As women move toward their forties and begin to experience many changes in their bodies they begin to question why. Menopause or perimenopause is often one of the last thoughts. The myriad of symptoms associated with perimenopause can be confusing and overwhelming. To add to the confusion and overwhelm each woman’s transition through perimenopause and menopause is different. The symptoms experienced and their severity vary drastically. The information available often varies widely from viewing menopause as a disease to the view of ‘it’s all in your head’. It’s no small wonder women are confused.



Clinically speaking menopause is defined as the cessation of menstruation for 1 year or more. Perimenopause, also referred to as climacteric, is the period of time prior to cessation of menstruation when the bulk of symptoms occur. This transition commonly begins between the ages of forty and fifty five and last for two to seven years. It is not unheard of too begin later or earlier. Menopause is not a disease. It is a natural transition process for women similar to adolescence, only this time moving out of the child bearing years. There is a wide variety of symptoms associated with menopause. Here are the most common twenty.

1. Change in Menstrual Cycle – frequency, duration, flow

2. Hot Flashes/Night Sweats

3. Insomnia

4. Weight Gain

5. Headaches

6. Mood Swings

7. Irritability

8. Depression

9. Infertility

10. Change in Body Odor

11. Decreased Sex Drive

12. Fatigue

13. Forgetfulness/Brain Fog

14. Hair Loss/Thinning Hair

15. Frequent Urination/Stress Incontinence(leaks)

16. Dizziness/Light Headed

17. Increased Anxiety

18. Increased Facial Hair

19. Vaginal Dryness

20. Increased Bloating and/or Gas

It is important to note that these symptoms may be from other causes so it’s always advisable to check with your health care provider.

What exactly is responsible for all these symptoms? A woman’s body is undergoing hormonal changes. Usually the first change is a gradual decline in progesterone. During this time estrogen levels generally remain stable. Estrogen and progesterone play a check and balance act in a women’s body, so when they are out of balance symptoms occur. As perimenopause progresses progesterone continues to decline and estrogen levels begin to fluctuate greatly, again triggering symptoms. At the same time the hormones associated with ovulation and follicle growth, follicle stimulating hormone (FSH) and luteinizing hormone (LH), are increasing resulting in changes in ovulation. The medical tests for menopause traditionally measure FSH and LH levels and increased level is considered a positive result. The problem with this method is that it doesn’t measure estrogen, progesterone, or testosterone levels which can not only confirm menopause but assist in a treatment plan. There are two other testing methods that are thought to be reliable. Salivary hormone testing measure free hormones in the saliva and can easily be done at the same time for several days to determine a women’s personal baseline. The other is a blood test for free (unbound) hormones in the blood. These are options to discuss with your healthcare provider especially if you are considering hormone replacement therapy. Ultimately developing an individual holistic approach is the best way to manage the menopause transition.