Perimenopause Recast as a Prolonged Transition Calling for Proactive Care

Overview

• Doctors describe perimenopause as the years before menopause when estrogen and progesterone decline, with menopause confirmed after 12 consecutive months without menstruation.
• Reported symptoms span irregular cycles, hot flashes, night sweats, sleep disturbance, irritability and anxiety, decreased libido and vaginal dryness, with neurotransmitter shifts linked to mood changes.
• Sexual desire, lubrication and sensitivity commonly change during this phase, while work pressures, caregiving and fatigue often compound reduced libido.
• Clinicians warn of rising cardiovascular risk from abdominal fat and adverse cholesterol changes, along with loss of bone and muscle mass, calling for screening and regular follow-up.
• Guidance centers on exercise with strength training, pelvic‑floor work, sleep and stress care, nutrition, supervised supplements such as omega‑3, magnesium and vitamin D, and medical review for hormone therapy when symptoms disrupt daily life, with individualized plans when tests appear normal despite persistent complaints.