Perimenopause: A Roller Coaster of Hormones and Symptoms

Perimenopause—the years leading up to menopause—is often called a “transition,” but for many women, it feels more like a roller coaster of unpredictable symptoms. Hormone levels rise and fall unevenly, affecting not just periods but the brain, blood vessels, bones, mood, and more. On average, perimenopause begins in a woman’s 40s and lasts 4 to 8 years, though for some women it may be shorter or extend up to 10 years. It ends when a woman has gone 12 consecutive months without a menstrual period, marking the start of menopause. During this time, fluctuating hormones can produce symptoms like irregular periods, hot flashes, mood changes, headaches, sleep disturbances, cognitive challenges, and palpitations—sometimes all at once. These changes aren’t just uncomfortable—they interfere with work, relationships, exercise, travel, and daily life. To illustrate what this can look like, here are some stories I've heard from my patients. If you recognize yourself, know that you’re not alone and that there are effective ways to manage symptoms.

The Juggling Act of Perimenopause

“I don’t know what’s happening to me. One week I’m snapping at everyone, the next I’m crying in the car. My periods are heavier and more unpredictable than ever. I wake up drenched in sweat at 2 a.m. most nights, and lately, I’ve started getting headaches that remind me of my old college migraines. It feels like everything in my body is out of sync.”

Want to read more?

Subscribe to purelymenopause.com to keep reading this exclusive post.

Subscribe Now