More than 20 million American women are currently going through perimenopause, a natural part of aging that can begin as early as age 35 and as late as 59. Perimenopause literally means "around menopause" and begins with hormone-related changes involving estrogen, progesterone and other hormones. It can last for as long as 10 years before menopause, which begins 12 months after a woman's final period and in the U.S. comes at an average age of 52.


The most classic symptom is an erratic menstrual cycle and, according to a study, 70 percent of women in their 40s experience irregular menstrual periods. Cycles can vary from 18 days to missed periods and excessive bleeding is common. A decline in estrogen during perimenopause causes many symptoms including:

  • Memory lapses and loss of concentration: Estrogen stimulates neurons, helps generate new synapses and triggers the production of substances that promote neuronal growth. It helps the brain learn and remember.
  • Mood swings: Estrogen stimulates the production of the brain chemical serotonin, which regulates emotion.
  • Dry Skin: A decrease in the protein collagen may be linked to a decline in estrogen, causing less elasticity and more wrinkles.
  • Bone Loss: Estrogen protects bone mass and those who go through early perimenopause may be at higher risk for osteoporosis.
  • Hot Flashes: A decline in estrogen changes the body's thermostat (the hypothalamus in the brain) and triggers hot flashes around the head and upper body as well as nocturnal night sweats.
  • Insomnia: Estrogen stimulates the production of serotonin which regulates sleep.

How to Alleviate Symptoms

Some of the ways to alleviate symptoms are through diet and exercise. It is important to:

  • Avoid alcohol and spicy foods in order to minimize hot flashes.
  • Have no caffeine (especially after midday) in order to sleep better.
  • Partake in weight-bearing exercise (including walking) to stimulate the production of new bone growth.
  • Eat calcium-rich foods including low-fat yogurt and spinach.
  • Take vitamin B6 which turns amino acids into the neurotransmitter serotonin, affecting mood, and Vitamin E, an antioxidant that may help hot flashes.
  • Drink or take soy, which is loaded with plant estrogens.  It may reduce hot flashes.
  • Eat flaxseed (powder or oil), an herb containing omega-3 fatty acids. It may reduce heavy menstrual bleeding.

Women who smoke enter perimenopause earlier and reach menopause about a year and a half sooner than those who don't.


The National Women's Health Information Center, North American Menopause Society, Newsweek "Health for Life" and Shady Grove and Washington Adventist Hospitals. . The Health Tip of the Week is for educational purposes only.  For more information, please consult your physician.

These Health Tips are for educational purposes only. For additional information, consult your physician. Please feel free to copy and distribute this health resource.