What are the symptoms of perimenopause (perimenopausal transition)?

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Last updated: May 23, 2025View editorial policy

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From the Research

Perimenopause symptoms include hot flashes, night sweats, disrupted sleep, genitourinary discomfort, mood fluctuations, cognitive changes, low sexual desire, bone loss, increase in abdominal fat, and adverse changes in metabolic health, as reported in the most recent study 1. These symptoms can occur in any combination or sequence and may be elusive in their link to menopause. The hallmark symptoms of perimenopause, such as hot flashes and night sweats, are experienced by most women during this transition phase, with vasomotor symptoms being most pronounced during the first four to seven years but can persist for more than a decade 1.

Common Symptoms

  • Hot flashes
  • Night sweats
  • Disrupted sleep
  • Genitourinary discomfort
  • Mood fluctuations
  • Cognitive changes
  • Low sexual desire
  • Bone loss
  • Increase in abdominal fat
  • Adverse changes in metabolic health The intensity and combination of these symptoms vary widely among women due to fluctuating hormone levels, particularly estrogen.

Management Options

Lifestyle modifications, such as regular exercise and stress reduction techniques, can help manage symptoms, and some women may benefit from hormone therapy or non-hormonal medications, as discussed in 2. It is essential for healthcare providers to recognize early signs and symptoms of perimenopause and offer individualized treatment to mitigate these symptoms, as emphasized in 3. The most effective treatment for many perimenopausal symptoms is estrogen-based hormonal therapy, which has a generally favorable benefit:risk ratio for women below age 60 and within 10 years of the onset of menopause 1.

References

Research

Management of perimenopausal and menopausal symptoms.

BMJ (Clinical research ed.), 2023

Research

The Menopause Transition: Signs, Symptoms, and Management Options.

The Journal of clinical endocrinology and metabolism, 2021

Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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