5 Ways Perimenopause Might Affect Your Body

Aparna Ramanathan, MD MPH FACOG
Aparna Ramanathan, MD MPH FACOG
Published: February 24, 2022Updated: May 19, 2022
most common perimenopause symptoms – woman laying in bed experiencing a hot flash before menopause

Reviewed by Dr. Lisa Czanko MD, MPH

Your 40’s and early 50’s can be an exciting time of personal growth. Maybe this means you’ve finally settled into the neighborhood you really like, or perhaps this means you’re getting through those books you’ve left on your shelf for far too long. They’re also a time for change in the body as it prepares to eventually enter menopause. This transitional stage before menopause is known as perimenopause. Read on to learn the most common perimenopause symptoms (like periods closer together) and more.

What happens during perimenopause?

Perimenopause typically starts between age 45-55 and can last anywhere from a few months to 14 years. This time is characterized by wide fluctuations in reproductive hormones, such as estrogen and the follicle stimulating hormone (FSH). These fluctuating hormones can lead to the most common perimenopause symptoms, such as periods being closer together and hot flashes before menopause. For some, these symptoms are not particularly bothersome. For others, feeling unwell can significantly impact their day-to-day life. For people in this category, it is important to talk to a healthcare provider.

Let’s talk about five common perimenopause symptoms and how they can affect the body.

The most common perimenopause symptoms

1. Changing menstrual cycles

Sometimes the first symptom of perimenopause is a change in the frequency of periods. In perimenopause, periods can be closer together or further apart. Some people experience much heavier bleeding than they did in the past. 

2. Hot flashes

Yes, it's true – you can get hot flashes before menopause. Changing levels of estrogen during perimenopause can cause hot flashes, a sudden feeling of heat in the upper part or all of the body that can cause flushing or red blotches. Hot flashes are fairly common, occuring in up to 80% of people.

For some people, hot flashes are mild or do not occur that often. For others, hot flashes can be so severe that they lead to waking up at night. 

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3. Trouble sleeping

In addition to waking up due to hot flashes, people may experience additional sleep problems during perimenopause, such as difficulty falling asleep or staying asleep. This can lead to increased fatigue during the day.

The good news is that there are some helpful lifestyle changes that have been shown to improve sleep quality, such as:

  • Going to bed and wake up at the same time each day
  • Avoiding naps in the late afternoon and evening
  • Developing a bedtime routine
  • Limiting phone and computer screen time just before bed
  • Exercising regularly, but not right before bedtime
  • Keeping the bedroom at a comfortable temperature
  • Avoiding large meals before bedtime
  • Avoiding caffeine and alcohol

Over the counter and prescription medications are also available to help with sleep. There is evidence that melatonin may help with getting better sleep as well as emerging evidence that magnesium can help with improving sleep quality and sleep duration. Before starting any supplement, it is important to talk to your doctor about your individual health concerns.

4. Uncomfortable sex

Decreasing levels of estrogen can lead to vaginal dryness. This can make penetrative sex less enjoyable or even painful. Fortunately, over-the-counter vaginal lubricants and moisturizers, as well as prescription medications, can help. 

5. Mood changes


Some people can experience more irritability or symptoms of depression during the perimenopause transition. One study showed that people are 2.5 times more likely to experience depression during this transitional time. For those that experience thoughts of suicide, the Suicide Hotline is available 24 hours a day, 7 days a week at 800-273-8255. 911 is also always available.  

Are you ready for perimenopause?

Try our new perimenopause assessment


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2. Randolph JF Jr, Sowers M, Bondarenko I, Gold EB, Greendale GA, Bromberger JT, Brockwell SE, Matthews KA. The relationship of longitudinal change in reproductive hormones and vasomotor symptoms during the menopausal transition. J Clin Endocrinol Metab. 2005;90(11):6106. Epub 2005 Sep 6. 

3. National Institute on Aging. What is menopause? September 30, 2021. Accessed January 31, 2022. https://www.nia.nih.gov/health/what-menopause

4. National Institute on Aging. Sex and Menopause: Treatment for Symptoms. September 30, 2021.  Accessed Jan 31, 2022. https://www.nia.nih.gov/health/sex-and-menopause-treatment-symptoms

5. National Institute on Aging.  Sleep Problems and Menopause: What Can I Do? September 30, 2021. Accessed January 31, 2022. https://www.nia.nih.gov/health/sleep-problems-and-menopause-what-can-i-do

6. Freeman EW, Sammel MD, Lin H, Nelson DB. Associations of hormones and menopausal status with depressed mood in women with no history of depression. Arch Gen Psychiatry. 2006 Apr;63(4):375-82. 

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