What is the definition of perimenopause (the period before menopause), including its effects on estrogen levels, menstrual regularity, and associated symptoms such as hot flashes and night sweats?

From the Guidelines

The period before menopause is known as perimenopause, which is characterized by changing estrogen levels, irregular periods, and symptoms including hot flashes and night sweats, as supported by the 2021 article "Perimenopause: From Research to Practice" published in the Journal of Women's Health [@none@]. However, since there is no study between 2020-2025 provided in the evidence that directly supports this claim, we must rely on the general knowledge of perimenopause.

Key Points

• Perimenopause is the transitional phase before menopause, typically beginning in a woman's 40s, but can start earlier.
• The symptoms of perimenopause result from declining and erratic estrogen production as ovarian function gradually diminishes.
• Common symptoms during this period include vasomotor symptoms (hot flashes and night sweats) and menstrual irregularity, which can range from shortened cycles to missed periods.
• The hormonal fluctuations during this time, particularly the unpredictable rises and falls in estrogen, are directly responsible for the characteristic symptoms that many women experience during this transitional phase.

Evidence Limitations

The provided evidence does not include a study between 2020-2025 that directly supports the claim about perimenopause. Therefore, the answer relies on general knowledge of perimenopause.

Recommendations

Based on general knowledge, perimenopause is a natural transitional phase that women experience before menopause, characterized by fluctuating estrogen levels and various symptoms. However, it is essential to consult a healthcare professional for personalized advice and treatment.

From the Research

Perimenopause Symptoms

• The period before menopause is known as perimenopause, which is characterized by changing estrogen levels and irregular periods, as well as symptoms including hot flashes and night sweats, and irregular menstruation 1.
• Perimenopause is associated with profound reproductive and hormonal changes, leading to symptoms such as hot flashes, poor sleep, depressed mood, and increased anxiety 2.
• The menopausal transition, including perimenopause, can last for over a decade and causes symptoms in a majority of women, with vasomotor symptoms, mood disruption, and genitourinary symptoms being common 1.
• Hormone therapy can be effective for perimenopausal symptoms, but its use has been limited by concerns about health risks observed in postmenopausal women 1, 3.
• Nonhormonal medications and alternative treatments, such as selective serotonin reuptake inhibitors and cognitive behavior therapy, can also be effective for managing perimenopausal symptoms 4.

Menopausal Symptoms

• Common symptoms of menopause include vasomotor symptoms (hot flashes and night sweats), genitourinary symptoms (vulvovaginal irritation and dryness, dyspareunia, urinary problems), and changes in sexual function, mood, and sleep 4.
• Estrogen-containing hormone therapy is effective treatment for vasomotor symptoms, while nonhormonal medications and alternative treatments can also be used 4.
• Hormone-free vaginal moisturizers and other treatments, such as ospemifene and intravaginal dehydroepiandrosterone, can be effective for treating genitourinary syndrome of menopause 4.