Perimenopause Symptoms and Support: A Family Medicine Doctor Explains What to Expect

Written By Dr. Osondu

By Dr. C. J OSONDU

Specialist in Family Medicine, registered and licensed by the College of Physicians and Surgeons of Alberta.

Many women are familiar with the concept of menopause, but few are aware of the stage that comes before it, called perimenopause. This phase can bring a range of physical and emotional changes and often starts without any warning. It is a normal part of aging, but it can still be disruptive and confusing.

As a GP, I regularly speak with women who are unsure whether their symptoms are part of perimenopause. This guide provides an overview of what to expect and how to manage the transition with confidence and care.

What Is Perimenopause

Perimenopause is the period when the ovaries begin to reduce the production of key hormones, particularly estrogen and progesterone. This typically begins in a woman's late 30s or early 40s and can last for several years before the final menstrual period.

Unlike menopause, which marks the end of menstrual cycles, perimenopause involves fluctuating hormone levels. This hormonal variation is why symptoms may come and go or feel inconsistent over time.

Common Symptoms of Perimenopause

Perimenopause can present in many ways. Common signs include:

  • Irregular periods, with changes in flow or skipped cycles

  • Hot flushes and night sweats

  • Increased anxiety or low mood

  • Mood swings or irritability

  • Difficulty with concentration or memory

  • Weight gain, especially around the abdomen

  • Poor sleep quality or insomnia

  • Vaginal dryness or discomfort during intercourse

  • Reduced libido

  • More intense premenstrual symptoms

  • Migraines that become more frequent or severe

  • Joint aches, heart palpitations, or changes in skin condition

These symptoms may develop gradually and can vary in intensity. Every woman experiences perimenopause differently.

Is Treatment Necessary

Not all women will need medical treatment, but it is important to know that help is available. There is no need to struggle through symptoms alone.

Treatment options may include:

  • Adjustments to nutrition, physical activity, and lifestyle habits

  • Hormone replacement therapy when clinically appropriate

  • Non hormonal medications to address mood changes, sleep difficulties, or hot flushes

  • Vaginal estrogen for dryness or urinary discomfort

  • Supplements to support bone strength, heart health, and cognitive function

  • Pelvic floor therapy or support for sexual wellbeing

The right plan will depend on your symptoms, medical history, and personal goals. A personalised approach is essential.

Why This Phase Matters

Perimenopause is not only a lead-up to menopause. It can have lasting effects on cardiovascular health, bone density, mental clarity, skin, metabolism, and emotional wellbeing. Early support can reduce long-term risks and improve quality of life during and after the transition.

Final Thoughts

If you are between the ages of 35 and 50 and have noticed changes in your body or mood, you are not alone and you are not imagining it. Perimenopause is a real and meaningful phase in a woman's life.

At EverWell Clinic- Lynnwood, we offer personalized care and evidence based treatments to help you manage this transition with clarity and confidence. Whether you are seeking reassurance or active treatment, we are here to support you. When primary care management is unsuccessful, or when additional medical concerns arise, we facilitate referral to appropriate specialists, including Gynecology and Endocrinology.

Dr. Osondu