For many women, the transition into menopause is a time of uncertainty, marked by changes in the body that can feel unpredictable and challenging. Sarah Whitehead, M.D., a board-certified gynecologist at UAB St. Vincent’s, sheds light on perimenopause — the phase leading up to menopause — and what women can do to manage its symptoms.
What is perimenopause?
Perimenopause is the transitional stage before menopause when a woman’s hormone levels fluctuate as her ovaries gradually stop producing estrogen and progesterone. “This phase can last anywhere from four to eight years on average; but for some women, it may begin in their late 30s and last up to a decade,” Whitehead said.
During perimenopause, women may experience symptoms similar to menopause, including hot flashes, night sweats, mood swings, brain fog, irregular periods, vaginal dryness, joint pain, and changes in metabolism and weight. “Every woman experiences these changes differently, largely due to genetic and lifestyle factors,” Whitehead said.
Managing symptoms through lifestyle changes
Although perimenopause is a natural part of aging, lifestyle adjustments can help alleviate symptoms. “Diet plays a major role,” Whitehead said. “Processed foods, excess sugar, caffeine and alcohol can worsen symptoms. Eating a diet rich in phytoestrogens — found in soy — as well as omega-3 fatty acids, calcium and vitamin D, can be beneficial.”
Exercise is another key factor. “Low-intensity cardio workouts can help regulate hormones and improve overall well-being,” she said. “Good sleep hygiene, including maintaining a consistent bedtime and reducing stress, can also have a significant impact.”
"It’s a natural stage of life, and there are ways to navigate it successfully.”
When to seek medical help
While some women manage perimenopause through lifestyle changes alone, others may require medical intervention. “There are benefits to hormone therapy for some women, especially those experiencing severe symptoms,” Whitehead said. “If heavy bleeding, extreme mood changes or other disruptive symptoms occur, it’s important to consult a health care provider.”
She reassures women that, for most, symptoms eventually subside. “About 20 percent of women continue to experience menopause-related symptoms for life; but for the majority, symptoms ease after roughly a decade, and treatment can be gradually tapered off.”
Breaking the stigma
Whitehead emphasizes the importance of open discussions about perimenopause. “Women shouldn’t be afraid to seek help,” she said. “It’s a natural stage of life, and there are ways to navigate it successfully.”
As awareness grows, experts like Whitehead continue to provide guidance and reassurance, ensuring that women have the knowledge and support they need during this transition.