Learn more about your symptoms, and what we’d recommend, with our short perimenopause quiz.
Hot flushes? Anxiety? Poor sleep? Weight gain? These are all common symptoms of perimenopause, the 2-12 year stage leading up to the menopause.
But which hormone imbalances are underlying your symptoms? Find out in our short perimenopause quiz.
What is perimenopause?
Perimenopause is a time of hormonal changes, similar to puberty. It is defined as the 2-12 year period or phase leading up to menopause (menopause being the single point in time when periods have ended for 12 months). Typically perimenopause can occur anywhere from the ages 38-50.
Common symptoms of perimenopause
How do you know if you’re in perimenopause? Let’s look at some common symptoms of perimenopause.
The best place to start is with Professor Jerilynn Prior’s list of new symptoms that reveal if you are likely to be entering perimenopause. Professor Prior states that a midlife woman – who previously had regular periods – is likely to be in perimenopause if she has three of the following symptoms:
- New-onset heavy and/or longer flow
- Shorter (25 days or less) menstrual cycles
- New sore, swollen or lumpy breasts
- New mid-sleep waking
- Increased menstrual cramps
- Onset of night sweats, in particular premenstrually
- New or markedly increased migraine headaches
- New or increased premenstrual mood swings
- Weight gain without changes in eating or exercise
It is important to note that these listed above are just a few of the symptoms that you may experience in perimenopause and it is a different experience for each individual. As there is no single test that can define if you are in perimenopause, the above signs and symptoms are the best guide.
The Four stages of perimenopause
Did you know that perimenopause occurs in four distinct phases? According to Canadian endocrinologist Professor Jerilynn Prior, the four stages are:
- Very early perimenopause, when periods are still regular. This is when progesterone levels fall.
- Early menopause transition, from the onset of irregular periods. Progesterone continues to call, and estrogen is high and fluctuating.
- Late menopause transition, from the first cycle of more than 60 days. Both estrogen and progesterone are lowering.
- Late perimenopause, which is 12 months from your final period. Estrogen and progesterone are low.
Our Perimenopause quiz
In the short perimenopause quiz above, we look at some common hormone imbalances that can drive symptoms in perimenopause. These include symptoms of:
- Low progesterone
- High oestrogen or low oestrogen
- High testosterone
- Insulin resistance
Bromberger, J. T., Kravitz, H. M., Chang, Y., Randolph, J. F., Jr, Avis, N. E., Gold, E. B., & Matthews, K. A. (2013). Does risk for anxiety increase during the menopausal transition? Study of women’s health across the nation. Menopause (New York, N.Y.), 20(5), 488–495. https://doi.org/10.1097/GME.0b013e3182730599
Brinton, R. D., Yao, J., Yin, F., Mack, W. J., & Cadenas, E. (2015). Perimenopause as a neurological transition state. Nature reviews. Endocrinology, 11(7), 393–405. https://doi.org/10.1038/nrendo.2015.82
C V, S. B., S, B., & A, S. (2012). Analysis of the degree of insulin resistance in post menopausal women by using skin temperature measurements and fasting insulin and fasting glucose levels: a case control study. Journal of clinical and diagnostic research : JCDR, 6(10), 1644–1647. https://doi.org/10.7860/JCDR/2012/4377.2646
de Kruif, M., Spijker, A. T., & Molendijk, M. L. (2016). Depression during the perimenopause: A meta-analysis. Journal of affective disorders, 206, 174–180. https://doi.org/10.1016/j.jad.2016.07.040
Freeman, E. W., Sammel, M. D., Lin, H., & Nelson, D. B. (2006). Associations of hormones and menopausal status with depressed mood in women with no history of depression. Archives of general psychiatry, 63(4), 375–382. https://doi.org/10.1001/archpsyc.63.4.375
Freedman R. R. (2014). Menopausal hot flashes: mechanisms, endocrinology, treatment. The Journal of steroid biochemistry and molecular biology, 142, 115–120. https://doi.org/10.1016/j.jsbmb.2013.08.010
Hitchcock, C. L., & Prior, J. C. (2012). Oral micronized progesterone for vasomotor symptoms–a placebo-controlled randomized trial in healthy postmenopausal women. Menopause (New York, N.Y.), 19(8), 886–893. https://doi.org/10.1097/gme.0b013e318247f07a
Hoyt, L. T., & Falconi, A. M. (2015). Puberty and perimenopause: reproductive transitions and their implications for women’s health. Social science & medicine (1982), 132, 103–112. https://doi.org/10.1016/j.socscimed.2015.03.031
Jerilynn C. Prior, MD, FRCPC. Clearing confusion about perimenopause. BCMJ, Vol. 47, No. 10, December, 2005, Page(s) 538-542
Li, R. X., Ma, M., Xiao, X. R., Xu, Y., Chen, X. Y., & Li, B. (2016). Perimenopausal syndrome and mood disorders in perimenopause: prevalence, severity, relationships, and risk factors. Medicine, 95(32), e4466. https://doi.org/10.1097/MD.0000000000004466
Molly C. Carr, The Emergence of the Metabolic Syndrome with Menopause, The Journal of Clinical Endocrinology & Metabolism, Volume 88, Issue 6, 1 June 2003, Pages 2404–2411, https://doi.org/10.1210/jc.2003-030242
Prior J. C. (2018). Progesterone for treatment of symptomatic menopausal women. Climacteric : the journal of the International Menopause Society, 21(4), 358–365. https://doi.org/10.1080/13697137.2018.1472567
Sander, B., & Gordon, J. L. (2021). Premenstrual Mood Symptoms in the Perimenopause. Current psychiatry reports, 23(11), 73. https://doi.org/10.1007/s11920-021-01285-1
Santoro, N., Roeca, C., Peters, B. A., & Neal-Perry, G. (2021). The Menopause Transition: Signs, Symptoms, and Management Options. The Journal of clinical endocrinology and metabolism, 106(1), 1–15. https://doi.org/10.1210/clinem/dgaa764
Whitcroft, S., & Herriot, A. (2011). Insulin resistance and management of the menopause: a clinical hypothesis in practice. Menopause international, 17(1), 24–28. https://doi.org/10.1258/mi.2011.011003
Zhang, Z., DiVittorio, J. R., Joseph, A. M., & Correa, S. M. (2021). The Effects of Estrogens on Neural Circuits That Control Temperature. Endocrinology, 162(8), bqab087. https://doi.org/10.1210/endocr/bqab087