How to Beat the Top Perimenopause Symptoms

Perimenopause symptoms got you feeling down? Use these tips to feel like your old self again.
Images loading...

Hot Flashes

What’s causing the intense heat, flushed face and increased heart rate? The leading theory suggests that reduced estrogen levels disrupt your hypothalamus-the area at the base of your brain that functions as your internal thermostat. Got hot flashes? Do this: If hot flashes have you shedding layers of clothes, try a yoga class, suggests a new report in the journal Menopause. In the study, women who participated in yoga for one hour at a time, five days a week, for eight weeks experienced fewer hot flashes and mood problems than women who did other forms of exercise. Or this: Schedule a hypnosis session. A recent study showed a 68 percent decrease in hot flashes, along with a reduction in anxiety and insomnia, after five hypnotherapy appointments. The technique may reduce symptoms because it helps women manage stress, explains Gary Elkins, PhD, of the Baylor University Department of Psychology and Neuroscience.


Headache rates rise when women enter the transition to menopause, probably because hormones play a role in the pain. Got migraines? Do this: If you are prone, take medication as soon as symptoms appear. "You stop the release of brain chemicals that cause painful swelling," explains Stephen Landy, MD, of the University of Tennessee Health Science Center. One drug, Treximet, which combines Imitrex with a painkiller, has been effective. Or this: Consider getting needled. An Italian study of 160 patients with moderate to severe migraines found that twice-weekly acupuncture, combined with medication, was more successful at minimizing pain than either medication alone or a "sham" procedure plus drugs.

Irregular Periods

Every two weeks, then not for two months; lasts three days, then three weeks: Menstrual mayhem is the poster symptom for perimenopause. Got irregular periods? Do this: The surefire way to regulate your cycle is to start on very-low-dose birth control pills. Their 20 micrograms of estrogen (versus 30 to 50 in other types) offer pregnancy protection — and bonus hot-flash reduction. Or this: Long bleeds result when hormones tell your uterus to start a period but not to stop it. "In some cases, your doctor can prescribe progesterone pills — either natural or synthetic — to provide the missing signal," says Andrew E. Good, MD, of the Mayo Clinic in Rochester, Minnesota.

Memory Problems

"Studies haven’t picked up changes, perhaps because they’re too subtle. But we know that women do frequently complain about forgetfulness," says Nanette Santoro, MD, of the Albert Einstein College of Medicine/Montefiore Medical Center, in New York. Got memory problems? Do this: Because creating visual links helps you remember a group of items, "If you need to buy bread and milk, envision bread dunking into a glass of milk," Santoro suggests. Or try, a free program that sends reminders to your cell phone or e-mail account. Or this: Focus on good sleep. Scientists from Singapore have documented their finding that a tired mind absorbs only a small amount of visual information. (That’s one way we take in important details.)

Joint Pain

One surprising finding of a large project known as the Penn Ovarian Aging Study: Nearly twice as many perimenopausal women complained of joint pain or other stiffness as women who were not yet in perimenopause. Got joint pain? Do this: Talk to your doctor if pain is stubborn or severe; you may need a workup to determine the cause. If pain is mild to moderate, consider these soothers: When joints revolt, relax them with a few minutes of heat (in the form of pads or baths) or numb them with ice. Or this: Give yourself a massage. Apply a small amount of oil or lotion to your hands, and gently glide them over sore spots. (Skip joints that are very swollen.) Or use the discomfort as an excuse to head to the spa!

Crazy Hair

Hair concerns are common: It grows where you don’t want it, or thins where you do. Blame the male hormones that stay constant as female ones decline, altering the balance. Got crazy hair? Do this: A 2 percent solution of minoxidil for women is sold over the counter, but the FDA has okayed a 5 percent for men, and that’s much more effective. So try it, says Wilma Bergfeld, MD, of the Cleveland Clinic. Apply once daily to minimize any side effects, she says. Do know that it could take six months to a year before you really notice a change. Or this: To slow down the development of lip fuzz, chin hairs, and other unwanted growth, Bergfeld recommends a daily supplement of 30 to 100 milligrams of zinc for its antiandrogen effect.

Vaginal Dryness

Surveys show that 30 to 40 percent of perimenopausal women complain of vaginal dryness, says Nanette Santoro, MD, of the Albert Einstein College of Medicine/Montefiore Medical Center, in New York. Got vaginal dryness? Do this: Lube up during sex. "There are so many natural-feeling products on the market now," says Cheryl B. Iglesia, MD, of the Washington Hospital Center, in Washington, D.C. "Just avoid any brand that contains drying alcohol." If itching and burning occur at other times of the day, use a vaginal moisturizer. Newer products like KY Liquibeads or Replens Long Lasting need to be applied only once every few days. Or this: Your doctor may prescribe vaginal estrogen rings, creams, or tablets. "These deliver much lower doses of estrogen than systemic hormone therapy and go right to the source of your problem, so they’re much safer," Iglesia says. Still, this is only for those near menopause who aren’t producing much estrogen themselves.

Urinary Tract Infections

As menopause approaches, the decline in estrogen levels thins the urethra, making you more infection-prone. Got urinary tract infections? Do this: Ask your doctor about a preventive antibiotic. "I tell my patients who regularly get these infections to take an antibiotic after sex if there is an association between the infection and intercourse," Iglesia says. (But do not take the antibiotic more than once in a 24-hour period.) Or this: Urinate both before and after sex, Iglesia suggests. Before, because bacteria around your urethra could be pushed up during intercourse; after, because you’ve got your partner’s germs to flush out also.

Gas and Bloating

The link between this problem and shifting hormones isn’t clearly understood, but estrogen receptors in the bowel may play a role, says Nanette Santoro, MD, of the Albert Einstein College of Medicine/Montefiore Medical Center, in New York. Got gas or bloating? Do this: Consider peppermint as a digestive aid, says gastroenterologist Anil Minocha, MD, author of Natural Stomach Care. He recommends a peppermint oil capsule of 0.2 to 0.4 milliliters, three times daily. (The capsules are sold in health food stores.) Or this: One popular yoga posture is so well known for helping bloating it’s actually referred to as the wind-relieving pose. Here’s how to do it: Lie on your back with your legs extended. Inhaling, draw the right knee toward the chest as you raise your head (as if to kiss the knee); exhale as you lower your head and leg. Repeat three times and switch sides. Then, do both legs together three times.

Low Libido

More than twice as many perimenopausal women complain of low libido and other sexual dysfunctions compared with those who are not perimenopausal, the Penn Ovarian Aging Study found. A small portion of the problem can be attributed to shifting hormones, but most of it likely springs from relationship issues and other stresses. Got low libido? Do this: Erotic books, videos, and role-playing can prime your brain — which is the largest sex organ you’ve got, says Hilda Hutcherson, MD, author of Pleasure. And consider couples counseling if necessary. Or this: Apply a packet of the botanic oil Zestra (available in pharmacies) to your clitoris five minutes before intercourse, Hutcherson suggests. This increases sensitivity of nerve endings and therefore boosts desire.

Dry Eyes

Dips in estrogen reduce secretions in many parts of the body, and the eyes are no exception, says Lama A. Al-Aswad, MD, assistant professor of clinical ophthalmology at New York’s Columbia University College of Physicians and Surgeons. Got dry eyes? Do this: Lubricate your eyes with drugstore drops. "If you use drops more than four times a day, choose brands that are preservative-free, or the preservative may further dry out the eyes," Al-Aswad advises. Or this: Turn away from the computer every few minutes to an hour (depending on how dry your eyes get), and blink, blink, blink. We tend to keep our eyes open when intensively reading, which causes our tear film to evaporate, Al-Aswad explains.

Cold Flashes and Clamminess

It’s often the aftereffect of a hot flash, but some women skip the heat and get the chill only. Because cold flashes can also be a symptom of diabetes or other conditions common in midlife, talk to your doctor if you experience them frequently. Got cold flashes or clamminess? Do this: If a cold flash strikes as you’re deciding what to wear, you may crave heavy cable knits. But if you indulge, you’ll sweat once the clamminess subsides. As with hot flashes, the best approach is to dress in removable layers. Or this: There’s no good research on how drinking tea can ease perimenopausal symptoms. It’s safe to say, though, that sipping a brew such as the Republic of Tea’s Get a Grip herbal tea, with licorice root, chasteberry, and other botanicals, will certainly warm you up. NEXT: Natural Sleep Aids and Strategies

Share Your Thoughts!


dana vigilante06.02.2011

I'm 43 and started perimenopause about a year ago. The hotflashes are the worst of all of my symptoms. I can usually tell when one is coming on though, because I will have a second or two of heart palpitations right before. Someone told me that the supplement "Soycare" works well. Has anyone tried it?

This is a good article, and has some good tips, but there are 2 common symptoms not mentioned in this article - Irritability and itchy skin. The irritability has made things tense at times between me and my husband. Since he is one of those people that needs to be always right - especially with me - he really knows how to push my buttons. The irritability seems to flare up unexpectedly in social situations. I am typically a laid-back, easy-going person, so this has really thrown me.
Itchy skin drives me crazy about 3 or 4 days a week, and it seems worse at night. It is not the same as dry skin - my skin has never been very dry, and I use moisturizers. Mine skin itches around my torso, especially around the breasts and armpits, but other women report that their itchy skin is on their thighs or arms. The only thing I have found so far that helps at all is ice.

Post new comment

Click to add a comment
Member Voices
Shoes & Accessories
Woman of Style and Substance
Swim & Lingerie