Perimenopause is nasty, messy and WILL make you miserable. Here is what nobody tells you

Perimenopause is the transition phase leading to menopause, when women stop having their periods. It literally means "around menopause." It can start as early as the age of 35. But, how do you know if you are in perimenopause? Women have not known about this condition for the longest time, and in fact, most of them have come across it on social media. When another woman described what she had been going through in perimenopause, something instantly clicked with others watching. "Yes, I could be in perimenopause," they said. However, it is important to know that the symptoms of perimenopause are the key here. They go beyond just hot flashes and irregular periods. "When people think about perimenopause, they usually think of irregular periods and hot flashes. But for many women, the transition begins years before menopause with symptoms that seem completely unrelated," Mugdha Pradhan, functional medicine practitioner, told WION.

"Suddenly, sleep becomes lighter, energy drops drastically, anxiety feels much higher than usual, and weight gain also appears despite eating the very same foods as earlier. Brain fog, mood swings, irritability, sugar cravings, and even worsening gut issues can start showing up. Many women are told these changes are simply a part of ageing, but there is often much more happening beneath the surface," she said.

What is perimenopause?

Perimenopause is a phase wherein the estrogen and progesterone levels start fluctuating. These hormonal shifts affect not just reproductive health but also blood sugar regulation, sleep quality, inflammation levels, stress resilience, and brain function throughout the body.

Symptoms of perimenopause

There are a whole lot of them, but not everyone will experience the same symptoms. Some of the basic symptoms include irregular periods and hot flashes, something we have all heard over the years. However, some of the symptoms are such that you would never know that they are linked to perimenopause.

Dr Nidhi Rajotia, Unit Head, Department of Obstetrics & Gynaecology, Artemis Hospitals, says, "Hot flashes and irregular periods are common symptoms, but many women have surprising symptoms that can be confusing and frustrating. Other less common symptoms include mood swings, anxiety, brain fog, poor concentration, sleep disturbances, joint pain, headaches, heart palpitations and sudden fatigue."

She added, "Many women also experience changes in skin, hair and weight. These symptoms can happen years before menopause and can vary from month to month."

The weird symptoms of perimenopause

Some women swear they have been feeling weird things that have practically no explanation. "I forget why I had entered a room, feel like something is crawling on my skin, hear sounds, see things through peripheral vision when nothing is there," Arushi, a 40-year-old professional, says. They are also linked to perimenopause in some cases. Kumkum, 43, says, “I have had all these body aches for a few years now. No amount of tests has been able to figure out what is wrong. So now I am living with them as I have been told that they are associated with perimenopause and will subside on their own after a few years.”

How to manage perimenopause symptoms?

Introducing changes in your lifestyle and diet is the first step. "The major highlight is that simple lifestyle changes can make a major difference. So the first thing has to be prioritising adequate protein intake at every meal as it helps in stabilising blood sugar and preserving muscle mass," says Mugdha, who is the founder & CEO of iThrive, a functional health company.

Exercise and stress control are the two other things you need to focus on. "Strength training becomes another important factor, especially important during this phase, as it supports metabolism, bone health, and insulin sensitivity. Daily movement, quality sleep, and stress-management practices like breathwork and yoga can also help regulate the nervous system and reduce symptom severity," she says.

Dr Nidhi backs what Mugdha says. "Regular exercise can boost your mood, sleep and energy levels. A healthy and balanced diet with fruits and vegetables, whole grains, calcium and protein can help maintain good overall health and keep bones strong. Drinking water and reducing caffeine, alcohol and highly processed foods may help with hot flashes and sleep," she said.

Mugdha further states that for some women, changes in their lifestyle alone might not be enough, specifically when the symptoms are significantly affecting factors like sleep, mood, energy, cognition, or quality of life. "In such circumstances, bioidentical hormone replacement therapy, when prescribed as well as monitored appropriately, can prove to be a highly effective intervention," she says, adding, "But you still need to work on "good nutrition, adequate protein intake, strength training, stress management, as well as gut health support."