What The Actual F*** Is Perimenopause?

You know how you go your whole life never hearing a word, and then maybe you read the word “panoply” in a book, and all of a sudden you’re hearing “panoply” in songs, and in the muffled conversations between particularly eloquent passersby, and it’s like all of a sudden the word “panoply” was just born? But really … it’s been around. You’re just now aware of it. Well, that’s me and the word “perimenopause”. I’ve heard of “menopause” for just about as long as I’ve heard of “menstruation”. But it’s only been in the last couple of years that I’ve started to read and hear “perimenopause” all over the place. And, as suspected, it’s not a new baby word that was born to be blog fodder, it’s just that I’m freshly aware of it. So I reached out to someone with a panoply of period knowledge, Dr. Jennifer Conti, Ob/Gyn and Co-host of The V Word Podcast, to help define what the actual f*** is perimenopause.

Pre-menopause, perimenopause, and menopause: What’s the difference between the 3?

Dr. Jenn: I think when you’re talking about it medically you often hear menopause and perimenopause, and then colloquially we’ve made up a lot of other words to describe the changes that happen even before that. What people are finding — people with uteruses, especially — is that the lived experience isn’t so black and white. It isn’t like, one day you have periods and one day you don’t have periods. And you have x, y, z symptoms or you don’t. It’s so different for everyone. Sometimes when people describe their perimenopause you’ll hear them say pre-menopause or transition to menopause, and it’s all the same thing.

So is it kind of like a line in the sand that you cross over … ?

Dr. Jenn: Technically, it is! Technically “the menopause” just means “the last time you bleed”. Your last period. How do you know if you’ve gone through it, or if you’ve had your last one? Because, you wait. The way we diagnosis it is actually retroactively. So if someone has not bled for 12 consecutive months, and there’s no other medical reason for that, and they’re in the right age group, then they’ve gone through the menopause. But we’re almost giving them that title, officially, a year after their last period.

So just because someone hasn’t been bleeding for a few months, it doesn’t mean they’re officially menopausal.

Dr. Jenn: Technically you need to have not bled for 12 consecutive months. What happens though is your period definitely starts to change, as do other parts of your body, and symptoms, in the years before that. So, like 4 to 8 years beforehand is typically the average length of the perimenopause, and the average age for the menopause in the US is 51. So there are changes that can occur in that 4-8 years before menopause — or maybe better to say, toward the end of your reproductive years — like, peoples’ cycles can start to shorten a little bit. You’ll hear people say their cycles are getting a little shorter in days, but then they’ll start to lengthen. So then as you’re going through the perimenopause you’ll hear people say they’re getting their cycles every 40-50 days, and then they go away. You’ll like, drop a period. And then you’re just sort of like waiting for the next one. And maybe you’ll have one a couple months later. And then eventually it will get to the point where you won’t have one for 12 months, and then technically it’s menopause.

Alright. Pretty much, wear a pantyliner everyday for the next decade, just in case.

Dr. Jenn: Legit. Have one with you. It’s rough because it’s unpredictable, and different for everyone. It’s not like, you are 41 and 3/4 so now is the time …. You just don’t know. So in terms of convenience, you do just need to always be prepared. But I think the other issue with perimenopause, and the lived experience, is that there are night sweats, there are hot flashes, there’s vaginal dryness, there are mood changes, all this stuff that goes along with it. You just don’t know what your experience will be until you live it.

So with those symptoms — like, me sleeping with a towel next to my bed for when I wake up cold, but sweaty — how do you tell what are normal perimenopause symptoms and what might be worth discussing with a care provider?

Dr. Jenn: Anytime that something is changing with your health, whether it’s night sweats, or mood symptoms, depression, it’s a good idea to check in. Because, at the very least, it’s important to rule other things off the list. Night sweats, if you’re in mid to late 40s, and your period is changing, are likely indicators of perimenopause, but could be caused by other factors.

Are there some best practices for self care during perimenopause to help mitigate those symptoms?

Dr. Jenn: Yes! First, I’d say educate yourself. Whether that’s talking to other people who’ve gone through it, checking in with your doctor, reading about it … the more we educate ourselves, the more we normalize the symptoms and we don’t feel so alone, and that can do wonders for mental health as well. And then for little life-hacks for symptoms like night sweats, I always recommend to people to get moisture-wicking pajamas, that will wick the moisture away better than sleeping in regular cotton. Or sleeping with a fan. And then diet and exercise are huge, too. Now’s the time more than ever to make sure you’re eating a healthy diet, and getting out and staying active and getting those endorphins up. It’s the best natural way to combat any mood changes or other symptoms that you’re going through with the perimenopause.

Thank you so very much to Dr. Jenn for taking the time (right before her 11am appointment!) to define and demystify perimenopause. There are changes ahead, folks. Better grab a few pantyliners, just in case.


Dr. Jenn Conti, Ob/Gyn, co-host of The V Word Podcast.

Dr. Jennifer Conti is one of our favorite trusted voices in reproductive and menstrual health. Tune in to listen and learn with Dr. Jenn and Dr. Erica on The V Word Podcast.

Follow @vwordpod on Instagram and Twitter.