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4 Signs Perimenopause is Ending

Updated: Apr 25

As you go through perimenopause you may experience many symptoms of hormonal ups and downs or you may get through it with minimal symptoms at all. However many women do wonder what signs indicate that perimenopause is ending soon.

Read on to find out more.


What is perimenopause?


Perimenopause is the period of time before and around menopause, which is 12 months after the final period. During this time, women may experience a wide range of symptoms, including hot flashes, mood swings, sleep disturbances, and changes in their menstrual cycle.


While these symptoms can be uncomfortable and frustrating, there are some signs that perimenopause is nearing its end.

These may include a reduction in hot flashes, improved sleep patterns, fewer mood swings, and less frequent monthly periods. If you are experiencing any of these signs, it is important to talk to your doctor about your concerns and discuss strategies for managing your symptoms during this transitional period.


When does perimenopause start?


The exact timing of perimenopause can vary from woman to woman A third of women start noticing perimenopausal changes in their late 30s, but most women will begin to experience symptoms in their mid-to-late 40s.


Women who experience early menopause prior to age 40 may experience perimenopausal symptoms for 3-7 years prior to their final period.

In general, the first signs of perimenopause may include non-period related symptoms such as dry skin or dry eyes, unrefreshing sleep, mood changes or and increase in pre-menstrual symptoms.

Your doctor may also note metabolic changes such as increases in your blood pressure, cholesterol levels, blood sugar or HBA1C (a measure of longer term blood sugars).

Your periods may change in a number of ways including longer days of spotting prior to your period., irregular periods or an increase or decrease in the amount of bleeding. As these changes progress, and estrogen levels decrease, you may also experience other common symptoms, such as hot flashes, night sweats, vaginal dryness, and sleep disturbances.

While these symptoms can be challenging to deal with during perimenopause, there are some steps that you can take to manage your symptoms and help ease the transition into menopause. These may include seeking support from family and friends, practicing relaxation techniques like meditation or yoga, and talking to your doctor about hormonal support, supplements or medications that may help.

Ultimately, the key is to stay positive and focus on taking care of yourself in a holistic way during this important time in your life.


4 Signs Perimenopause is Ending, Otepoti Integrative Health


Symptoms of perimenopause


There are a wide variety of perimenopausal symptoms due to the fluctuating estrogen and progesterone levels. Estrogen and progesterone are steroid hormones that have effects in every body system, which is why women experience so many changes during the menopause transition. These are some of the common symptoms you will experience during perimenopause.


Dry Skin, Dry Eyes and Dry Vagina


One of the first signs can be dry skin, itchy skin, and dry eyes, as estrogen levels decrease in perimenopause. This can also cause vaginal dryness, which can contribute to discomfort or pain during sex. It can also contribute towards increased number of urinary symptoms and increased infections with bacterial vaginosis or thrush.


Hot flashes


Hot flashes are another common symptom of perimenopause, caused by hormonal fluctuations that affect your body's thermostat in the brain. These hot flashes can be accompanied by a reddening of the face and sweating.


Irregular periods


As you start to experience irregularities in your periods, it be an indicator that perimenopause has started, or is about to. This can also be caused by things like lifestyle (stress, insufficient sleep, poor diet ), hormonal contraception, thyroid disorders, or other medical conditions. If you are concerned about the changes in your menstrual cycle, discuss this with your doctor.


Longer, heavy periods


Periods can become heavier during perimenopause as well, due to the changes in estrogen and progesterone levels. This increased flow may also be accompanied by more intense cramping and PMS-like symptoms.


If you have heavy periods where your flow is heavy, you are experiencing flooding or needing to change period products every 2 hours, or you feel dizzy or faint you should seek medical attention. Sometimes there are other causes than perimenopause for these types of bleeding including fibroids, endometrial hyperplasia (thickening of the uterus lining), miscarriage that need to be investigated and treated.

Mood changes such as anxiety or depression during perimenopause


Both estrogen and progesterone have beneficial effects on mood stability in the brain. The hormonal fluctuations can increase your risk of mood changes like anxiety or depression during perimenopause. It can be distressing to experience these mood changes.


If you are experiencing prolonged periods of sadness, irritability, or other symptoms that impact your quality of life, your should talk to your doctor about getting support and help managing these symptoms.

Insomnia during perimenopause


Insomnia or difficulty sleeping is a common symptom during perimenopause as well, due to the fluctuations in estrogen and progesterone levels. Estrogen is necessary for circadian rhythm syncing. Progesterone is converted into allopregnanolone and in the brain this is calming and relaxing and supports sleep.


If you are experiencing disrupted sleep, try making some changes to your routine to support better sleep quality such as improving diet, exercising more regularly, avoiding screens before bedtime, or practicing relaxation techniques like meditation.


You can try natural remedies such as chamomile tea, valerian root supplements, tart cherry or magnesium that can be beneficial for improving sleep.



Night sweats


Many women will experience night sweats during perimenopause. These can be quite dramatic and it's important to try to keep your sleeping environment cool and comfortable.

Some other things that you can do to manage night sweats are to wear layers of clothing or extra blankets at night, use a fan or air conditioning to cool the room, or try a cool shower before bed. If hot sweats are interferring with your quality of sleep and life it is worth discussing hormone replacement therapy (HRT) with your doctor.


Headaches and Migraines


As the levels of estrogen and progesterone fluctuate during perimenopause, you may also experience more headaches or migraines. These can be quite prominent in the pre-menstrual luteal phase of your cycle or may occur at random times during your cycle. Headaches and migraines can be distressing and interfere with your daily activities.


If you are experiencing frequent headaches, try to change your diet to include foods that are known to help with headache such as foods or supplements containing magnesium, fish oil, or turmeric. Avoid trigger foods such as foods containing colours, chemical preservatives and MSG as well as alcohol, caffeine and aged cheese.


Perimenopausal Acne


You may have thought you left acne behind in your teen years, but alas, it often makes a come-back during perimenopause. It is those same hormonal fluctuations in both puberty and perimenopause that can increase inflammation and infection in the skin sebaceous glands to create acne.


Avoid oily products on the skin as well as soaps that alter the skin pH and therefore alter the skin microbiome.


How long does perimenopause last?


The duration of perimenopause can vary from woman to woman, but it typically lasts for several years. It may be as short as 3 years or take longer than a decade.


What Are the Signs Perimenopause Is Ending?


These are some common signs that perimenopause is ending.


Less frequent periods


As you progress closer to the end of having menstrual cycles, the time between each period gets progressively longer. If you are experiencing a menstrual cycle of longer than 60 days, you are likely to be close to your final period.


Stabilization of mood


As both estrogen and progesterone levels drop, you experience less fluctuations in hormone levels which can have dramatic effects on your mood. Your mood and anxiety symptoms should start to stabilize as your hormone levels become consistently low.


More frequent hot flashes and night sweats


As estrogen levels drop off, you may experience more frequent hot flashes. For many women these do stop within a few years of having your final period, but for some women they persist for mant years without hormonal therapy.


Poorer quality of sleep


If your hot flashes and night sweats are worsening you may experience worsening sleep duration and quality. Also the low levels of progesterone mean you have less calming sleep neurotransmitter to support healthy sleep. Declining levels of estradiol interferes with circadian signaling in the brain, confusing the day night rhythm that normally drives regular sleep.


If you are using hormone replacement therapy some of these symptoms may already have abated so it can be tricky to know if you are close to menopause.


What can support me through the end of perimenopause?


Lifestyle Changes


There are many lifestyle changes you can make to support yourself through perimenopause. These include:


  • limiting your stress levels, having boundaries around what you can take on.

  • practicing meditation or mindfulness to reduce the impact of stressors on the body

  • eating a balanced diet that includes sufficient protein and diverse plant fibers including fruits, vegetables whole grains, nuts, seeds, herbs and spices

  • exercising regularly including weight bearing exercises such as walking, running, dancing, and weight training to maintain muscle and bone mass.

  • avoiding alcohol and caffeine as unfortunately these can exaccerbate symptoms of perimenopause.

Supplements for perimenopause


There are a number of supplements that can support women through perimenopause. These will vary depending on your symptom profile. These include magnesium and fish oil supplements, which help to reduce inflammation in the body. Other options include turmeric and probiotics, which can help to improve skin health and sleep quality.


Ashwagandha can also support sleep and help you adapt to stressors.


Some women use herbal support such as Remifemin, black cohosh, or vitex, which are used to help reduce the severity of perimenopausal symptoms like hot flashes and night sweats.


If you take other medications or health conditions, it is important to speak with your doctor before taking any supplements or herbal remedies during perimenopause, as they may interact with other medications you are taking and can cause negative side effects


Hormone Replacement Therapy or Menopause Hormone Therapy


Hormone replacement therapy (HRT or MHT) is an excellent option for many women, it uses physiological levels of natural hormones to as this can help to balance the fluctuating hormone levels of estrogen and progesterone. By balancing the hormonal levels, it can help to reduce the severity of perimenopause symptoms.


There are many different options of HRT available to support you through your journey into menopause and perimenopause. You can use both body identical estradiol and micronised progesterone. Estradiol is safer in creams, gels or patches, but it also comes in tablet form.


You can also use synthetic estrogens and progestins which have a higher side effect profile, but some women prefer them for convenience as they come in a combined tablet. By working with your doctor or healthcare provider, you can create a strategy to support you menopause transition in a holistic way, no matter whether it is long or short.


Dr Deb Brunt @ Ōtepoti Integrative Health would love to support you as you navigate perimenopause and menopause.

She practices Lifestyle Medicine and Integrative Medicine in New Zealand and Menopause health coaching internationally. She has a passion for supporting women adapt to their changing female physiology for optimum health and wellbeing.

Schedule a free health discovery call with her to learn more.

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