The Final Stretch: Approaching the End of Perimenopause

Perimenopause is also called the menopausal transition, the time period when your ovaries gradually lessen production of estrogen and progesterone until they finally stop releasing eggs.  Menstrual periods become irregular and happen farther apart. Menopause is the point when you haven’t had a period for 12 consecutive months. The median length of perimenopause is 4 years, but it varies a lot, from just a few months to 10 years or more. Perimenopause typically starts in your mid-40s or 50s but may start earlier.

How can you tell when the transition is nearly over?  It’s not always clear, and symptoms can be erratic, but there are signs that indicate menopause will happen soon.

What is Perimenopause, Really?

Perimenopause is the transitional phase leading up to menopause. It’s a time of hormonal fluctuations—namely, the gradual decline of estrogen and progesterone—as your body prepares for the end of your reproductive years. During this time, you might experience a rollercoaster of symptoms, including:

• Irregular Periods: Your periods may become shorter, longer, heavier, or lighter. You might even skip a few months.
• Hot Flashes and Night Sweats: Sudden feelings of heat and sweating can disrupt your sleep and daily activities.
• Mood Swings: Hormonal changes can lead to mood swings, irritability, and anxiety.
• Vaginal Dryness: This can cause discomfort during sex and increase your risk of urinary tract infections.
• Sleep Disturbances: Hot flashes, night sweats, and mood swings can make it difficult to get a good night’s sleep.

Remember, even though your periods might become irregular, you can still get pregnant during perimenopause. So, it’s important to continue using birth control if you don’t want to get pregnant.

Signs You’re Nearing the Perimenopause Finish Line

One of the clearest signs that you’re approaching the end of perimenopause is the increasing gap between your periods. As you get closer to menopause, your periods may become further and further apart, eventually stopping altogether. However, this final stage can last anywhere from a few months to a couple of years.

As you near the end, you might notice changes in your symptoms. Some women find that their hot flashes, night sweats, and mood swings start to subside—while some symptoms may continue and sometimes worsen in the postmenopause period. Others may even experience an increase in vaginal dryness or a decrease in libido. While these changes can be frustrating, it’s important to remember that every woman’s experience is unique. Your doctor can perform tests to measure hormone levels: A blood test to measure levels of follicle stimulating hormone (FSH) can be done, although it is not always reliable since FSH levels can vary from day to day. Tests for estradiol or antimullerian hormone can also be performed; these are usually done if you’re trying to conceive, to help determine how many eggs you have in your ovaries. But, it’s important to note that these tests aren’t always definitive.

Life After Menopause: Embracing the Next Chapter

Once you’ve officially reached menopause, you might experience some relief from those pesky hot flashes and mood swings. However, the permanent drop in estrogen can cause other physical symptoms, such as increased hot flashes, vaginal dryness, urinary incontinence, sexual problems or painful sex, and development of osteoporosis, which makes bones more likely to weaken or fracture. 

During perimenopause and postmenopause, your emotions may change.  Crankiness and feelings of sadness are common, as are loss of confidence or self-esteem.  Some women experience anxiety or depression, especially if they have experienced these before.  Some people feel sad or anxious because menopause is a reminder of aging and the end of their reproductive years. It’s also common to experience changes in your skin, hair, and weight. You might gain weight, especially around your midsection, and your skin may become drier and less elastic.

It’s important to remember that these changes are normal and affect many women. By taking good care of yourself through a healthy diet, regular exercise, and stress management, you can navigate this stage of life with grace and confidence.

Preparing for the Future—Menopause

Lifestyle changes can enhance your quality of life during the menopausal transition and post menopause.  Eating a healthy diet with plenty of fruits and vegetables, exercising regularly, and avoiding food or actions that trigger your hot flashes can make you more comfortable.  You may feel better and stay healthier if you:

• Fuel Your Body: Eat a balanced diet rich in fruits, vegetables, and whole grains.
• Get Moving: Regular exercise, like walking, yoga, or dancing, can help boost your mood, improve sleep, and manage hot flashes. Strength training is highly recommended to keep bones strong and reduce muscle wasting.
• Prioritize Sleep: Aim for 7-8 hours of quality sleep each night. Create a relaxing bedtime routine to help you unwind.
• Manage Stress: Practice stress-reducing techniques like meditation, deep breathing, or spending time in nature.
• Stay Hydrated: Drink plenty of water throughout the day to keep your body hydrated.
• Consider Supplements: Talk to your doctor about supplements like calcium and vitamin D to support bone health.

If you’re struggling with persistent symptoms, don’t hesitate to seek help from your healthcare provider—and book a consult with your WIN Nurse Care Advocate. They can offer personalized advice and recommend treatments to alleviate your discomfort.