10 Signs You’re in Perimenopause (And What to Do About It)

Perimenopause is a natural phase in a woman’s life, typically beginning in the mid-30s to late 40s. This transitional period can last anywhere from 2 to 10 years, during which significant hormonal changes occur. These fluctuations, primarily involving estrogen and progesterone, play a crucial role in bringing about various physical and emotional symptoms.

Recognizing the signs of perimenopause early on is essential for better management and improved quality of life. Early detection allows you to take proactive steps to ease symptoms and navigate this phase more comfortably.

Hormonal changes during perimenopause can impact daily activities, relationships, and overall well-being. Symptoms such as irregular menstrual cycles, mood swings, hot flashes, and weight gain around the abdomen are common indicators of this phase.

1. Irregular Menstrual Cycles

During perimenopause, irregular menstrual cycles are a common occurrence due to fluctuating hormone levels. You might notice various changes in your periods, such as:

Shorter or longer cycles: Your cycle length may vary significantly from month to month.
Skipped periods: It’s not uncommon to miss a period entirely, leading to uncertainty.
Heavier or lighter flow: The intensity of your menstrual flow can also change, sometimes becoming unusually heavy or surprisingly light.

The unpredictability of your menstrual cycle can be frustrating. Tracking your cycle is a great start to being more aware of perimenopause and what it is like for you. In clinic, I teach a way of understanding your cycle and the symptoms you experience, looking for patterns that can help you understand what is happening to your body

One concern in perimenopause is heavier periods. As soon as you notice your flow is getting heavier, it is a good time to book in for a Chinese medicine health assessment. Heavy periods can be an incredible drain on your health, and managing it earlier is the best course of action. Chinese herbal medicine has many herbs to reduce heavy periods.

2. Hot Flashes and Night Sweats

Hot flashes are sudden feelings of intense heat that can occur at any time, often accompanied by sweating and flushing of the skin. These episodes can be unpredictable and vary in intensity, making them particularly challenging to manage.

Night sweats refer to episodes of excessive sweating during sleep, which can disrupt rest and lead to daytime fatigue. Experiencing night sweats frequently can impact your overall well-being and energy levels.

Practical strategies for coping with hot flashes and night sweats include:

Dressing in layers: This allows you to adjust your clothing according to your body temperature.
Keeping your bedroom cool at night: Use fans or air conditioning to maintain a comfortable sleeping environment.
Trying relaxation techniques: Deep breathing or meditation can help manage stress and potentially reduce the frequency of these symptoms.

Recognizing and addressing these symptoms early on can significantly improve your quality of life during perimenopause.

Many women put up with these symptoms rather than seeking help to ease them. In clinic, I prescribe herbs to manage these symptoms and in Menopause yoga classes, which are offered online, there are yoga poses, breathing techniques and visualisation that also help manage the symptoms of hot flushes, reframing our view of them.

3. Mood Swings and Brain Fog

Hormonal changes during perimenopause can cause significant emotional shifts, including mood swings that range from irritability to sadness or anxiety. You might find yourself reacting more strongly to situations that wouldn’t have bothered you in the past.

Imagine being at work or home and suddenly feeling overwhelmed by frustration over a minor issue that wouldn’t have affected you before. This intensified emotional response can strain relationships, family life and impact your work performance.

Mood swings is an area Chinese herbal medicine and acupuncture excels in. In our menstrual years we may experience mood swings prior to our period, and as we move into perimenopause, these days can become weeks. As with PMS, perimenopause mood changes can be helped with Chinese medicine.

Brain fog is another common symptom, characterized by difficulty concentrating and mental fatigue. Tasks that once seemed simple may now feel challenging, as if you’re constantly in a mental fog. Brain fog can be so detrimental to our ability to function at work, home, in social situations. It can be embarrassing for us. I have created a Chinese herbal tincture, that is prescribed along side Chinese herbal formula to help reduce brain fog. Acupuncture is another tool often used too.

4. Sleep Disturbances

Sleep disturbances, such as difficulty falling asleep or staying asleep throughout the night, are common during perimenopause. These disruptions can be caused by hormonal changes and can significantly affect your overall well-being and energy levels.

Out of all the symptoms you may experience in perimenopause, this one can be the most debilitating. It is so hard to function on very little sleep, and it can add to a whole host of other symptoms – including irritability and fatigue. I have heard women say – if only I can sleep, it wouldn’t be so bad.

Along with Chinese herbal medicine – and yes, you will hear this a lot as I go through the symptoms, and acupuncture, yoga is a wonderful addition to preventing insomnia. However, if you don’t have good sleep hygiene, even the best efforts will fail.

To improve sleep quality during this time, try these practical tips:

Avoid screen light – Turn off all screens at least 2 hours before bed
Establish a calming bedtime routine: Engage in relaxing activities like reading or taking a warm bath.
Avoid caffeine and electronic devices close to bedtime: Limit stimulants and screen time to help your body wind down.
Create a comfortable sleep environment: Ensure your bedroom is cool, dark, and quiet to promote restful sleep.

By incorporating these strategies, you can better manage insomnia during perimenopause and enhance your daily functioning.

5. Vaginal Dryness and Discomfort During Intercourse

Vaginal dryness during perimenopause often results from decreased estrogen levels, leading to discomfort during sexual activity and a higher risk of urinary tract infections (UTIs). This symptom can significantly impact intimate health during perimenopause.

Vaginal dryness, low libido, increased UTIs are all common in perimenopause and menopause. And in Chinese medicine, we have herbs that improve libido, and help with dryness, including vaginal dryness. There are other self care treatments that can help, such as vaginal steaming that may also help.

6. Weight Gain Around the Abdomen Area

Hormonal changes during perimenopause can lead to weight gain, especially around the abdomen. This is often attributed to fluctuating estrogen levels which affect how your body stores fat.

There is a lot of confusing information around weight gain and what to do about it. SOme people swear by a keto diet, others a low fat, high carbohydrate diet, intermittant fasting, eating small amount often.

Nutrition and styles are eating is something you need to explore as there is not a one diet that is good for all. In fact in Chinese dietary therapy – there are recommendations for constitutional types of bodies, for symptoms experiences, for patterns of disharmony. However, there are guideline that we suggest regardless of your eating style:

Balanced Nutrition: Prioritize whole foods such as fruits, vegetables, and lean proteins.
Regular Physical Activity: Incorporate aerobic exercises and strength training into your routine.
Stress Management Techniques: Activities like yoga and mindfulness can help regulate stress hormones that contribute to weight gain.

Our body changes during perimenopause and menopause, and because of this, we also need to address what we eat, the way we eat and exercise. In post menopause, for example, bone density is a big concern. And our bone density rapidly declines after menopause. Ensuring you are exercising, including weight bearing exercise, and eating appropriately is important in maintaining health in our post menopausal years.

7. Hair Thinning or Loss

Hormonal changes during perimenopause can cause noticeable changes in hair texture and thickness, a symptom often referred to as “hair thinning menopause symptoms.” As estrogen levels decrease, hair may become finer and fall out more easily, leading to reduced volume and even bald patches in some cases.

Understanding the Impact

Reduced Estrogen Levels: Estrogen helps maintain hair growth cycles. Lower levels can shorten these cycles, making hair thinner and more prone to shedding.
Increased Androgens: Hormonal imbalances may also increase androgens, which can shrink hair follicles and slow down hair production.
Stress and Diet: This period of life often coincides with increased stress levels and nutritional deficiencies, both of which can worsen hair thinning.

Practical Tips for Managing Hair Thinning

Nutrient-Rich Diet: Focus on foods high in vitamins A, C, D, E, zinc, iron, and omega-3 fatty acids to support healthy hair growth.
Chinese herbal tonics – Herbs that are known to contribute to hair health and growth
Gentle Hair Care: Use mild shampoos and conditioners designed for thinning hair. Avoid tight hairstyles that pull on the scalp.

Adopting these strategies can help lessen the impact of perimenopausal hormonal changes on your hair.

8. Breast Tenderness or Changes in Size/Shape

Breast tenderness can be one of the menopause symptoms experienced during perimenopause. This discomfort is often due to fluctuating hormone levels, particularly estrogen and progesterone. You may notice that your breasts feel more sensitive, swollen, or achy at various times in your cycle. Just like PMS, we can experience this during perimenopause and in acupuncture treatment we have some great points for breast tenderness, and of course, there are Chinese herbs that can assist in reducing pain, sensitivity and swollen breasts

Common Experiences:

Increased Sensitivity: Your breasts might feel more tender than usual, especially during the days leading up to your period.
Swelling: Some women report a noticeable increase in breast size or a sense of heaviness.
Pain: This can range from mild discomfort to more intense aches.

If breast pain persists or you notice any unusual changes, consult your healthcare provider for advice and potential treatment options.

9. Increased Fatigue Levels Than Usual

Feeling more fatigued than usual can be a sign of perimenopause. Hormonal changes during this time may cause ongoing tiredness or a feeling of being exhausted, even after a full night’s sleep. This fatigue can come from various reasons like disrupted sleep patterns, night sweats, and the body’s natural adjustment to shifting hormone levels.

Fatigue is another area Chinese herbal medicine excels in. As women, by the time we get to our late 30s and early 40s we are juggling so many different roles. Not only are we working, often full time, but we may also be still caring for children at home and managing a household.

Perimenopause is a time to have a look at your lifestyle and if it is serving you or causing you to burn out. It is time to take a pause – to add time for rest, to really rest. To take time off, go on a vacation, or stay-cation, have wellness days, (or week), set boundaries and say no when you need to rest.

Practical Tips for Managing Fatigue

Prioritize Sleep: Establish a consistent bedtime routine to improve sleep quality.
Balanced Diet: Eating nutrient-rich foods can help sustain energy levels throughout the day.
Regular Exercise: Incorporating physical activity can boost your overall energy and combat fatigue.
Stay Hydrated: Drinking plenty of fluids keeps your body functioning optimally.
Stress Management: Practices such as yoga or meditation can reduce stress and its impact on your energy levels.

Knowing that increased fatigue might be part of your perimenopausal journey helps you take proactive steps to manage it effectively. If fatigue becomes overwhelming or significantly affects daily life, it’s best to consult with a healthcare provider.

10. Heightened Sensitivity To Stressors

Some women report experiencing heightened sensitivity to stressors they previously managed without issue during perimenopause. This increased sensitivity can be attributed to fluctuating hormone levels, particularly estrogen and progesterone, which impact the body’s stress response.

Yoga and acupuncture are great remedies for heightened stressors. Our nervous system may be so fatigued, and we remain in the sympathetic nervous system, and not transitioning into the rest and digest state. This is where acupuncture and yoga can excel. However, you want to be adding restorative yoga poses to your sequences, or yoga nidra, which can bring you into a deep restorative state, helping to decrease the overwhelm our nervous system can experience during perimenopause and menopause.

Common Signs of Increased Stress Sensitivity:

Emotional Reactivity: Feeling more easily overwhelmed or upset by situations that were once manageable.
Physical Symptoms: Experiencing headaches, muscle tension, or digestive issues as a reaction to stress.
Cognitive Impact: Difficulty concentrating or making decisions under stress.

Practical Tips for Managing Stress Sensitivity:

Mindfulness Practices: Engaging in activities like meditation, yoga, or deep breathing exercises can help regulate your stress response.
Routine Adjustments: Prioritizing tasks and setting realistic goals can reduce the feeling of being overwhelmed.
Support Systems: Leaning on friends, family, or professional counselors can provide emotional support and coping strategies.

Recognizing and addressing heightened sensitivity to stressors is crucial for maintaining mental and physical well-being during perimenopause.

When To Seek Help From A Chinese Medicine Practitioner?

If you’re experiencing persistent symptoms that are affecting your quality of life, it’s important not to ignore them.

Early intervention can make a significant difference in managing symptoms effectively and improving your overall well-being.

Treatment Options For Managing Symptoms Effectively

Recognizing the signs of perimenopause early can significantly improve your quality of life. Various treatment options are available to manage symptoms effectively:

Lifestyle Changes

Balanced Diet: Focus on whole foods, rich in fiber, iron, and calcium.
Regular Exercise: Engage in both aerobic and strength training activities.
Stress Management: Practice yoga or meditation to alleviate stress.

Holistic Approaches

Chinese Medicine & Acupuncture: These treatments address hormonal imbalances and have shown efficacy in managing symptoms such as hot flashes and sleep disturbances.
Initial Consultation: Typically involves an assessment.
Treatment Sessions: Weekly sessions followed by monthly maintenance.
Yoga – has many health benefits including relaxation and stress relief

A multidisciplinary Approach to Peri-menopause

A holistic and multidisciplinary approach for peri-menopause includes all aspects of women’s well-being (physical, emotional, psychological, social, and spiritual).

– The multidisciplinary approach involves the collaboration of different health professionals (doctor, psychologist, nutritionist, yoga teacher, etc.) for comprehensive and coordinated care. You do not need to choose just one approach but may use many modalities to help you through peri-menopause.

– A preventative approach, promoting good lifestyle habits, can help reduce the risks of chronic diseases related to menopause and encourage healthy ageing. You can also look at the factors that can influence menopause timing.

– Holistic support helps you find meaning in this stage, identify resources, and define new life projects for self-fulfillment.

– engage in support groups such as Menopause Cafes or workshops to help break down isolation woman can experience in perimenopause and menopausal years. Learning from one another and supporting each other to create community and avoid social isolation is key in navigating this time in our life.