Perimenopause
Perimenopause is a span of time that begins with the onset of menstrual cycle changes and other menopause-related symptoms and extends through menopause (the last menstrual period) to 1 year after menopause. Perimenopause is experienced only with spontaneous (natural) menopause, not induced menopause. Perimenopause is also called the menopause transition.
Perimenopause is a span of time that begins with the onset of menstrual cycle changes and other menopause-related symptoms and extends through menopause (the last menstrual period) to 1 year after menopause. Perimenopause is experienced only with spontaneous (natural) menopause, not induced menopause. Perimenopause is also called the menopause transition. Inline content unavailable
Why It Matters
Perimenopause literally means "around menopause" and is the time when your body naturally starts moving toward menopause—the end of your menstrual cycles and reproductive years. Inline content unavailable
Perimenopause can start at different ages. Many women begin noticing changes in their 40s, but some may see symptoms as early as their mid-30s. During this time, the levels of estrogen in your body rise and fall unevenly. This can cause changes in your periods and other symptoms similar to menopause. Inline content unavailable
You are considered to be in menopause once you have gone 12 months in a row without a period, not attributable to other physiological or pathological causes, marking the permanent cessation of ovarian function and the end of reproductive capacity. Until then, you are in perimenopause. Inline content unavailable
Common Symptoms of Perimenopause
Irregular periods– Your cycle may become shorter or longer, the flow may be heavier or lighter, and you might skip periods. A gap of 60 days or more between periods is often a sign of late perimenopause.
Hot flashes and sleep issues– Hot flashes can vary in intensity and frequency. Night sweats or hormonal changes can also disrupt your sleep.
Mood changes– You may feel more irritable, anxious, or down than usual. Poor sleep from night sweats may add to these feelings.
Vaginal and bladder changes– Lower estrogen levels can cause dryness, irritation, or pain during sex. You may also be more prone to infections or leaks (incontinence).
Fertility decline– Ovulation becomes unpredictable, making it harder to get pregnant. But pregnancy is still possible until menopause is complete, so use birth control if needed.
Changes in sexual function– Arousal and interest in sex may decrease, though this varies for each person.
Bone loss– Lower estrogen leads to faster bone loss, raising your risk of osteoporosis.
Cholesterol changes– Estrogen drop may raise “bad” LDL cholesterol and lower “good” HDL cholesterol, which increases your risk of heart disease.
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When to See a Doctor
Not all women need medical treatment for perimenopause. Some manage their symptoms on their own, while others don’t have symptoms at all. However, if hot flashes, mood swings, or other changes affect your daily life or relationships, talk to your doctor.
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What Causes Perimenopause?
Perimenopause is caused by changes in two main female hormones: estrogen and progesterone. These levels go up and down during this time, leading to many of the symptoms you may experience.
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Possible Complications
While irregular periods are normal during perimenopause, some changes may signal a health issue. Call your doctor if:
You bleed heavily and soak through pads or tampons every 1–2 hours for more than two hours
Bleeding lasts more than 7 days
You bleed between periods
Your periods come less than 21 days apart regularly
These could be signs of a condition that needs treatment.
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How Amissa Helps
With Amissa, you can track symptoms daily, helping identify patterns in mood, sleep, bleeding, energy, or discomfort. This is especially useful when your cycle becomes unpredictable or when symptoms are hard to describe in a short doctor’s visit. The app also integrates with wearables, so your activity levels, sleep quality, and stress markers are captured alongside your symptom reports—providing deeper insight into how your body is changing.
If you're using hormone therapy or lifestyle strategies to manage perimenopause, Amissa helps monitor your response over time. You’ll receive reminders to track key changes, attend follow-ups, or complete lab work, making it easier to stay on top of care. With everything in one place, Amissa supports more informed, personalized decisions—helping you feel more in control during this important life stage.
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