Conditions & Treatments

Perimenopause

Perimenopause refers to the transitional period of time before menstruation actually stops, which is marked by changes in the menstrual cycle, along with other physical and emotional symptoms.

Perimenopause

What is perimenopause?

Perimenopause refers to the transitional period of time before menstruation actually stops, which is marked by changes in the menstrual cycle, along with other physical and emotional symptoms. Perimenopause can last two to 10 years and during this time the following processes are occurring within a woman's body:

  • Ovaries release eggs less regularly

  • Ovaries gradually produce less estrogen and other hormones

  • Fertility decreases

  • Menstrual cycles shorten, there are fewer ovulations, and more cycle irregularity

  • Circulating levels of estrogens and progesterone are markedly reduced

  • Androgen (androstenedione) is reduced

  • Testosterone decreases

What causes perimenopause and perimenopausal symptoms?

Perimenopause is caused by the declining function of the ovaries. Ovulation may become erratic and then stop altogether. The menstrual cycle length and flow may become irregular before the final menses (last menstrual period).

As fluctuations of hormones occur, symptoms result from the changing levels of estrogen and progesterone in the body. At times, estrogen levels may be higher, which may trigger symptoms similar to premenstrual syndrome (PMS). At other times, the estrogen levels may decrease, which may trigger hot flashes or night sweats. This fluctuation of estrogen levels may be interspersed with normal menstrual cycles during perimenopause. Research studies demonstrate that perimenopausal women show varying patterns of hormonal fluctuations. No two women will experience perimenopause in the same way.

What are the symptoms of perimenopause?

The following are the most common symptoms of perimenopause. However, each woman may experience symptoms differently. Symptoms may include:

  • Mood changes

  • Changes in sexual desire

  • Difficulty concentrating

  • Headaches

  • Night sweats

  • Hot flashes

  • Vaginal dryness

  • Sleep disturbances

  • Joint and muscle aches

  • Extreme sweating

  • Frequent urination

  • Similar symptoms as experienced with PMS

The symptoms of perimenopause may resemble other conditions or medical problems. Always consult your health care provider for a diagnosis.

Treatment for perimenopause

Specific treatment for perimenopause will be determined by your health care provider based on:

  • Your age, overall health, and medical history

  • Current symptoms

  • Your tolerance for specific medications, procedures, or therapies

  • Your opinion or preference

More and more health care providers are treating perimenopausal symptoms. These treatments may include:

  • Hormone therapy using estrogen or estrogen and progestins (to keep hormone levels more constant)

  • Antidepressants (to stabilize mood swings)

Other lifestyle changes your health care provider may recommend include the following:

  • Eat a healthy diet with fruits and vegetables and whole grains.

  • Get at least 1,000-1,200 mg of calcium each day through your diet or supplements.

  • Exercise regularly.

  • Identify what triggers hot flashes (for example, coffee or tea) by keeping a diary or record to help reduce their likelihood.

  • Discuss the use of other treatments in relieving menopausal symptoms with your health care provider.

Some of the same suggestions used for coping with hot flashes in menopausal women may also be helpful for perimenopausal women. It is important to remember that herbal supplements are not subject to regulation by the FDA, and, therefore, have not been tested in an FDA-approved clinical trial to prove their effectiveness in the treatment or management of medical conditions. Consult your health care provider about symptoms you are experiencing and discuss herbal supplements before beginning use.

To learn more, view the  Online Resources of Women's Health.

Treatment Programs


Massachusetts General Hospital understands that a variety of factors influence patients' health care decisions. That's just one reason why we're dedicated to ensuring patients understand their diagnosis and treatment options. Because a single option might not serve all patients, we offer a wide range of coordinated treatments and related services across the hospital. Patients should consult with their primary care doctor or other qualified health care provider for medical advice and diagnosis information.

Select a treatment program for more information:



MassGeneral Hospital for Children

  • Pediatric Endocrine Program and Diabetes Center
    The Pediatric Endocrinology Program and Diabetes Center at MassGeneral Hospital for Children is an international referral center for the management of pediatric diabetes and endocrine disorders in children and adolescents.
Obstetrics and Gynecology

  • Midlife Women's Health Center
    The Massachusetts General Hospital Midlife Women’s Health Center brings together experts from more than 15 specialties to improve, promote and advance health care for women at menopause and beyond through research, collaboration and education.
  • Reproductive Medicine Program
    The Reproductive Medicine Program at the Massachusetts General Hospital Department of Obstetrics and Gynecology provides sophisticated, compassionate care for reproductive health problems, placing the highest emphasis possible on patient safety.
  • Benign Gynecology Program
    The Benign Gynecology Program at the Massachusetts General Hospital Department of Obstetrics & Gynecology delivers compassionate, expert care for the full range of gynecologic issues.
Benson Henry Institute for Mind Body Medicine

  • Mind Body Program for Women
    Specifically for women. Designed to give women a variety of mind body skills and interventions to decrease medical symptoms and build resilience.
  • Peri/Menopause - Individual Sessions
    Women learn mind body skills designed to reduce stress, enhance resiliency, and reduce symptoms commonly associated with this transition.
Reproductive Endocrine Unit

  • Reproductive Endocrine Associates
    The Reproductive Endocrine Associates provide the highest quality reproductive medical care to both men and women, while providing our patients the benefits of the most recent scientific and technological advances resulting from the ongoing basic and clinical investigations.

View all departments

Departments and Centers at Mass General have a reputation for excellence in patient care. View a list of all departments.