by BMC Obstetrics & Gynecology
Boulder, Longmont, and Louisville, Colorado
Perimenopause — also called the “menopausal transition” — is the stage leading up to menopause when hormone levels begin to change. For many women in their late 30s or 40s, this is when cycles become irregular, hot flashes appear, and sleep or mood shifts feel more noticeable.
Perimenopause is a natural phase of life, but understanding what to expect can make the journey easier.
What Is Perimenopause?
Perimenopause usually begins in the 40s, though some women notice changes in their late 30s. It ends once menopause is reached — defined as 12 months without a period.
During this time, the ovaries gradually produce less estrogen and progesterone. Progesterone often declines earlier and more steadily, while estrogen levels can spike and dip before falling overall. These shifts cause many of the symptoms associated with perimenopause.
Symptoms of Perimenopause
Every woman’s experience is unique, but the most common signs include:
- Irregular periods – cycles may be shorter, longer, heavier, lighter, or skipped altogether
- Hot flashes and night sweats – sudden waves of heat, flushing, and sweating, sometimes disrupting sleep
- Mood changes – irritability, anxiety, or emotional sensitivity linked to hormonal shifts
- Sleep disturbances – trouble falling asleep or staying asleep, often tied to night sweats or stress
- Vaginal dryness and low libido – hormonal changes may reduce comfort during intimacy
- Brain fog and memory issues – difficulty focusing, sometimes worsened by poor sleep or stress
Managing Symptoms Naturally
Many women find that lifestyle changes can ease the transition:
- Balanced diet – focus on calcium, vitamin D, lean protein, and vegetables; limit alcohol, caffeine, and sugar
- Exercise – walking, yoga, and strength training support bone health, mood, and sleep
- Prioritize sleep – aim for 7–9 hours with a consistent routine and screen-free bedtime
- Stress management – meditation, breathing exercises, and hobbies help reduce tension
Medical Options for Perimenopause Relief
If symptoms interfere with daily life, talk with your healthcare provider. Treatment options may include:
- Hormone replacement therapy (HRT)
- Low-dose birth control to regulate cycles and ease symptoms
- Non-hormonal medications (such as certain antidepressants, gabapentin, or clonidine) for hot flashes and sleep
Before starting treatment, discuss risks, benefits, and personal health history with your provider.
When to Call a Doctor
While perimenopause is natural, see a doctor if you experience:
- Very heavy or prolonged bleeding
- Bleeding between periods
- Severe depression or anxiety
- Symptoms that significantly disrupt your quality of life
Support for Women in Boulder County
Perimenopause can feel overwhelming, but you don’t have to go through it alone. If you’re experiencing perimenopause symptoms or want to understand your options better, our Boulder Medical Center OB-GYN providers are here to help you feel supported and informed.
Learn more about OB-GYN services at Boulder Medical Center.