Perimenopause is the stage before natural menopause, and is when the ovaries are running out of eggs. It is often the time when women begin to experience the symptoms of menopause, such as hot flushes, vaginal changes and mood swings.

Because of the hormonal swings during perimenopause, this is the time many women experience the most symptoms. Symptoms of perimenopause are:

• hot flushes
• mood changes (low or swinging mood/irritability/anxiety)
• decreased ability to do normal activities or inability to cope
• increased forgetfulness
• migraines
• increased aches and pains
• bloating
• sore or tender breasts

The menopausal transition is an excellent opportunity for a general health assessment including:

• assessment of cardiometabolic risk, 
• bone density and osteoporosis risk factors, cervical screening, and 
• breast screening. 

Early adoption of healthy eating and exercise regimens and limitation of alcohol consumption is indicated for all women.  Because of cycle irregularity and unpredictability of ovulation, contraceptive measures are also imperative.

It is also reassuring to know that the menopausal transition is usually more symptomatic, than postmenopausal, which is also easier to manage clinically. 

The transition through perimenopause usually takes 2-6 years.

Management and treatment of menopausal symptoms depend on each individual woman, stage of life, symptoms, relationships and general level of health and wellbeing. 

Healthy living, natural and complementary therapies, menopause hormone therapy, or MHT (formerly called hormone replacement therapy, or HRT) and some prescription medications can help relieve menopausal symptoms. 

Speak with your doctor or a trusted health care professional for advice and support during this potentially challenging time.