients see and feel. For many, muscle mass begins to break down and more fat starts to accumulate around the midsection. Combined with a slowing midlife metabolism, weight often fluctuates.