Perimenopause Symptoms: What to Expect and How to Manage Them Effectively

Article by: By Dr. Salina Sany, Consultant Obstetrician and Gynaecologist

06 June 2025

Perimenopause is a natural yet often misunderstood phase in a woman’s life. As your body begins the transition to menopause, hormonal fluctuations can cause a variety of physical and emotional symptoms. Many women don’t realise they’re in this stage until these symptoms start affecting daily life. This article explains what perimenopause is, how to recognise its symptoms, and practical ways to manage your health during this significant transition, often with the guidance of an obstetrician and gynaecologist specialist.

What is Perimenopause?

Perimenopause, also known as the menopausal transition, is the phase leading up to menopause. During this time, the ovaries gradually produce less oestrogen, causing hormonal changes that affect the body in multiple ways. Unlike menopause — defined as no menstrual periods for 12 consecutive months — perimenopause can start several years earlier, typically in a woman’s 40s, but sometimes as early as the mid-30s or as late as the early 50s. 

In Malaysia, most women reach menopause between the ages of 50 and 52.

Common Perimenopause Symptoms

The hormonal shifts during perimenopause may cause a wide range of symptoms, including:

• Irregular periods (shorter, longer, heavier, or lighter cycles)
• Hot flashes and night sweats
• Difficulty sleeping or insomnia
• Mood swings, anxiety, or depression
• Vaginal dryness and discomfort
• Reduced libido or sexual desire
• Brain fog or memory difficulties
• Unexplained weight gain or changes in body shape

Symptoms vary widely between individuals; some women experience many, while others may have only a few mild symptoms.

Perimenopause vs Menopause: What’s the Difference?

Confusing perimenopause with menopause is common. Here’s a simple way to distinguish them:

• Perimenopause: The phase before menopause, characterised by fluctuating hormones and irregular periods. Symptoms start to appear but menstruation still occurs intermittently.
• Menopause: Officially diagnosed after 12 consecutive months without a period, marking the end of reproductive years.

If you experience menopausal symptoms such as missed periods, night sweats, or mood changes but still have occasional bleeding, you are likely in the perimenopausal stage.

How Long Does Perimenopause Last?

Perimenopause can last anywhere from a few months to up to 10 years. The duration varies widely depending on genetics, lifestyle, and overall health. On average, most women spend about 4 years in this transition phase.

Managing Perimenopause Symptoms

You don’t have to suffer in silence. Here are evidence-based strategies to ease symptoms:

• Eat a balanced diet: Focus on calcium, iron, fibre, and foods rich in phytoestrogens like soy and flaxseeds.
• Stay active: Regular exercise, including walking, yoga, or swimming, improves mood and reduces hot flashes.
• Prioritise sleep: Establish good sleep hygiene, avoid caffeine late in the day, and consider relaxation techniques.
• Manage stress: Meditation, deep breathing exercises, and hobbies can lower anxiety and mood swings.
• Use vaginal moisturisers or lubricants: These relieve dryness and discomfort during intimacy.
• Consider hormone therapy: Consult a healthcare provider if symptoms are severe or impact your quality of life. Hormone Replacement Therapy (HRT) can be effective but must be personalised and monitored.
   

When Should You See a Doctor?

If symptoms interfere with daily life or if you’re uncertain whether your changes are related to perimenopause, seeking medical advice is important. A gynaecologist may suggest:

• A comprehensive health screening to assess symptoms and menstrual cycle changes
• Blood tests to check hormone levels
• Pelvic ultrasound or pap smear if needed

For those searching for a gynaecology clinic or specifically a gynaecologist clinic in Penang, Sunway Medical Centre Penang offers comprehensive services. Early diagnosis allows for better management and personalised care.

Perimenopause is a natural, important transition in a woman’s life, not a disease. By recognising symptoms early and seeking proper support, you can navigate this stage with confidence and ease. Remember, you’re not alone, and many resources and treatments are available from obstetrics and gynaecology doctors to support your health and well-being.

FAQs About Perimenopause
Q: Can perimenopause symptoms be prevented?
A: While you can’t fully prevent perimenopause, healthy lifestyle choices such as diet, exercise, and stress management can reduce symptom severity.

Q: Is hormone therapy safe?
A: Hormone therapy is generally safe when prescribed appropriately and monitored by a healthcare professional, but it may not be suitable for everyone.

Q: What are some natural remedies for hot flashes?
A: Lifestyle changes like avoiding triggers (spicy foods, caffeine), staying cool, and practising relaxation can help manage hot flashes.