Life's transitions
Preparing for perimenopause

As Julia dealt with yet another unpredictable period ruining a vacation, she wondered what it would be like to never have her period again. She knew that was in her near future—along with possible hot flashes and mood swings—when she entered menopause.

Julia was years away from the milestone of menopause that typically arrives around age 50. But she was actually in the midst of perimenopause, a less well-known stage of a woman's reproductive years when hormone levels begin to change, bringing unpredictable periods among its symptoms.

What is perimenopause?

Toward the end of your reproductive years, perimenopause is the two to eight years before menopause and one year after your last period. This natural transition usually starts sometime in your 40s, but some women notice changes as early as their mid-30s.

Hallmarks of perimenopause include:

Irregular periods. As your estrogen and progesterone hormones start to rise and fall unevenly, your periods may be longer or shorter, lighter or heavier and you may skip some periods.

Hot flashes. About 65% to 75% of perimenopausal women experience hot flashes, or sudden rushes of heat in your upper body.

Sleep problems. Tossing and turning at night are common during perimenopause.

Mood changes. Some women experience mood swings, irritability or depression during perimenopause.

Vaginal and bladder problems. Low estrogen levels can lead to vaginal dryness, urinary or vaginal infections. Loss of tissue tone may contribute to urinary incontinence.

Decreasing fertility. Your ability to conceive decreases as ovulation becomes irregular, but you can still get pregnant as long as you're having periods.

Changing cholesterol levels. Low estrogen may lead to increased low-density lipoprotein (LDL) or "bad" cholesterol and decreased high-density lipoprotein (HDL) or "good" cholesterol. These changes increase your risk of heart disease.

Positive transformations

Ease your symptoms and stay healthy and positive by:

Eating healthy. Adopt a low-fat, high-fiber diet rich in fruits, vegetables, whole grains and calcium-rich foods such as dairy products. Avoid alcohol, caffeine or spicy foods that can trigger hot flashes.

Staying active. Regular exercise helps prevent weight gain, improves sleep, strengthens bones and elevates your mood.

Reducing stress. Practicing meditation, breathing techniques or yoga, and taking time out for yourself can promote relaxation and good health, and reduce hot flashes and insomnia.

Staying connected. Social support and laughing with friends are key to health and happiness.

Staying mindful. Do you view the glass as half full or half empty? The absence of positive thoughts can have a greater negative impact on your health and well-being than the presence of negative ones. Try writing down three things every night for which you are grateful.

When to see a doctor

Not all women are bothered by their perimenopausal symptoms. However, see your doctor if you experience menstrual bleeding that occurs between periods, is extremely heavy, lasts longer than eight days or if your periods regularly occur less than 21 days apart.

The transition to menopause can be challenging, but can also be a time for inspiration and personal growth. Talk to your doctor if you're concerned about your perimenopausal symptoms.