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Perimenopause Symptoms - What You Need to Know.

Perimenopause, also called the menopause transition, is defined as a temporary state leading to menopause or the cessation of periods. Perimenopause is marked by a surge of various symptoms. In fact, 85% of women will experience perimenopausal symptoms that can last from a few months to several years.

There are at least 34 symptoms associated with perimenopause.

Here are the most common ones:

  • Hot flashes (on face or all around the body)

  • Night sweats (like hot flashes, during the night)

  • Vaginal dryness (can lead to discomfort during sex)

  • Urinary urgency (sometimes incontinence)

  • Difficulty sleeping (either falling or staying asleep)

  • Emotional changes (irritability, mood swings, depression, anxiety)

  • Dry or itchy skin

  • Breast tenderness

  • Worsening of premenstrual syndrome (PMS)

  • Irregular periods

  • Headaches or migraines

  • Joint and muscle aches and pains

  • Change in libido (sex drive)

  • Difficulty focusing

  • Brain fog

  • Heart palpitations

  • Weight gain (especially around the abdominal area)

  • Hair Loss or thinning

  • FatigueBloating or changes in the digestive system

  • Water retention (puffiness)

  • Memory loss

Why do women experience these symptoms during perimenopause?

To answer that question, we need to understand the functions of some key hormones in women’s health and what happens as women age to the levels of these hormones.

During a woman’s lifetime, from puberty until perimenopause, most women will experience a cyclical behavior of 4 main hormones: estrogen, progesterone, FSH (Follicular Stimulating Hormone), and LH (Luteinizing hormone) that work like a well-rehearsed orchestra to prepare the uterus for pregnancy.

However, as a woman ages, her reproductive system starts to change, and the production of hormones will change accordingly.

As you can see in this graph, progesterone and estrogen behave unpredictably until menopause, where there’s a new norm: their levels decline and flatline, while FSH and LH levels increase.

This erratic behavior accounts for most of the symptoms experienced by women during the menopause transition. In fact, perimenopause is marked by physiological stress, where the body is trying to adapt to the erratic messages sent by the fluctuating hormones in an attempt to reach homeostasis or balance.

How do you know if it’s perimenopause or not?

Since no blood tests can determine if you’re in perimenopause, especially at its beginning phases, the best way to find out is to track your symptoms. If you have a relatively regular cycle and it starts to become irregular, that’s a sign of some hormonal issues.

In any case, you can take this test:

* Also available in the Free Workbook I offer at

If you score 12 or over, there’s a good chance you’re in perimenopause.

What to do if you are experiencing symptoms of perimenopause?

There are ways to treat many of these symptoms.

Menopause Hormone Therapy or also called HRT (Hormone Replacement Therapy) can help women with moderate to severe hot flashes or night sweats, vaginal dryness, and at risk of osteoporosis.

Other medications can also treat hot flashes, like some anti-depressants.

It’s crucial to see a doctor to evaluate if the benefits outweigh the risks of starting hormone therapy.

Herbal Supplements – although many supplements have not shown significant results in research studies, many women report finding benefits from them. Different blends and types of herbs can help, but my favorite supplements are Ashwagandha, Tulsi, Black Cohosh, Maca, and others, depending on the symptom. This should be assessed by a qualified health professional as there are risks associated with some of these herbs.

Lifestyle Changes – This is risk-free, the best overall treatment option for perimenopausal women. I always say that this time in a woman’s life is a fantastic opportunity to improve your quality of life by implementing long-lasting positive health lifestyle habits that will not only make you feel better but will increase the chances of longevity and better health now and in the future.

The Pillars of Health during Perimenopause and Beyond


This is a critical time to get your nutrition right: have enough of the macronutrients like protein, carbs, and fats, as well as micronutrients such as calcium, magnesium, vitamin D, and B vitamins.

Since many women experience weight gain during perimenopause, there’s a tendency to try restrictive diets and increase exercise.

I definitely don’t recommend this strategy because, as I mentioned previously since the body is under physiological stress, any significant changes in caloric or nutrient needs can be an additional stressor. And cortisol (the stress hormone) is one of the abdominal fat storage drivers. A well-balanced diet with the right amounts of macro and micronutrients according to individual needs is recommended, ideally with a qualified nutritionist.


Movement is essential at this time. No matter what type, exercise is important for physical and mental health. Exercise can also help sleep and stress.

Along with consistent exercise (150 minutes minimum per week), perimenopausal women should incorporate resistance training for muscle growth and strength – both tend to decrease drastically as we approach and after menopause.

More muscles can also increase metabolism, which is essential at this time to favor fat burning.


Mindset is really an umbrella term that focuses on emotional and mental health. Stress management is key at this phase of life since perimenopausal women are more sensitive to stress and the effects of it in their physical body and their mental state. It’s important to incorporate stress management strategies and prioritize sleep. Self-care should be viewed not as “indulging” but as a needed component of health as it can significantly improve quality of life.

As you can see, there’s a lot that you can do to manage your symptoms. I often say that perimenopause is an opportunity to prioritize your health and improve your overall quality of life. It’s the right time to pay attention to work towards a vibrant and functional future self. To address negative habits or behaviors and substitute them with more positive ones.

And I guarantee that others around you will benefit as much as you will yourself.


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