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Understanding perimenopause: symptoms and management tips

Posted by Dignity Health Medical Group Staff on 5/22/23 12:20 AM

All women will go through perimenopause, but it is not commonly discussed among women suffering from symptoms or as a women’s health issue in general. 

As we recognize Women’s Health Month, Paniz Heidari, DO, an OB/GYN with Dignity Health Medical Group —  Northridge, discusses what perimenopausal women can expect and when to seek support from your health care team.

Perimenopause vs menopause: What's the difference?

For most women, menopause occurs after they’ve experienced 12 consecutive months without a menstrual cycle. While this is a normal phase of a woman's life, the transitional phase before menopause, also known as perimenopause, can often pose questions for women experiencing symptoms. 

HeidariDr. Heidari says the average age of a woman beginning menopause is around 52 years old, but this can vary depending on genetics or past surgical procedures that may have induced an earlier menopause, such as the removal of the ovaries.

The transitional phase of perimenopause can last from three to five years and in some cases, up to 10 — which means that women in their late 30s and early 40s may experience perimenopausal symptoms. 


Symptoms may include: 

  • Irregular menstrual cycles that are either heavier or lighter than usual
  • Mood irritability
  • Insomnia
  • Brain fog
  • Hot flashes
  • Night sweats
  • Pain during intercourse and vaginal dryness
Dr. Heidari recommends women track their symptoms and menstrual cycle and discuss these changes with their doctor.

Alleviate symptoms 

Symptoms associated with perimenopause can be highly uncomfortable,but there are available treatments for different symptoms. Depending on the severity of the symptoms, hormone replacement therapies may help with hot flashes and brain fog. Mindfulness and behavioral health tactics, including breathwork, medication, and journaling have also been shown to help. Dr. Heidari encourages discussing mental health concerns with a licensed therapist or counselor. 

Certain health risks are associated with perimenopause

Estrogen plays a crucial role in the bone, heart and brain health of women. When estrogen declines during perimenopause, women are at an increased risk for cardiovascular disease, osteopenia and osteoporosis, a condition that causes weak bones. Dr. Heidari  recommends speaking with a physician if a patient has a family history of these conditions, as it may affect one's risk.

Key Takeaways

Perimenopause is a natural part of life, but there is relief for symptoms available with varying treatments and medications. As you enter this phase, it’s important to remember to:
  • Track symptoms and irregularities in menstrual cycles
  • Talk to your physician about treatment options that are right for you
  • Consult your physician on risks of developing heart and bone disease 

Regardless of the symptoms, Dr. Heidari strongly recommends that women speak with their physician if perimenopause is getting in the way of their day-to-day activities. 

If you think you may be entering perimenopause, or need support exploring treatment options, schedule an appointment with your primary care physician. Our “Find a Doctor” tool can help you find a Dignity Health Medical Group physician near you.

Meet Dr. Heidari

Topics: OB/GYN, Women's Health, DHMG - Northridge

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