If you are experiencing changes in your body and are wondering if they are related to menopause, this guide will help you understand the distinct symptoms, health impacts, and management strategies for both perimenopause and menopause. 

Understanding these natural life transitions and their differences will help you navigate this important phase of life with confidence.

What is Perimenopause? Symptoms and what to expect

Perimenopause marks the beginning of your body’s natural transition toward menopause. Typically starting in your mid 30s or 40s, it involves a gradual decline in the production of key hormones like estrogen and progesterone. This phase can last 4-10 years, bringing various physical and emotional changes to your everyday life.

Most common perimenopause symptoms include:

• Irregular periods: Menstrual flow or cycle length changes affect up to 80% of women (SOGC Guideline No. 422a, p. 1193).
• Hot flashes and night sweats: Experienced by approximately 75% of women (SOGC Guideline No. 422a, p. 1194).
• Sleep disturbances: Insomnia or disrupted sleep impacts 40–60% of women (SOGC Guideline No. 422c, p. 1319).
• Mood changes: Anxiety, depression, or irritability due to hormonal shifts.
• Vaginal dryness: Affects up to 50% of women (NAMS 2020 Position Statement, p. 1).
• Weight fluctuations: Often due to slowed metabolism and hormonal changes.

What is menopause? Symptoms and how to prepare

Menopause officially begins after 12 consecutive months without a menstrual period, typically around age 51. It signals the end of ovarian hormone production and fertility. Understanding the symptoms women experience during this time can help prepare and manage them effectively.

Most common menopause symptoms include

• Persistent hot flashes and night sweats: Can last 7+ years for some women (SWAN Study, referenced in SOGC Guideline No. 422c, p. 1321).
• Bone density concerns: Estrogen decline may lead to up to 20% bone loss within 5–7 years (SOGC Guideline No. 422g, p. 530).
• Genitourinary symptoms: Vaginal dryness, irritation, and urinary issues.
• Cognitive and mood changes: Memory lapses, “brain fog,” and potential depression.
• Heart health risks: Hormonal shifts may increase cardiovascular disease risk (SOGC Guideline No. 422e, p. 1443).

Proven strategies to manage symptoms and improve your well-being

Managing menopause isn’t just about symptom relief – it’s crucial for preventing chronic health conditions that can develop during this life stage. By taking a proactive approach to managing menopause, the quality of your life after this transition will be better protected against long-term health risks.

Lifestyle tips:

• Adopt a nutrient-rich diet: Include calcium, vitamin D, and whole foods to support bone and heart health.
• Stay active: Regular aerobic and strength-training exercises can help maintain muscle mass and cardiovascular fitness.
• Practice stress management: Mindfulness, yoga, and meditation can improve mood and sleep.

Medical treatments:

• Hormone Replacement Therapy (HRT): Used within recommended guidelines, this treatment can help women manage vasomotor symptoms and prevent bone loss.
• Nonhormonal options: SSRIs, SNRIs, and gabapentin are effective alternatives for some women (NAMS 2023 Position Statement, p. 579).
• Targeted genitourinary treatments: Low-dose vaginal estrogen or nonhormonal lubricants can alleviate dryness and irritation.

Remember, every woman’s menopause journey is unique. Working with healthcare providers to develop a personalized management plan can help you navigate this transition successfully while protecting your long-term health.

For guidance on when to seek medical care for menopause symptoms, read our expert Q&A on seeking care for menopause.

References:

1. SOGC. (2021). Guideline No. 422a: Menopause – Vasomotor Symptoms, Prescription Therapeutic Agents, Complementary and Alternative Medicine, Nutrition, and Lifestyle, p. 1193–1194.
2. SOGC. (2021). Guideline No. 422c: Menopause – Mood, Sleep, and Cognition, p. 1319–1321.
3. SOGC. (2022). Guideline No. 422g: Menopause – Osteoporosis, p. 530–531.
4. SOGC. (2021). Guideline No. 422e: Menopause – Cardiovascular Disease, p. 1443.
5. NAMS. (2020). Genitourinary Syndrome Position Statement, p. 1.
6. NAMS. (2023). Nonhormone Therapy Position Statement, p. 579.

For more information, visit North American Menopause Society or Society of Obstetricians and Gynaecologists of Canada.

Disclaimer: The information provided here is for informational purposes only. It is not intended as medical advice. Always consult with your doctor or healthcare provider to determine what is best for your individual health needs.