Menopause occurs naturally in a woman one year after her last period. Around this time, major changes take place that affect the body’s levels of the hormones progestin and estrogen—changes that can also cause unpleasant symptoms such as vaginal dryness, hot flashes, mood swings and loss of libido. Perimenopause is the transition stage in a woman's reproductive life that begins, on average, 4 to 5 years before menopause. During that time, your ovaries gradually produce less estrogen, causing follicle-stimulating hormones (FSH)—which are responsible for growing and developing eggs—to rise and menstrual cycles to shorten. Eventually, you begin to miss periods. Then estrogen plummets, FSH levels remain high, and ovulation (and finally menstruation) stops. When you've gone 12 months without a period, perimenopause ends and menopause officially begins.
What's reassuring: Shifting hormones don't make you any less healthy, says Nanette Santoro, MD, director of the division of reproductive medicine at Montefiore Medical Center/Albert Einstein College of Medicine. And there's a lot you can do—from diet and lifestyle changes to medications—to reduce your symptoms dramatically. Here is how to recognize the signs and successfully navigate this next phase of life with your health and happiness intact.