the science of nutrition

Perimenopause: What Are the Real Signs and How to Manage Them

Paula James-Martinez

Perimenopause: What Are the Real Signs and How to Manage Them

Perimenopause seems to be popping everywhere at the moment. At least for a women of a certain age (like myself), it's seems to be showing up more and more in social feeds, discussed in favorite podcasts, and is frequently blamed for various odd ailments—ranging from feeling too hot to having itchy ears by friends over tea.

What is Perimenopause? 

But what exactly is perimenopause, and what are its actual symptoms? Many of us have a basic understanding of menopause, which the World Health Organization (WHO) defines as the time in a woman's reproductive journey when monthly menstruation ends due to the loss of ovarian follicular function. In other words, the ovaries stop releasing eggs for fertilization.

Perimenopause is the transitional phase leading up to menopause. During this period, hormonal changes cause a variety of symptoms. While it has been an understudied area like much of women's health, in the past seven years going back to 2015, approximately $530 million has been invested in startups addressing menopause care. 

For individuals understanding these signs and learning how to manage them can allow women to take back some control through this transition.

Recognizing the Signs of Perimenopause

During perimenopause, estrogen and progesterone levels fluctuate, leading to various symptoms. Below we outline some of the most common symptoms that you might be experience in perimenopause.

Irregular Periods

Changes in menstrual cycle length, flow, or frequency are common. Periods may become irregular, with variations in
duration and flow.

Hot Flashes and Night Sweats

Sudden warmth, often with sweating and flushing, are known as hot flashes. These can occur during the day or night and disrupt sleep. 

Mood Changes

Hormonal fluctuations can lead to mood swings, irritability, and an increased risk of depression and anxiety. If you are struggling with your mental health please reach out to your provider urgently or "The Mental Health Hotline" at 866-903-3787 which can answer your questions confidentially and free of charge.

Sleep Disturbances

Insomnia or difficulty staying asleep can result from night sweats or anxiety. 

Vaginal Dryness and Discomfort

Decreased estrogen levels can cause vaginal dryness, itching, and discomfort during intercourse.

Decreased Libido

Changes in hormone levels can lead to reduced interest in sex. Read more about Libido here.


Persistent tiredness and lack of energy can be exacerbated by sleep disturbances.

Weight Gain and Metabolism Changes

Changes in metabolism may lead to weight gain, particularly around the abdomen.

Cognitive Changes

Some women report memory lapses, difficulty concentrating, and a general sense of mental fog. 

                                  Managing Perimenopause Symptoms

                                  Managing perimenopause symptoms is different for everyone but often involves a combination of lifestyle changes to support your health and medical interventions:

                                  Healthy Diet

                                  A balanced diet rich in fruits, vegetables, whole grains, and lean proteins helps manage weight and provides essential nutrients. With some research suggesting foods high in phytoestrogens, such as soy products, may impact hormones. It's also recommended that you support your body with a robust multivitamin like Needed's Women's Multi.

                                    Regular Exercise

                                    Physical activity helps maintain a healthy weight, improves mood, and promotes better sleep. Aim for at least 150 minutes of moderate exercise per week. A 20 minute walk each day in nature has been shown to lower stress hormones.

                                      Stress Management

                                      Techniques such as yoga, meditation, and deep-breathing exercises reduce stress and improve emotional well-being.

                                        Sleep Hygiene

                                        Maintaining a regular sleep schedule, creating a comfortable sleep environment, and avoiding caffeine and electronics before bed improves sleep quality.

                                          Hydration and Skincare

                                          Drinking plenty of water and using moisturizers helps alleviate dry skin and vaginal dryness. Needed hydration support is specifically designed to support your bodies liquid needs.

                                            Hormone Replacement Therapy (HRT)

                                            For severe symptoms, HRT can be effective. It's essential to discuss the risks and benefits with a healthcare provider


                                            Calcium and vitamin D supplements support bone health, while other supplements, like black cohosh, may help with hot flashes according to some studies. Always consult a healthcare provider before starting any new supplement.

                                                Like the article? Share it!

                                                Paula James-Martinez, Filmmaker and Editorial Director

                                                Paula James Martinez is a writer, filmmaker, and women's health advocate. She is the director and producer of the documentary Born Free, which investigates the truth about birth and maternal health America. Sits on the boards of non-profit organization "The Mother Lovers" and "4Kira4Moms" to raise awareness of the US maternal health crisis, and co-hosts the parenting podcast "Scruunchy."