Perimenopause to Postmenopause: Navigating the changes, living your best life
Many women ask: What’s the difference between perimenopause, menopause, and postmenopause?
Here’s a quick breakdown:
Perimenopause is the transitional phase that can begin as early as your late 30s and continues up to your final menstrual period.
Menopause is the year of no menses.
Postmenopause begins after one year of no menses—and lasts the rest of your life.
In fact, women often spend one-third of their lives in postmenopause. Surprised? You're not alone.
When Does Perimenopause Start?
It may feel early, but perimenopause can start in your late 30s. That doesn’t mean you’re entering menopause prematurely—it simply means your hormone levels are fluctuating, and those fluctuations can bring on a wide range of symptoms.
Common Symptoms of Perimenopause
Some of the most common (but often unexpected) symptoms include:
Fatigue
Weight gain
Irregular or heavy periods
Insomnia
Brain fog
Difficulty focusing (many women describe it as adult-onset ADD)
Vaginal dryness
Decreased libido
Joint pain
Hair loss
Dry skin
Is There a Diagnosis for Perimenopause?
Perimenopause is a natural biological process—not a disease—so most women’s health providers avoid using the term “diagnosis.” However, that doesn’t mean you should dismiss the symptoms as just a normal part of aging.
I like to say: the symptoms are common, but that doesn’t make them normal.
For years, women have been told to "push through it." Today, we know better. Hormone testing—whether timed with your cycle or done randomly—won’t pinpoint exactly where you are in the transition, but it can provide a helpful baseline for your healthcare provider.
The Four Pillars of Wellness During the Transition
When navigating perimenopause to postmenopause, I recommend starting with the Four Pillars of Wellness to build a strong foundation:
1. Optimal Sleep
Restorative sleep is crucial for hormone balance and overall well-being. Poor sleep increases your body’s stress load and makes symptoms worse.
2. Optimal Nutrition
Your body’s nutritional needs change during perimenopause. Protein and fiber are key for blood sugar stability and muscle maintenance. Avoid extreme dieting—what worked in your 20s may not work now. Consider working with a dietitian who understands hormonal shifts.
3. Optimal Exercise
Your workouts may need to evolve. Strength training becomes essential to preserve muscle mass, protect bones, and support metabolism. Cardio is still important—but lower intensity may be more effective and sustainable. A knowledgeable trainer can help you customize a plan.
4. Optimal Stress Management
Your stress response changes with hormone fluctuations. Develop a personal “toolkit” that might include yoga, breathwork, meditation, nature walks, journaling, or prayer. Build a support network of friends, family, or a therapist to help manage emotional and physical changes.
Treatment Options: Beyond Lifestyle Changes
While lifestyle adjustments can significantly improve symptoms, medical treatment options are available if symptoms affect your emotional or physical health.
Non-Hormonal Options:
Herbal supplements
Vitamins and minerals
Lifestyle interventions
Hormonal Options:
Estradiol: Delivered via patch, gel, cream, spray, or occasionally oral
Progesterone: Most commonly oral; topical options exist
Testosterone: Typically in topical form, sometimes as a pellet
DHEA: Available orally or topical form.
We’ll dive deeper into hormone replacement therapy (HRT) in an upcoming blog post.
Final Thoughts
Yes, this can be a challenging phase. But it’s also an opportunity to learn more about your body, prioritize your health, and take control of your wellness for the decades ahead.
🩺 Schedule a visit with your women’s health provider to discuss your symptoms and options.
❗ And remember: If your provider isn’t listening—find one who will.
-Melinda Rhoads, CNM