Perimenopause is the time when your body begins the transition into menopause. It can last anywhere from two to eight years, including the first year after your final period. 

What happens during perimenopause?
During perimenopause, estrogen levels rise and fall unevenly. Your menstrual cycles may lengthen or shorten, and you’ll start having cycles in which you don't ovulate. Only during cycles when you do ovulate can you become pregnant. 

How long does perimenopause last?
The duration of perimenopause varies, but you'll probably notice signs of impending menopause, such as menstrual irregularity, sometime in your 40s. But some women notice changes as early as their mid-30s.

What are the symptoms of perimenopause?
The symptoms of perimenopause include menstrual irregularity, hot flashes and sleep problems, mood changes, vaginal and bladder problems, decreasing fertility, changes in sexual function, bone loss and changing cholesterol levels. If these symptoms interfere with your day-to-day well-being, talk with your doctor. 

Though menopause is a natural phase in a woman’s life, it can start earlier for those who have particular risk factors such as smoking, family history, childhood cancer treatment, never having delivered a baby and having had a hysterectomy. 

Irregular periods are a hallmark of perimenopause and are nothing to be concerned about. However, if your bleeding is extremely heavy, lasts longer than eight days or occurs between periods or if you have periods that regularly occur less than 21 days apart, you should see your doctor.

What to share with your doctor
Monitor your menstrual cycle and record your symptoms for a few months. Also make sure that your doctor knows the names and dosages of all of the medicine you’re taking, including nonprescription drugs and supplements. 

Your doctor may treat your perimenopausal symptoms using oral contraceptives, progestin therapy or endometrial ablation, which is when the lining of the uterus (endometrium) is destroyed using a laser, electrical energy or heat. 

What can you do at home?
Healthy lifestyle choices can help to promote good health as well as alleviate perimenopausal symptoms. Be sure to adopt a low-fat, high-fiber diet rich in fruits, vegetables and whole grains Adding calcium-rich foods helps, and since alcohol and caffeine can trigger night flashes, avoiding them altogether will bring some relief.

Regular exercise can help control weight gain and provides an added bonus of putting you in a better mood! But don’t stop at 30 minutes of exercise a day—be sure to practice regular meditation or stress-reducing activities such as yoga to help you relax.

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