Signs Perimenopause Is Ending, What to Expect, and How to Support Your Body
Navigating the changes your body undergoes during perimenopause can feel like a hormone-driven roller coaster. For many, knowing what to expect can be both reassuring and empowering.
As a nurse practitioner, I’ve had countless conversations with women about the nuances of this stage of life. What does perimenopause look like? How long does it last? And are there signs perimenopause is ending? Let’s explore what you need to know.
What Is Perimenopause (and Menopause)?
First, let’s start with some basic definitions.
Perimenopause, literally meaning “around” menopause, is the transitional phase all women go through leading up to menopause, and it can last anywhere from three to 10 years. During this time, women’s hormone levels begin to change, with progesterone production gradually declining and estrogen production fluctuating up and down. Perimenopausal symptoms stem from these hormone changes, and can range from mild to disruptive.
Menopause is, by definition, when a woman goes a full year without a menstrual period. Once you hit that milestone, perimenopause is officially over. By this point, hormone levels settle into their new normal and perimenopausal symptoms gradually improve.
Signs and Symptoms of Perimenopause
It’s important to understand that the signs of perimenopause are wide-ranging and often vague. Many common perimenopausal symptoms, such as mood changes or heart palpitations, can also indicate completely unrelated health conditions, so a clear diagnosis often requires a conversation with your healthcare provider. A physician can investigate your hormone levels and other symptoms to uncover the root cause.
With that in mind, some signs of perimenopause women commonly experience include:
Irregular Periods: One of the earliest signs of perimenopause is an unpredictable menstrual cycle. You might notice shorter or longer gaps between periods. Sometimes the timing feels like an “accordion,” where bleeding lasts a short time one month, takes a break the next, and then suddenly shows up for 10 days.
Hot Flashes: This notorious symptom can be sudden and intense, making you feel flushed and sweaty.
Night Sweats: Night sweats can disrupt your sleep, leaving you feeling exhausted (and icky).
Insomnia or Sleep Disturbances: Many people report a newfound struggle with sleep during perimenopause. If you’re waking up at odd hours or struggling to fall asleep, it could be related to hormonal shifts.
Mood Changes: From irritability to bouts of anxiety, mood fluctuations catch many women off guard. The drop in progesterone in particular can lead to more anxious or unsettled feelings.
Vaginal Dryness: The reduction in estrogen can lead to vaginal dryness, causing discomfort during intercourse and more frequent UTIs.
Decreased Libido: Women may also experience decreased libido due to the drop in hormones. Symptoms that affect intimacy can feel isolating and difficult to discuss, but they’re worth addressing with your healthcare provider. Solutions are available, and you’re not alone.
Heart Palpitations: Some women experience heart palpitations, which can seem quite concerning. However, heart palpitations can result from stress or other medical conditions as well, so it’s important to bring this symptom up with your doctor.
Migraines: New or worsening migraines may appear during perimenopause, and can significantly impact your daily life. It’s another reminder that perimenopause symptoms are broad and sometimes unexpected.
Weight Gain: One of the most frequent and frustrating complaints that accompanies perimenopause is seemingly unexplained weight gain. Due to hormone fluctuations, you may begin to put on a few extra pounds, especially around your belly, even if your eating and exercise routines haven’t changed.
How to Manage Perimenopause Symptoms
As a nurse practitioner, I want women to know that you don’t have to suffer in silence. Interventions — both medical and lifestyle-oriented — exist to help mitigate the signs of perimenopause and make this stage of life more manageable.
Here, I’ll discuss several lifestyle strategies that can support women during this time.
Focus on Anti-Inflammatory Nutrition
In my experience, I’ve observed that women with lower overall inflammation tend to experience fewer and/or less severe signs of perimenopause. And one way to tackle inflammation is through anti-inflammatory nutrition.
Eating a Mediterranean-style diet is an excellent way to reduce inflammation (and manage weight gain). Load up on healthy fats from sources like avocados and olive oil, and incorporate omega-3-rich foods, like salmon and flaxseeds. Reducing, but not eliminating, your carbohydrate intake can be helpful as well; for the carbs that remain, focus on high-fiber items like brown rice and sweet potatoes.
While these general guidelines seem to benefit many, every woman’s body is unique. Experiment to find the nutritional rhythm that works for you.
Keep Your Body Moving
Regular exercise isn’t just about burning calories. Movement, especially weight-bearing exercise, is critical for maintaining bone health as your estrogen levels drop.
Aim for at least 30 minutes of movement daily. Yoga, strength training, or even a brisk walk can work wonders for both your mood and hormone balance.
Prioritize Sleep Hygiene
Perimenopause often introduces sleep disturbances, but getting quality sleep is an effective way to manage symptoms. It might seem like a catch-22, but there are steps you can take to improve your rest. Aim to boost your sleep hygiene with steps like these:
Establish a consistent bedtime.
Avoid screen time at least one hour before bed.
Create a calming environment in your bedroom.
Consider bedtime supplements like magnesium glycinate or melatonin (though use of the latter can be controversial).
Signs Perimenopause Is Ending
The only definitive sign perimenopause has ended is the complete cessation of your period for a year. Before this point, however, you may notice some signs that indicate perimenopause is ending soon. They aren’t one-size-fits-all, but some common developments include:
Longer gaps between periods: Your periods may become fewer and farther between before disappearing altogether.
Worsening or easing symptoms: Some symptoms, like hot flashes, may intensify as your hormone levels drop more steeply. Others, like irregular bleeding or migraines, may gradually resolve.
Remember, your experience is uniquely yours. The signs perimenopause is ending can overlap with the symptoms of menopause itself, making it tricky to pinpoint the exact transition. Ultimately, menopause is defined retrospectively, once you’ve gone a full year without a period.
Final Thoughts on the Signs Perimenopause Is Ending
The signs perimenopause is ending (or beginning) may be subtle or pronounced, but recognizing and understanding them can help you feel more prepared. Remember that this journey is a natural part of life. Listening to your body, making healthy lifestyle choices, and consulting with your healthcare provider can make this transition smoother.
Remember, you’re not alone. If your perimenopause symptoms are disrupting your quality of life, reach out, ask questions, and find the support you need to return to feeling like yourself again.
Katherine Jacobs, RN, MSN, FNP-BC
Katherine Jacobs is a board-certified Family Nurse Practitioner with nearly two decades (17 years) of experience in pediatrics and women's health, along with specialized training from The Institute of Functional Medicine. She focuses on identifying the root causes of illness and guiding patients toward optimal health through personalized, holistic care. With a commitment to integrating lifestyle choices and environmental factors into her treatment plans, Katherine is dedicated to empowering her patients on their wellness journeys. Outside of work, she enjoys outdoor adventures, baking, and spending time with her family.
Disclaimer: The content on the Haven Birth and Wellness website is created and/or reviewed by qualified Certified Nurse Midwives and healthcare professionals. We strive to provide accurate and detailed information for our readers. However, this blog is intended for informational purposes only and should not be considered a substitute for professional medical advice. Your own healthcare provider is best equipped to understand your unique situation and medical history. Always consult with your healthcare provider before making any decisions that may affect your health.