Perimenopause: what it is, symptoms, age of onset, and how to identify it

Are you noticing changes in your cycle, energy, or sleep and don't know why? Perimenopause could be the cause. It's a natural but often poorly explained stage that can bring many questions.

In this clear, evidence-based guide, you'll understand what perimenopause is, when it starts, its symptoms, and options for managing it better..

What is Perimenopause and Why Understanding This Stage Matters

What is Perimenopause?

Perimenopause is the transitional stage before menopause. During this period, ovarian function begins to become irregular, and hormones fluctuate.

This can lead to changes in your menstrual cycle and other aspects of your body.

While often associated only with hot flashes or irregular periods, perimenopause can involve physical, emotional, and metabolic changes.

What Happens in the Body During Perimenopause?

Perimenopause is part of natural reproductive aging. As menopause approaches:

• The production of estrogen and progesterone fluctuates

• Menstrual cycles become less predictable

• Physical and emotional symptoms appear

These hormonal changes explain why symptoms like these may occur:

• Hot flashes

• Night sweats

• Sleep disturbances

• Mood swings

It's not an illness: it's part of natural reproductive aging.

Differences Between Perimenopause and Menopause

It's important to clearly distinguish between perimenopause and menopause, as they are sometimes used interchangeably when they shouldn't be:

Perimenopause: When Does It Start?

Perimenopause usually begins between the ages of 40 and 50, although it can start earlier in some cases.

There's no exact age, but many women start noticing changes in their cycle several years before menopause. A shorter period, a week of increased irritability, or a couple of nights with hot flashes can be early signs.

Symptoms of Perimenopause

The symptoms of perimenopause vary greatly from one woman to another. Some notice few changes, while others feel their body starts behaving differently from one month to the next.

Among the most common symptoms are:

•        irregular periods (shorter cycles, longer cycles, or missed periods)

•        hot flashes and night sweats

•        difficulty falling asleep or staying asleep

•        irritability and mood swings

•        vaginal dryness

•        fatigue or brain fog

•        changes in body composition and physical recovery

You don't need to have all the symptoms to be in this stage. Often, the first sign is a change in your cycle, with the rest appearing progressively.

Is It Normal to Feel This Way During Perimenopause?

Yes. Perimenopause is a completely natural stage, not an illness. However, just because it's normal doesn't mean you have to resign yourself to feeling unwell.

If the symptoms:

• Affect your sleep

• Alter your mood

• Interfere with your daily life

It's advisable to explore support options. The key is to distinguish between what's expected and what's already affecting your quality of life.

Options for Managing Perimenopause

This is where many women start looking for solutions, and it makes sense: perimenopause isn't always easy to manage with patience alone. There are several complementary layers of support.

Lifestyle Habits

They are the foundation of everything:

• Getting enough sleep

• Maintaining regular physical activity

• Eating a healthy diet

• Reducing factors that worsen symptoms

Small, sustained improvements, maintained over time, help more than you might think.

Menopause Supplements: What the Evidence Says

When we talk about menopause supplements, it's important to put them in the right context: they are a support.

Some examples:

• Creatine: it's starting to be studied in the context of women's health, although specific evidence for this stage is still limited.

• Omega-3: shows variable results depending on the symptom being evaluated.

• Magnesium, Vitamin D, and Calcium: they are usually evaluated based on levels, specific needs, and individual context.

Rather than seeking a single supplement, it's often more useful to adjust based on each person's context.

Medical Support

When symptoms are intense, professional support can make a difference.

There are effective medical options, especially for:

• Intense hot flashes

• Sleep problems

• Significant emotional changes

Perimenopause and Exercise: How to Adapt Your Routine

For active women or those who train regularly, perimenopause particularly affects:

• Recovery

• Energy levels

• Sleep

Some useful tips during this stage:

• Maintain strength training

• Adjust the load based on fatigue

• Prioritize rest

• Prioritize nutrition and hydration to aid recovery

Perimenopause and Hormonal Well-being: How We Understand It at IVB

At IVB Wellness Lab, we understand perimenopause as a stage that deserves clear explanation. Not just because of hormonal changes, but also because it can influence:

• Sleep

• Mood

• Body composition

• How you feel about yourself

Talking about perimenopause with expertise matters. When you understand what's happening to you, you stop experiencing it as chaos and start seeing it for what it is: a real, common, and manageable biological transition. Perimenopause is not the end of anything. It's a stage that deserves attention and support.

Frequently Asked Questions About Perimenopause

What is perimenopause?

It's the transitional stage before menopause, during which hormone production fluctuates and the menstrual cycle may become irregular.

What are the most common symptoms of perimenopause?

The most frequent are irregular periods, hot flashes, night sweats, insomnia, irritability, vaginal dryness, fatigue, or brain fog.

Are perimenopause and menopause the same thing?

No. Perimenopause is the preceding transition; menopause is confirmed after 12 consecutive months without menstruation.

What supplements can help during perimenopause?

It depends greatly on the case. It's advisable to measure, analyze, and evaluate the use of each supplement based on individual needs and, whenever possible, with professional support.

Can you get pregnant during perimenopause?

Yes. As long as ovulation occurs, even if it's irregular, there is still a possibility of pregnancy.

What to do now?

If you think you might be in perimenopause, the first step is to understand what's happening in your body.

From there, you can make informed decisions to improve your well-being. If you want support, you can explore specific options tailored to your situation.

MenoMaster: Your Ally Against Estrogen Decline 

When estrogen levels begin to drop, it's common to experience the typical symptoms of perimenopause. MenoMaster is formulated with natural extracts such as soy isoflavones, valerian, sage, and saffron (Safrasol®). This combination naturally alleviates vasomotor symptoms and helps maintain a positive and relaxed mood.

Total Magnesium: The Essential Mineral for Your Sleep and Energy 

During perimenopause, stress, insomnia, and fatigue often take center stage. Our Total Magnesium (a highly absorbable blend of patented Albion® magnesium bisglycinate and malate) is essential for relaxing your muscles and nervous system. Taking it at night promotes the natural production of GABA (a relaxing neurotransmitter), helping you achieve deeper, more restorative sleep. Additionally, it's vital for improving insulin sensitivity and protecting your cardiovascular health by regulating blood pressure.

FemmeBalance: For Androgenic Imbalance 

Have you noticed sudden acne on your jawline, increased hair loss, or significant fluid retention? During perimenopause, as estrogen levels drop, there can be a relative predominance of androgens (testosterone). FemmeBalance helps reduce this peripheral androgenic activation and modulate prolactin, combating inflammation thanks to turmeric and N-acetylcysteine. It's fully compatible with MenoMaster if you have mixed symptoms!

Vitamin D3+K2: Your Bone and Cardiovascular Shield 

With the decline in estrogen, women lose cardiovascular and bone protection. Vitamin D3+K2 is essential at this stage: vitamin D ensures the absorption of dietary calcium, while vitamin K2 directs that calcium directly to your bones, preventing it from depositing in your arteries. Remember to always take it with your Total Magnesium, as magnesium is responsible for activating and transporting vitamin D in your body.

Taking care of yourself during perimenopause is the best investment for your future. As we always say at IVB: know more to fear less and choose better.

If you have questions about how to combine these products for your specific case, write to us and we'll help you design your ideal routine!

Scientific References

1. “The 2022 Hormone Therapy Position Statement of The North American Menopause Society” Advisory Panel. The 2022 hormone therapy position statement of The North American Menopause Society. Menopause. 2022 Jul 1;29(7):767-794. doi: 10.1097/GME.0000000000002028. PMID: 35797481.
2. Avis NE, Crawford SL, Greendale G, Bromberger JT, Everson-Rose SA, Gold EB, Hess R, Joffe H, Kravitz HM, Tepper PG, Thurston RC; Study of Women's Health Across the Nation. Duration of menopausal vasomotor symptoms over the menopause transition. JAMA Intern Med. 2015 Apr;175(4):531-9. doi: 10.1001/jamainternmed.2014.8063. PMID: 25686030; PMCID: PMC4433164.
3. Harlow SD, Gass M, Hall JE, Lobo R, Maki P, Rebar RW, Sherman S, Sluss PM, de Villiers TJ; STRAW + 10 Collaborative Group. Executive summary of the Stages of Reproductive Aging Workshop + 10: addressing the unfinished agenda of staging reproductive aging. J Clin Endocrinol Metab. 2012 Apr;97(4):1159-68. doi: 10.1210/jc.2011-3362. Epub 2012 Feb 16. PMID: 22344196; PMCID: PMC3319184.
4. Santoro N, Lasley B, McConnell D, Allsworth J, Crawford S, Gold EB, Finkelstein JS, Greendale GA, Kelsey J, Korenman S, Luborsky JL, Matthews K, Midgley R, Powell L, Sabatine J, Schocken M, Sowers MF, Weiss G. Body size and ethnicity are associated with menstrual cycle alterations in women in the early menopausal transition: The Study of Women's Health across the Nation (SWAN) Daily Hormone Study. J Clin Endocrinol Metab. 2004 Jun;89(6):2622-31. doi: 10.1210/jc.2003-031578. PMID: 15181033.