What is perimenopause?

Perimenopause is the stretch of time leading up to menopause, when estrogen and progesterone rise and fall less predictably than they used to. It often begins in the early-to-mid forties, sometimes earlier, and can last anywhere from a few years to a decade. Menopause itself is a single point: twelve months after your last period. Everything before that point is perimenopause.

What tends to change

No two people get the same set of changes, and they come and go rather than arriving all at once. The common ones include:

• Cycles that get shorter, longer, lighter or heavier before they stop.
• Waking in the night — often around 3 a.m. — sometimes with heat.
• Reaching for a word that will not come, or walking into a room with no idea why.
• Mood that swings faster, and irritability that seems out of proportion to the trigger.
• Changes in body shape, energy, sex and desire.

Why it feels so hard to name

Much of this overlaps with ordinary midlife stress, so it is easy to be told it is probably stress and sent home. It is not in your head. The shifts are hormonal, they are documented, and they are a fair thing to bring to a clinician who will listen.

The part worth holding onto

For most people the sharpest changes ease on the other side. The cognitive dip that shows up in the transition tends to recover after menopause, and the body recalibrates. This is a passage, not a door closing — and there is a great deal you can do to feel more like yourself along the way.

Grounded in Jen Gunter, The Menopause Manifesto; the SWAN study (Study of Women’s Health Across the Nation); and The Menopause Society. See how Still Me uses these on the home page.