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Patient guide · Hormones

Perimenopause and menopause, explained

Hot flashes, irregular periods and a short fuse often start years before menopause itself. Knowing which stage you are in changes the conversation.

An illustration of a clinician and hormone balance

Menopause is one day

The Menopause Society defines menopause as your final menstrual period. It can only be confirmed looking back, once you have gone 12 months in a row without a period. When it happens on its own, the average age is 52 (The Menopause Society).

Perimenopause is the years before

The transition leading up to that last period is perimenopause, and it is often when women first notice changes. The symptoms women bring to Total Body Renewal include:

  • Hot flashes
  • Irritability and mood changes
  • Irregular cycles
  • Lower desire, or less interest in sex
  • Weight that changed without a clear reason
  • Fatigue

Not every symptom is hormonal, and that is the reason for testing. Thyroid problems, low iron or low vitamin D can look much the same.

What the visit looks like

A women’s health consultation at Total Body Renewal is complimentary. Dr. Wood talks through your symptoms and history, and the hormone panel — drawn in the office — looks at estrogen, progesterone, testosterone, DHEA, a full thyroid panel and more.

Treatment options

Hormone replacement therapy is one of the answers Dr. Wood offers. Depending on your labs it can include estrogen, progesterone and, for some women, testosterone. The first recheck comes 8 to 12 weeks after you start, then every three months once you are steady.

The years around menopause can also weaken the pelvic floor. If leaking has started, Emsella treats it while you sit fully clothed.

Questions

Questions about this guide

How do I know if I have reached menopause?

Menopause is confirmed once you have gone 12 months in a row without a period, according to The Menopause Society. The final period itself is the date of menopause.

What is the average age of menopause?

52, for menopause that happens naturally, according to The Menopause Society.

What is the difference between perimenopause and menopause?

Perimenopause is the transition before the final period, when symptoms such as hot flashes and irregular cycles often begin. Menopause is the final period itself, confirmed after 12 months without one.

Do symptoms like fatigue always mean perimenopause?

No. Thyroid problems, low iron and low vitamin D can cause similar symptoms, which is why Dr. Wood orders a panel before deciding on treatment.

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