Two-ten Years of Chaos? Be Prepared!
Here, as your gynecology professor, I answer your most burning questions about menopause and gynecology;
Today’s question is a very good one, and also a very basic one. It comes up again and again. And, once you understand the answer to the question, you’ll understand why it comes up again and again.
The question is, “How will I recognize the symptoms of peri-menopause?”
Two Scenarios
In order to answer this question, we need to put it into context for how it will come up in your life. So, there are two different scenarios:
In either case, you need to know how to recognize the symptoms of peri-menopause.
In both cases, peri-menopause is when your ovaries start decreasing their production of estradiol, the estrogen produced by your ovaries, and progesterone. The progesterone decreases first, followed by estradiol.
Ultimately, they both end up at zero. They are both gone, gone, gone by the time you reach post-menopause.
The problem is that none of this happens suddenly. It all happens little by little, producing a few symptoms here, and a few symptoms there. It takes a full two to ten years for both hormones to completely disappear.
And during this long period of time, there are non-linear changes in both of these hormones. That’s what makes it difficult for women to recognize the symptoms of peri-menopause.
Instead of these hormones steadily decreasing, they are actually both on a roller coaster for the full two to ten years. They are erratic. They are chaotic. And the erratic and chaotic nature of these two decreasing hormones causes your entire body and your entire life to be chaotic, too. Your symptoms of peri-menopause are the result of these two hormones erratically, chaotically, and progressively disappearing.
Estradiol and progesterone are the two hormones that produce your menstrual cycles. So your menstrual cycles are a reflection of the decreasing quantities of both of these hormones. However, whether or not you will have any visible symptoms pertaining to your menstrual cycle will depend on whether or not you still have your uterus, and that is why I’ve created two scenarios for our discussion.
With regard to your menstrual cycles, most of the symptoms present themselves as a change in your periods.
For women with their uterus, peri-menopause is a time when their periods become:
But, in addition to those changes in your periods, there’s a whole slew of other changes in various parts of your body that are due to rollercoastering and disappearing estradiol and progesterone. They include all the following:-
All these symptoms make peri-menopause a very “noisy” transition indeed. It really gets your attention! The crazy thing about peri-menopause is that you can have any combination of any thing in either list.
Of course, whether or not you still have your uterus will determine whether or not you have any of the menstrual symptoms. If you still have your uterus, changes in your menstrual cycle may help you recognize peri-menopause as peri-menopause. If you don’t have your uterus, you will have to rely on all the other symptoms that are not menstrual symptoms in order to recognize peri-menopause as peri-menopause.
But my goodness! That list of symptoms that is not related to your menstrual cycles is a very long list of symptoms. And those symptoms span from your head to your toes, from your family life to your work life, and from your physical well-being to your emotional well-being.
Let’s not forget that peri-menopause typically occurs at about midlife. But don’t focus on age for peri-menopause. Age means nothing. Peri-menopause can start at any age. Regardless of your age, you’ll behave like a geriatric teenager and feel like a geriatric trainwreck.
The only thing that is true for all women is that it is going to happen. You are going to become peri- and then postmenopausal at some point in your life. So, it’s important to recognize it when it begins.
The process of peri-menopause can last two to ten years. And since it’s such an erratic, chaotic, rollercoaster, it destroys your quality of life little by little.
Some women wonder why we don’t just use lab tests to determine whether or not you have reached peri-menopause. The reason we don’t use laboratory testing is because the labs are totally unreliable.
I just told you that peri-menopause is a time when your female sex hormones are erratic, chaotic, and on a rollercoaster. So, if you use any sex hormone labs of any kind at any time, you will not see the reality of your situation. Instead, you will get one snapshot in time that does not tell you the whole story.
If you were to check all of your sex hormone labs every day during peri-menopause, the pattern would shock you. You would see something that looks like a seesaw pattern lasting for years. The chaotic appearance would explain why your whole life is chaotic during this time.
There’s no need to prove anything with lab testing when this is an inevitability for all women. You didn’t have to prove puberty with labs. So why prove peri-menopause with labs?
Knowing the symptoms enables you to recognize peri-menopause when it comes knocking. And because the symptoms are wide-ranging and affect so many different aspects of your body and your life, it should be easy to recognize peri-menopause.
Unfortunately, most medical professionals have no education whatsoever on menopause. And because of this unfortunate circumstance, it is not uncommon for a woman experiencing peri-menopausal symptoms to go to her doctor to determine their cause … only to get shut down. All too often, the doctor tells her she’s normal, or she’s crazy, or that her labs are fine. None of these responses is appropriate.
If you encounter any medical professional who dismisses or downplays your symptoms of peri-menopause, keep shopping for one who will listen to you and help you manage your menopause your way.
My goal is to arm you with the ability to recognize the symptoms of peri-menopause so that you can smooth out the hormonal chaos … and therefore smooth out your life. You just have to find a practitioner who will listen to you.
So recognizing peri-menopause will boil down to one or more of the following things:
Either way, your ability to recognize peri-menopause as peri-menopause requires you to know the big long list of symptoms. It’s a noisy transition with all sorts of warning signs.
There’s so much more to it than just hot flashes. And, while women talk about hot flashes, hot flashes are not the most common or the most bothersome symptom of peri-menopause.
Instead, insomnia, joint pain, forgetfulness, weight gain, and vaginal symptoms are much more common and much more bothersome.
You may think you’re lucky if your peri-menopause is “silent,” and you don’t have any symptoms. If so, you are greatly mistaken.
Having symptoms alerts you to the fact that something is wrong. Having any, or even all of the symptoms of peri-menopause, enables you to do something to manage your peri-menopause. Managing your symptoms of peri-menopause can result in prevention of the three diseases of estrogen deficiency, which are heart attack, osteoporosis, and Alzheimer’s Disease.
If you have no symptoms, you do not get the wake-up call that enables you to manage your peri-menopause in a way that prevents the fatal diseases. So you’ll consider yourself “lucky” for not having symptoms, but won’t consider yourself “lucky” when you end up with heart attack, osteoporosis, and Alzheimer’s.
While a silent peri-menopause with no symptoms may seem like a benefit, it is not. A noisy peri-menopause with lots of symptoms is always more life-saving in the long run.
So wake up and recognize the symptoms of peri-menopause as peri-menopause when you have the symptoms of peri-menopause!
Ask Barbie: How Will I Recognize the Symptoms of Peri-Menopause?September 2, 2025 - 11:43 amSymptoms of peri-menopause fall into two categories. Know and watch out for them.
Ask Barbie: Is Early Menopause Linked to Dementia?August 5, 2025 - 7:25 pmLet’s talk about your brain and what happens to it when you lose estradiol, the estrogen produced by your ovaries.
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