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Perimenopause Symptoms: What is Perimenopause

by | Last updated: Apr 7, 2022 | Menopause, Perimenopause | 3 comments

In this article, I expand on perimenopause symptoms. Hi, I’m Deborah Maragopoulos, Intuitive Integrative Nurse Practitioner. I wrote this because I want you to understand what the perimenopausal symptoms are, so you are prepared for the change of life.

The first thing you need to understand, is that perimenopausal symptoms are caused by a shift in your hormones. The image above is the menstrual cycle. Your first few days of your menstrual cycle, none of your hormones are very high. Estrogen progesterone levels are very low. In a normal menstrual cycle, estrogen doesn’t start to rise till day five or seven. Even as late as day nine prior to ovulation. And only after ovulation do your progesterone levels rise. In perimenopause, because you are running out of eggs, you stop making as much progesterone first. Then you start to have issues with low estrogen levels. Those will cause a myriad of symptoms.

Hormone Healing Tip 1: Discern if you have Perimenopause or Not

But the first thing that we are going to talk about is the number one issue. Whether or not you are having perimenopause, increased PMS, or premature ovarian failure. Perimenopause is the five to 15-year period before you actually go through menopause and stop having menstrual cycles altogether. PMS of course is the time before your menstrual period when your symptoms are exaggerated.

But perimenopause can look like exaggerated PMS. And premature ovarian failure looks like menopause. But it happens very early. Usually before the age of 35. Clinically, it’s before the age of 40. But I am seeing perimenopausal patients as early as 37, 38, 39, starting into perimenopause.

So what are perimenopause symptoms?

Hormone Healing Tip 2: Figure out your Progesterone

Well, number two is, you really need to look at what are the low progesterone symptoms. Progesterone is really your hormone to actually calm down your body. Calm down the growth factors that are related to estrogen so that you don’t bleed as heavily. So you have regular cycles.

The first thing that happens when you have less progesterone production is that your cycles become very irregular. One of the first signs of perimenopause is irregular cycles. Either becoming very short, going from perhaps a 28 to 30 day cycle to more of a 21 – 23 day cycle. Or your body is starting to skip periods altogether. You can have premenstrual spotting and also your periods will last longer. So if you normally only bleed for three to five days, you may be spotting a few days before, bleeding for a few days and spotting a few days after. That is all a sign of very low progesterone levels that we see in perimenopause.

Progesterone also helps you with your stress and anxiety. So when your progesterone levels start falling, you tend to get stressed out a lot more easily when you are in perimenopausal mode. Which is why it seems like your PMS is exaggerated. But it’s PMS that does not end. It’s not just the week before, or a few days before your period. It may be a full two to three weeks before you start menstruating. That’s because your progesterone levels have fallen.

Hormone Healing Tip 3: Is your Estrogen Imbalanced?

The third symptom of perimenopause is estrogen imbalance. A lot of the symptoms of perimenopause are related to the estrogen levels being out of balance with progesterone. Not only is your estrogen levels lower, but they are out of balance with progesterone. You have estrogen dominance, too much estrogen compared to progesterone and your estrogen levels are lower than you are used to. So you can have swollen breasts or very tender breasts, an estrogen dominant symptom, and also have night sweats which is an estrogen deficiency symptom. You are not making much estrogen as you did earlier new reproductive years, but because your estrogen is out of balance with progesterone, you are actually feeling like you have a little bit too much estrogen on board.

You will see weight gain, insomnia, you are going to have issues with breast tenderness, you may have some issues with even an increase in hair shedding and hair losses, your estrogen levels fall. Memory issues, focus issues, concentration issues, all of these are symptoms of low estrogen, and the weight gain, especially the water retention is an estrogen level that is out of balance with progesterone, all symptoms of perimenopause. Sometimes in perimenopause, you can have such exaggerated PMS symptoms that it almost feels like you’re having the flu, like flu-like aches and pains, slightly feverish, and that is all because your progesterone levels have fallen.

So, if you are having any of these symptoms of perimenopause:

  • breast tenderness
  • bloating
  • weight gain
  • insomnia
  • hot flashes
  • irregular periods
  • skipping periods
  • mental fog
  • brain fog
  • trouble focusing
  • lack of concentration
  • moodiness
  • irritability
  • what feels like increased PMS

Those are all signs of perimenopause.

What I want you to do when you are done reading this, is to download my Change of Life Checklist. That will help you understand where you are in the perimenopausal range. So you can see which symptoms are perimenopausal versus menopausal. I will see you in my next post, on the Hormone Healing Blog!

About the Author - Deborah Maragopoulos FNP

Known as the Hormone Queen®️, I’ve made it my mission to help everyone – no matter their age – balance their hormones, and live the energy and joy their DNA and true destiny desires. See more about me my story here…



  1. Arelys

    I am feeling horrible, i need help from someone who knows what i have to do?

  2. Sabrina Pattison

    I thought I had a mild hormonal thyroid but the more I read the more I think I have peri menopausal I am 43 I been loosing and gaining most of my life but since I turned 43 but about 5 months ago I gained so much weight about 30 pounds over my weight I started gaining after my gallbladder surgery that was 5 years ago

    • Deborah Maragopoulos FNP

      Genesis Gold can help reset your hypothalamus which controls your weight set point, appetite, digestion and metabolism


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