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Perimenopause
Symptoms and Treatments for Women in Massachusetts
Perimenopause is the transitional stage that precedes menopause. It typically begins sometime in a woman’s 40s, though some women start to experience it in their late 30s. Perimenopause usually lasts a few years, though for some women it can last as little as a few months or as long as 10 years.
What is Perimenopause?
During perimenopause, your estrogen levels fluctuate, causing hormonal imbalance. As a result, your menstrual cycles are likely to become uneven and somewhat unpredictable. While it’s possible to become pregnant during perimenopause, it’s rare.
During the later stages of perimenopause, women begin skipping periods as their estrogen levels decline dramatically. The most marked menopausal symptoms begin at this time, usually about 6 months before the woman’s periods finally stop completely. Once your periods stop, you are no longer able to get pregnant.
Symptoms of Perimenopause
Some symptoms you may experience during perimenopause and menopause are quite obvious — you’re likely to notice when your periods stop, for instance. Others may be less noticeable, and you may not realize what you’re experiencing is actually a result of menopause. Among the most common symptoms are the following:
Chronic Fatigue
Persistent exhaustion during perimenopause is often linked to shifting hormone levels, poor sleep quality, and increased stress, leaving many women feeling drained even after rest. Learn More.
Low Libido
Hormonal fluctuations during perimenopause can lead to a noticeable decrease in sexual desire, often accompanied by other changes like vaginal dryness or mood shifts that affect intimacy. Learn More.
Low Energy
During perimenopause, fluctuating hormone levels—particularly drops in estrogen—can disrupt sleep, mood, and metabolism, all of which contribute to a persistent sense of fatigue. This ongoing lack of energy can make it difficult to stay focused, maintain physical activity, or keep up with daily responsibilities. Learn More.
Other symptoms that some women experience during perimenopause and menopause include:
- Increased PMS
- Changes in hair texture and volume
- Breast tenderness
- Headaches
- Heart palpitations
- Insomnia
- Decreased sex drive
- Difficulty concentrating
- Fatigue
- Dry skin and changes in skin texture
Health Risks Associated With Perimenopause
While perimenopause is a natural phase of life, it can bring increased health risks due to hormonal changes. Women may face a higher likelihood of developing conditions such as osteoporosis, heart disease, and high cholesterol as estrogen levels decline. Mood disorders like anxiety and depression may also become more common, along with weight gain and changes in insulin sensitivity. Understanding these risks allows women to take proactive steps—such as regular health screenings, lifestyle adjustments, and hormone management—to protect their long-term well-being during this transitional time.
When To See a Doctor for Perimenopause Symptoms
Many women feel they should tolerate the perimenopausal symptoms they experience. However, there’s no need to suffer if those symptoms are interfering with your daily life or your sense of well-being. Treatments are available to help you cope with everything from mood swings and hot flashes to discomfort with sexual intercourse.
Call your doctor if your symptoms are causing you enough discomfort to affect daily life. And definitely seek medical help if you experience blood clots during your period, excessively long or heavy periods, bleeding after sex or spotting when you don’t have your period. These symptoms may have causes that require medical attention.
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Help for Women in Massachusetts
Perimenopause Treatment Options
While hormone replacement therapy remains the top choice of treatment for most women experiencing menopausal symptoms, other options may also be of some help.
Estrogen and Hormone Replacement Therapy
Hormone replacement therapy delivers estrogen or a combination of estrogen and progestogen to boost your hormone levels after your body reduces its production of estrogen. (Estrogen alone is used for women who don’t have a uterus, typically as a result of a hysterectomy.)
This therapy normalizes your estrogen levels so you don’t experience symptoms caused by the hormonal imbalance of menopause. It reduces or does completely away with symptoms such as hot flashes and mood swings, and it can reduce the risk of osteoporosis.
Your doctor will prescribe estrogen in any of several forms. While most women prefer the ease of taking a pill, estrogen skin patches, gels and creams are also available.
Lifestyle Remedies
Various lifestyle changes can also help you decrease menopausal and perimenopausal symptoms. Try some of these options to see if they help you feel better:
- Exercising can help with weight gain, mood swings, sleep disturbances and even hot flashes.
- Practicing good sleep habits, including a regular sleep routine and relaxing activities before bedtime, can help with insomnia
- Avoiding spicy foods, caffeine, alcohol and hot drinks can help you minimize hot flashes
- Lowering the temperature in your home can help with night sweats
- Using over-the-counter vaginal moisturizers and lubricants can alleviate vaginal dryness
Other Medications
While hormone replacement therapy treats most of the major symptoms of menopause simultaneously, other pharmaceutical treatments target specific symptoms. Prescription and over-the-counter options include:
- Vaginal creams to minimize dryness and painful intercourse
- Vitamin D and calcium to decrease the risk of osteoporosis
- Antidepressants to regulate mood swings
- Neurontin (a prescription seizure medication) to treat hot flashes
- Supplements, including black cohosh and dong quai, to treat hot flashes — though they may not be effective and may have dangerous complications
- Clonidine (a prescription blood pressure medication) to treat hot flashes
- Testosterone to treat loss of sex drive and boost bone density
- Osphena (a non-hormonal prescription medication) to treat vaginal dryness
Many of these medications have side effects, so you should discuss them thoroughly with your doctor before trying them.
