Early Signs of Menopause
Pamela Edwards Christiani
Jan. 26, 2022
How to know if you're in peri-menopause, menopause or neither? It's a basic question with complex answers.
“Sixty-five percent of women report not feeling prepared for menopause,” says Nate Matusheski, Ph.D. and Chief Science Officer of Phenology. “And everyone experiences the menopausal transition differently, and over different time frames,” he says. Part of the reason women feel unprepared is that, often, they may not know they're in peri-menopause or menopause. Technically, menopause is only one day. It marks that one day after twelve consecutive months without a period (not due to any other cause). After that day, you’re officially post-menopausal. The prefix “peri” means “about” or “around” or “in front of,” so peri-menopause is the lead-up to menopause, a transition period between one’s reproductive years and the post-menopausal years. According to NAMS, the North American Menopause Society, peri-menopause usually begins in one’s 40s, but it can also start in your 30s. Most women experience menopause between 40 and 58 and the average age, in the US, is 51. On average, peri-menopause can last from four to eight years. Your mother may have had practically zero symptoms, or severe episodes, but your experience could be the complete opposite. Again, there are multiple variables and each woman’s journey is quite personal, which is why being informed is key.
One of the most common symptoms of peri-menopause is an irregular period—ovulation is now a little less predictable and the result is a period that’s either heavier, or lighter, briefer, or more frequent—due to fluctuating hormone levels, particularly estrogen and progesterone. As ovulation becomes more erratic, the ability to conceive does decrease, however pregnancy is still possible if you have a menstrual cycle. (So, if you’re not interested in getting pregnant, it’s wise to use birth control until you reach the post-menopausal stage.)
In addition to changes to your menstrual cycle, you could experience hot flashes, night sweats, insomnia, intense PMS, mood swings, vaginal dryness, brain fog, a decreased libido, weight gain, loss of bone density or even depression. This all sounds a bit intense, but know that most people don’t experience all of these symptoms and certainly not at the same time—though that scenario is a possibility. One’s symptoms of peri-menopause could also be quite subtle and possibly confused with the symptoms of PMS or a Thyroid disorder. If you think you’re peri-menopausal, especially if the symptoms are interfering with your quality of life, like hot flashes or insomnia, it’s a good time for a thorough examination by a physician, preferably with one who understands how to properly assess this stage of life. Note that even with an accurate confirmation, your doctor may not be able to predict all that’s to come on this very personal journey.
Chloe Giraldi, VP of Nutrition Science at Phenology adds that “when it comes to hormone testing, there is no blood test that will tell you exactly where you are in the transition, but elevated levels of follicle stimulating hormone (FSH) and decreased levels of estrogen are two major indicators.” Giraldi also shares that “decreased progesterone levels in the latter part of the menstrual cycle are indicative of a missed ovulation (which tends to occur more frequently during peri-menopause), and lower progesterone levels are associated with some of the emotional health symptoms of menopause.”
Sign Up for Exclusive Access
Curated content, perks, menopause guidance, and insights on health, nutrition, beauty, and more delivered to your inbox.
It’s good to understand what might be coming down the road, so other useful resources to consider include STRAW+10, the gold standard of studies that assesses reproductive aging in research and clinical contexts, NAMS (The North American Menopause Society), and The Cognitive Behavioral Workbook for Menopause, by Phenology Scientific Advisor, Sheryl Greene, Ph.D. Familiarize yourself with the terrain, see your doctor if you feel it’s necessary—and know that this is another of part of life that you can handle.