Perimenopause 101 — The Early Hormone Shifts Every Woman Should Understand
What Perimenopause Actually Is
Perimenopause is the transitional period before menopause where hormones begin to shift and fluctuate. Estrogen becomes less predictable, progesterone gradually declines, and ovulation becomes less consistent. This shift can last 4–8 years.
You are not in menopause until you’ve gone 12 consecutive months without a menstrual period.
Common Symptoms Women Often Miss
Many women attribute early signs of perimenopause to stress, aging, or lifestyle. But these symptoms often reflect changing hormonal patterns:
Heavier or lighter periods
Shorter or longer cycles
Night sweats or occasional hot flashes
Mood swings, anxiety, or irritability
Decreased resilience to stress
Sleep disturbances
Increased PMS symptoms
Weight changes, especially around the midsection
Brain fog or difficulty concentrating
Lower libido
Vaginal dryness or discomfort
If you’re experiencing several of these—especially if they’re new—it may be perimenopause.
Why Hormone Fluctuations Affect So Many Systems
Estrogen and progesterone interact with neurotransmitters, metabolism, temperature regulation, and sleep patterns. This is why perimenopause can feel “full body” rather than limited to cycles alone.
Early intervention during perimenopause can improve quality of life and reduce the severity of symptoms later on.
Treatment Options
Care during perimenopause should be individualized. Evidence-based tools may include:
Hormone therapy (may include estrogen, progesterone, and testosterone)
Targeted lifestyle interventions (sleep, resistance training, protein, stress management)
Supplements
Support for sexual wellness
For women who don’t want or aren’t candidates for hormones, there are non-hormonal therapies with strong evidence for symptom relief.
ICONA’s Perspective
We don’t rush women into treatment—but we also don’t wait until symptoms are overwhelming to offer help. Our approach to personalized, lasting results:
Step 1: Initial Visit – Meet with our experienced provider to complete a comprehensive assessment of your symptoms, medical history, lifestyle and goals.
Step 2: Custom Plan – Receive a made-for-you, evidence-based treatment plan.
Step 3: Follow-Up Visits – Provide feedback about your treatment plan so our provider can make adjustments and refine your plan to better serve your goals.
Step 4: Ongoing Support – Follow-up with our provider every 3 to 6 months to ensure your treatment plan is still effective and hormone levels are optimal.
Perimenopause is a transition, not a loss of vitality. With the right support, it can be one of the most empowering seasons of a woman’s life.