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How Perimenopause May Be Affecting Your Life

Women expect to deal with hot flashes and mood swings when they reach menopause. But most of the patients at our practice are taken by surprise when they struggle with these symptoms (and more) long before they enter menopause.

Here’s the thing: All of the classic symptoms associated with menopause can appear during perimenopause. Let’s talk about what you need to know about perimenopause and how it affects your life.

Here’s what happens during perimenopause

Perimenopause starts in the 3-5 years before menopause. On average, women enter perimenopause around the age of 47 and reach menopause near the age of 51, but each woman has her own timing. For some, perimenopause may last a few months, while others may journey through this stage for well beyond five years.

During perimenopause, your levels of estrogen and progesterone begin to fluctuate. The most obvious impact of up-and-down hormones is a change in menstrual periods. Your cycles may become longer or shorter than usual, your flow may get lighter or heavier, and you’ll begin to skip periods.

Most women experience a longer time between menstrual periods as they get closer to menopause, but this varies for each person. You could have minimal menstrual changes for a short time, then your periods could stop altogether as you transition into menopause.

The bottom line is that this unpredictable time factor — never knowing what to expect from your periods, or when they’ll start or stop — can have a significant impact on your life.

Here are some of the other changes frequently experienced by women during perimenopause:

Hot flashes

Estrogen helps regulate many systems in your body, including temperature. Fluctuating estrogen translates into irregular body temperature, making hot flashes the most common problem affecting women in perimenopause.

What is a hot flash? It’s a sudden and intense feeling of heat followed by sweating and flushing. It occurs when your body’s core temperature rises, causing a sudden spike in skin temperature and blood flow.

Studies show that moderate-to-severe hot flashes make you less productive at work and affect your health. Developing sudden, uncontrollable, and extreme through-your-clothes sweating while at work or while enjoying dinner at your favorite restaurant tends to interfere with your quality of life.


The nighttime counterpart of hot flashes — night sweats — are renowned for waking women up throughout the night, drenched in sweat, and too hot to get back to sleep. But night sweats aren’t the only reason you may struggle with insomnia during perimenopause.

Estrogen and progesterone can influence the quality of your sleep. Progesterone is a relaxing, mildly sedative hormone. When its levels fluctuate during perimenopause, it may affect your ability to sleep. Estrogen also influences the quality of sleep by boosting REM sleep and increasing total sleep time.

Risk of pregnancy

You can still get pregnant during perimenopause, and with irregular menstrual periods, you may constantly wonder and worry about pregnancy every time you skip a period. Staying on a reliable and effective method of birth control gives you peace of mind during this ever-changing stage of life.

Low sex drive and painful sex

It’s estimated that one-third of all women develop vaginal atrophy during perimenopause. Estrogen is essential for maintaining strong and elastic tissues inside your vagina. You also need estrogen for normal vaginal blood flow and lubrication.

When estrogen levels begin to stay at lower-than-normal levels during perimenopause, the loss of this vital hormone causes the vaginal walls to become thin, dry, and less elastic. This is a condition called vaginal atrophy.

Vaginal atrophy results in symptoms that begin during perimenopause, and without treatment, continue throughout the years after menopause. You may experience:

Dr. Weyhrich can recommend a variety of treatments that effectively overcome vaginal atrophy symptoms.

Depression, anxiety, and mood swings

Perimenopause influences your emotions and moods for a variety of reasons. For starters, estrogen and progesterone directly impact areas of your brain involved in emotions and cognition. Additionally, estrogen influences the synthesis of brain chemicals that regulate mood.

The emotional volatility many women experience during perimenopause is associated with fluctuating hormone levels. As a result, you’re more likely to become depressed or anxious. Beyond the impact of hormonal changes, many women face emotional challenges as they come to grips with the end of their reproductive years.

No matter what challenges develop during perimenopause, you can count on our team to help you overcome your symptoms and thrive during this transitional time in your life. If you have any questions, call our office in Boise, Idaho, or schedule an appointment online so we can review your health and find solutions.

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