Understanding the Symptoms of Perimenopause and Menopause and What Comes Next

Perimenopause and menopause affect millions of women, bringing changes to the menstrual cycle, mood, sleep, fertility, and more. Learn what symptoms to expect, how to manage them, and when to talk with your doctor.

Women’s bodies go through many transitions over a lifetime, and perimenopause and menopause are among the most significant. These changes are natural, but they can also be confusing, disruptive, and emotional. For some, it starts with a few irregular cycles or a shift in sleep or mood. For others, symptoms come on stronger and faster.

Wherever you are in the transition, having a clearer understanding of what is happening in your body and knowing what kinds of care and support are available can help you feel more in control and less alone. These changes are personal, but you don’t have to navigate them without help. Compassionate, informed care can make a world of difference.

Perimenopause Symptoms and What They Mean for Your Health

Perimenopause is the period leading up to menopause when hormones like estrogen and progesterone begin to fluctuate. These shifts can affect everything from your cycle to your energy levels and mood.

Perimenopause often begins for women in their 40s, though some notice changes earlier. Periods can become irregular. You might feel more tired, have trouble sleeping, find it harder to focus, or feel more emotionally uneven. Skin changes, weight shifts, and changes in libido are also common.

Because symptoms build gradually, they’re often mistaken for stress or just “getting older.” But these signs may be clues that your body is entering a new phase.

Can You Still Get Pregnant During Perimenopause?

Pregnancy is still possible during perimenopause. A common misconception is that fertility disappears once cycles become irregular. But ovulation continues, just less predictably, which means conception can still happen.

Whether planned or unplanned, pregnancies during perimenopause carry higher risks. These may include a greater chance of complications such as gestational diabetes, high blood pressure, or chromosomal differences. That’s why it’s important to work closely with your provider if you’re thinking about pregnancy during this stage.

If you’re not trying to get pregnant, it’s important to continue using contraception as prescribed by your doctor. Birth control pills are often used during this phase, not just for pregnancy prevention but also to help regulate cycles and ease symptoms like heavy bleeding or mood shifts.

If you're unsure about your fertility or family planning goals, an OB/GYN can help you understand your options and what steps make the most sense for your health.

What Happens When You Reach Menopause

For some women, reaching menopause brings a sense of relief. The uncertainty of irregular periods fades, and the constant shift in hormone levels begins to settle. It can feel like the body is finally finding a new rhythm.

At the same time, this phase can bring new adjustments. While some symptoms like frequent bleeding or intense mood swings may ease, others such as hot flashes, night sweats, sleep problems, and vaginal dryness may continue. For many women, it takes time to understand what their bodies need in this next stage.

This is also a time when staying connected to your overall health becomes even more important. Monitoring bone strength, heart health, and emotional well-being can help you feel healthier and more confident in the years ahead.

Menopause marks the end of one chapter, but it opens the door to another. With the right care and information, this can be a time of renewed attention to your health and a stronger connection to your body.

What Perimenopause and Menopause Can Feel Like

No two experiences are exactly alike. Some women notice only a few changes. Others find that symptoms affect many areas of daily life.

Common symptoms may include:

• Hot flashes or night sweats
• Difficulty falling or staying asleep
• Forgetfulness or mental fog
• Mood swings or emotional sensitivity
• Skin changes, including dryness or sensitivity
• Shifts in libido or sexual comfort
• Fatigue or low energy
• Weight gain or body composition changes

These are all common experiences, and you have options to find relief.

Navigating the Emotional Ups and Downs

The emotional side of perimenopause and menopause is often less visible, but its impact on your life matters just as much. Hormonal changes can affect how you process stress, how clearly you think, and how steady your mood feels. You might feel more anxious than usual or experience sadness without an obvious cause. Some women say they feel like a different version of themselves. This stage of life often arrives during a busy chapter in your life, and it might feel harder to cope with everything on your plate.

Your mental well-being is just as important as your physical health. Whatever you’re experiencing, you deserve support that meets you with care and respect.

Finding Relief and Support

There’s no single solution for managing perimenopause or menopause. The most effective approach depends on your symptoms and what works for your lifestyle.

Treatment options include:

• Hormone therapy – Effective for hot flashes, sleep issues, mood changes, and vaginal dryness. Progesterone is typically added if you still have a uterus. Learn more about this option below!
• Low-dose antidepressants – May help ease hot flashes and support mood.
• Non-hormonal medications – Some are specifically designed to manage hot flashes or insomnia.
• Vaginal moisturizers and lubricants – Can relieve dryness and discomfort during intimacy.
• Lifestyle changes – Exercise, balanced nutrition, and stress-reduction techniques like yoga or mindfulness can support overall well-being.
• Birth control pills – Often prescribed during perimenopause to regulate cycles and reduce symptom intensity.

The best treatment plans are tailored to your individual needs. Talk with your provider about what feels supportive and sustainable for you.

Care That Looks at the Whole You

At Kelsey-Seybold, our OB/GYNs work closely with primary care doctors and specialists to offer coordinated, thoughtful support. Whether you’re just noticing changes or have been managing symptoms for years, we’re here to help you move forward with confidence.

Let’s Talk About What You’re Feeling

You may be wondering if your symptoms are perimenopause or menopause or whether treatment could help you feel more like yourself again. Our OB/GYN team brings experience and compassion to women’s midlife health. We’re here to talk through your symptoms, explore your options, and help you find a care plan that fits where you are now.

Visit our website to learn more or schedule an appointment. You deserve care that supports you every step of the way.

What To Know About Hormone Therapy

Hormone therapy is one of the most effective ways to relieve symptoms like hot flashes, sleep disruption, mood changes, and vaginal dryness. But many women hesitate to start hormone therapy because of outdated information or mixed messages. Here’s what current research tells us:

• Is it safe? For most healthy women under age 60, or within 10 years of menopause, hormone therapy is considered safe and beneficial. Studies show that starting therapy early can make a meaningful difference, and for many, the benefits outweigh the risks.
• What about breast cancer and heart disease? The risk is smaller than many assume. Estrogen alone (for women without a uterus) may even reduce breast cancer risk. For those who need both estrogen and progesterone, the increased risk is minimal and comparable to that associated with many other common medications. Early use may also support heart and bone health.
• Why add progesterone? If you still have a uterus, progesterone protects the uterine lining and makes estrogen therapy safer.
• Are there alternatives? Yes. If hormone therapy isn’t the right choice, there are non-hormonal options that can still bring meaningful relief.
• How do I decide? There’s no one-size-fits-all answer. A provider who understands your health history can help you weigh the options and make a decision that feels right.

You deserve to feel confident in your care. The science is clearer than ever, and you don’t have to make these decisions alone.