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Perimenopause: How to Manage the Transition

Updated: Nov 24, 2023

Three middle aged women stand together with their arms around each other at a gym.  One woman is wearing a black cropped hoodie with a light marron shirt under it with dark maroon leggings.  The woman in the middle is wearing a black  V-neck sports bra and black leggings.  The woman to the far right is wearing black sports bra with thin straps and light maroon leggings.

It probably comes as no surprise that, over their lifetime, women experience many ups and downs during their overall reproductive journey, from puberty to the emotional and physical changes during childbearing and menopausal years. However, one of the stages not often discussed is perimenopause, the natural transition that leads to menopause or the end of fertility.

Unfortunately, lack of information leaves many women wondering why they suddenly don't quite feel like themselves as hormone fluctuations affect their overall well-being. In addition, managing the various symptoms of perimenopause can be frustrating. Being informed about what's happening and how to treat it can help ease the shift and empower you to take charge of your health.

What is Perimenopause?

Perimenopause is the stage in a woman's life that marks the progression towards menopause as the menstrual cycles cease. As a woman approaches menopause, her ovaries produce less of the reproductive hormones called estrogen, progesterone, and testosterone. The lower levels of these hormones lead to symptoms such as weight gain, vaginal dryness, mood swings, depression, hot flashes, and night sweats [1].

Because these signs often come on slowly, women may not even realize they are entering perimenopause or may ignore the symptoms due to a lack of knowledge. As a result, women often feel unsupported during perimenopause, affecting their mental and emotional health and impacting their social and sex life.

During our recent podcast with Ann Garnier, Founder, and CEO of Lisa Health, she shared, "We're starting to recognize that we need to rethink how perimenopause is characterized so that women are getting the support they need much earlier in this journey."

Common Symptoms and Treatment of Perimenopause

Mood swings and hot flashes are the most common perimenopause symptoms. However, lower hormonal levels can lead to many more changes affecting women's bodies and emotional states. Some of these changes are subtle, but others may come on suddenly. Common side effects of perimenopause can include:

• Lower libido

• Decreased energy levels

• Loss or thinning of hair

• Water retention

• Breast tenderness

• Sleep issues

• Urinary incontinence

• Headaches

• Vaginal dryness

• Mental confusion/brain fog

Depending on a woman's unique needs and symptoms during this transition and previous medical history, there are many different treatment options for the above-mentioned synonyms, including [2]:

• Hormone therapy

• Antidepressants

• Medications to treat vaginal dryness and hot flashes

• Herbs and supplements

• Exercise and diet

• Complementary treatments such as acupuncture, massage, and yoga

During perimenopause and menopause, women are also at an increased risk of heart disease and bone loss due to the reduction of estrogen. [3] Because this transition period increases the risk for chronic disease, Garnier said, "Your forties offers the perfect opportunity to double down on healthy lifestyle behaviors that are going to contribute to longevity." Preventive measures such as cancer screening, exercise and diet counseling, and bone mineral density screening are all actions that can be taken to start taking charge of this next stage of life.

It's important to talk with your physician about symptoms of perimenopause to understand the best management options for your situation.

Support for Perimenopause

Because some of the changes that occur during perimenopause are sudden, it can lead to challenges in relationships and careers. Feelings of irritability or stress, reduced motivation at work, and a sense of unfamiliarity in one's body are not uncommon. Adjusting to this natural aging period takes time, patience, and support.

Open and honest discussions with your physician or therapist or joining a support group can help you to feel less alone and more validated in your perimenopause journey.

Additionally, technology can play a key role in helping provide women with the knowledge and support they need as they experience perimenopause changes.

One example is an app called Midday, developed by Garnier, which uses AI and sensor technology to personalize insights on what's happening emotionally and physically during menopause. As Garnier shared, this app "helps to provide the right intervention at the right time to manage symptoms and promote healthy aging."

Perimenopause can also be a powerful time to reflect on inner growth, life goals, and meaningful relationships. Support and encouragement to seek help during perimenopause increase confidence in handling the changes of this natural phase of life..

Garnier sees this phase of life as an opportunity for her and others, “I’m devoting the rest of my career to transforming this life stage for women so that they can celebrate this stage, which I think can bring so much joy, reward, and accomplishment.” She goes on to say that “Every woman should have that available to her and shouldn't feel the burden of symptoms that are making her feel like she's less than her best self every day.”


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