Perimenopause

Perimenopause is the transitional period before menopause, during which the ovaries gradually reduce hormone production. It often begins in the late 30s or 40s and precedes the final menstrual period by several years. Hormone levels (especially estrogen and progesterone) become erratic — sometimes high, sometimes low — leading to fluctuating symptoms and unpredictable menstrual cycles.

Common symptoms

During perimenopause, people may experience:

• Irregular menstrual cycles (shorter, longer, heavier or lighter)

• Hot flashes, night sweats

• Sleep disturbances, insomnia

• Mood swings, irritability, anxiety or low mood

• Decreased libido, sexual changes

• Vaginal dryness, discomfort

• Fatigue, brain fog / memory problems

• Bone density changes (gradual bone loss)

• Changes in metabolism / body composition.

How hormones May improve symptoms

Appropriately delivered hormones during perimenopause may help:

• Stabilize fluctuating estrogen/progesterone levels and associated mood, sleep, and vasomotor symptoms (hot flashes, night sweats).

• Maintain bone density and reduce risk of early bone loss.

• Preserve urogenital health (reduce vaginal dryness, maintain lubrication, reduce urinary symptoms).

• Improve sleep, energy, mood, libido, motivation, and overall quality of life.

Because perimenopause is highly individual and hormone levels vary, therapy should be personalized — balancing potential benefits and risks, and re-evaluated often.