Getting Perimenopause Ready: What to Know Before the Changes Begin

Perimenopause can arrive before many women expect it. A subtle shift in your period. Waking up in the middle of the night for no obvious reason. Feeling more irritable than usual. Changes in your body that are easy to dismiss individually, but together may be telling you something.

In this Perry Short, created in collaboration with Bonafide Health and shaped around the questions we hear from women in the Perry community, Perry Community Manager Kristin Cohen sits down with Dr. Alyssa Dweck, board-certified OB-GYN, practicing gynecologist and Chief Medical Officer of Bonafide Health, to talk about something we believe every woman deserves: the opportunity to get perimenopause ready.

Rather than waiting until symptoms become disruptive, what if women knew what to look for, what to track and what conversations to start before they found themselves asking, “What is happening to me?”

Perimenopause Education Is Preparation

One of Dr. Dweck’s central messages is simple: education matters.

Perimenopause is becoming much more visible within healthcare, but many women still enter this stage of life without knowing what to expect. Recognizing the connection between new symptoms and hormonal changes can be an important first step.

And the first signs may be surprisingly subtle.

According to Dr. Dweck, one of the earliest clues can be a change in the menstrual cycle, including changes in the length of the cycle or duration of bleeding. Mood changes, particularly irritability, and sleep disruption such as suddenly waking during the night may also be early signs.

The important part is noticing when something has changed from what is normal for you.

You May Be Younger Than You Think

One of the biggest misconceptions about perimenopause is when it begins.

Dr. Dweck explains that some women experience signs and symptoms in their mid-to-late 30s. That can come as a shock, particularly when perimenopause isn’t even on someone’s radar.

The transition itself can also last much longer than many women realize. Perimenopause can span approximately two to ten years before menopause.

This is one reason symptoms are so often missed or attributed to something else. Perimenopause has historically not been top of mind for many women or their healthcare providers, and awareness of the transition is only now becoming more widespread.

What Should You Track?

Your menstrual cycle is a good place to start, but it shouldn’t necessarily be the only thing you pay attention to.

Dr. Dweck recommends keeping track of periods while also paying attention to broader health markers. These can include blood pressure and blood work such as cholesterol, certain vitamin levels, anemia and iron stores. Changes in weight and body composition can also be important to discuss with your healthcare provider.

Mood deserves attention too.

Tracking emotional changes alongside your menstrual cycle may help reveal patterns and give you better information to bring into conversations with your healthcare provider.

The goal isn’t to obsess over every symptom. It’s to understand your own baseline well enough to recognize meaningful changes.

Build the Foundations Before You Need Them

Preparing for perimenopause isn’t only about knowing which treatments are available.

Dr. Dweck points to several familiar but important pillars: nutrition, exercise, sleep habits, stress management and community. And she makes an important distinction: the goal isn’t necessarily to eliminate stress, which may be unrealistic, but to learn how to manage it.

Community matters too.

Knowing that other women are experiencing similar changes can make this transition feel less isolating and frightening. That is one of the reasons community-driven perimenopause education matters so much to us at Perry. The questions women ask each other can identify the gaps that traditional health education has too often missed.

Ask About Your Family History

If you have the opportunity, talk to your mother, sisters or other relatives about their menopause experiences.

Genetics can play a role in both the timing and experience of menopause. At the same time, Dr. Dweck explains that other factors may also influence the experience, including smoking, weight, stress, diet and exercise.

Understanding family history doesn’t predict exactly what your experience will look like, but it can give you another useful piece of information.

There Isn’t Just One Treatment Path

Another important part of becoming perimenopause ready is understanding that you have options.

The conversation around perimenopause can sometimes become dominated by hormone therapy. Hormone therapy is an important option for many women, but it isn’t the only tool available.

Dr. Dweck discusses evidence-based non-hormonal approaches including cognitive behavioral therapy, as well as prescription medications that may be used for symptoms such as hot flashes, night sweats, mood changes and sleep disruption. She also discusses clinically studied supplements as another potential part of the toolbox.

Hormonal options can also vary. During perimenopause, some women may use oral contraceptives, particularly when contraception or erratic bleeding is a consideration, while others may use estrogen with or without progesterone or progesterone alone.

The bigger message is that perimenopause care should not be one-size-fits-all.

When Should You Talk to Your Doctor?

You don’t have to wait until symptoms become unbearable.

Dr. Dweck’s advice is that it’s never too early to start a conversation with your healthcare provider about changes that concern you. Gynecologists may be particularly familiar with conversations about menstrual changes, vaginal symptoms and sexual function, while primary care physicians and endocrinologists can also be valuable resources.

Going into those conversations with information about your cycle, sleep, mood and other changes can help you explain what you’re experiencing more clearly.

The Most Important Thing? Pay Attention.

At the end of the conversation, Dr. Dweck is asked to leave women with one piece of advice for getting perimenopause ready.

Her answer: pay attention.

Pay attention to your menstrual cycle. Your sleep. Your diet. Your mood. Your symptoms. Notice when something feels different from your normal, and bring those changes to a healthcare professional when needed.

And there is an equally important message for healthcare professionals: remain open-minded.

There is a growing toolbox for managing perimenopause, and care should be individualized to the person sitting in front of you.

At Perry, that’s exactly why we believe perimenopause education has to begin with women themselves. We listen to the questions coming from our community, bring those questions to trusted experts and turn the answers into education that women can actually use.

Because women shouldn’t have to reach perimenopause before someone tells them what perimenopause is.

Medical Disclaimer

This content is provided for educational and informational purposes only and is not intended as medical advice, diagnosis or treatment. Individual symptoms, health histories and treatment needs vary. Always speak with a qualified healthcare professional about your personal health, symptoms and treatment options. Never disregard or delay professional medical advice because of information you have read or watched through Perry.