7 Signs That Indicate Perimenopause Is Ending and What Happens Next

Key takeaways:

• Changes in menstrual cycle patterns typically occur during perimenopause: The cycle may become more frequent, less frequent, or irregular.
• But perimenopause ends after 12 months of no menstruation, ushering in the menopause phase. A significant drop in estrogen levels accompanies this later phase.
• Some signs that may indicate perimenopause is ending include longer duration between periods and an increase in the severity of symptoms like hot flashes and mood swings
• Regular check-ups by a healthcare provider are essential during the transition from perimenopause to menopause to help manage the symptoms and overall health.

Perimenopause is a transitional state before menopause. Changes in hormone levels, abnormal periods, and symptoms like mood swings characterize it. It usually begins at age 40 but can sometimes start in the late 30s or early 50s.

The start of perimenopause can differ among individuals due to different factors like family history, smoking, and underlying health issues like autoimmune disease.

Sometimes chemotherapy, surgery, or radiation to the pelvic region can be the reason for early menopause. 

When perimenopause is about to end, there are some signs which indicate that menopause is about to start. These signs that indicate the end of perimenopause include:

1. Longer gaps between periods

Towards the end of perimenopause, there is usually an increased time apart between periods. You may experience a gap of more than two months until the next menstrual cycle, until your period stops entirely. Still, some people may experience shorter cycle lengths, leading to frequent menses.

2. Period flow changes

There is an abnormal period bleeding pattern during perimenopause. Sometimes, there is light discharge of blood, and sometimes, there is unusually heavy bleeding before it stops completely.

3. Hot flashes and night sweats

Hot flashes and night sweats are vasomotor symptoms that are usually common during perimenopause and menopause, but when the perimenopausal stage is about to end, they usually become more intense.

Other symptoms like chills, feeling hot, and skin flushing typically also accompany hot flashes and night sweats.

4. Changes in sleep patterns

People with vaginas usually experience changes in sleep patterns during perimenopause. This gets worse as they near the end of perimenopause and are about to transition into menopause.

Many people in this transitional phase report insomnia and poor sleep associated with hormonal changes and hot flashes.

5. Mood swings

Changes in hormonal levels during perimenopause result in changes in emotions, mood swings, increased anger, and irritability, which may worsen as you get towards the end of this phase.

6. Lowered libido or vaginal dryness

Due to low estrogen levels, some symptoms like low libido or vaginal dryness may occur. These symptoms may increase towards the end of perimenopause and once the menopausal stage is reached.

7. Changes in skin and hair

Due to a decline in estrogen levels, skin becomes rough and dry. Some women also experience hair thinning during this phase.

What happens after perimenopause?

At the end of perimenopause, there is the beginning of the next phase, i.e., menopause, in which there is a complete end of bleeding for at least 12 months. In menopause, there is an end to the fertility of a woman due to a drop in estrogen and progesterone levels.

Common symptoms that occur with increased severity during menopause include hot flashes, mood swings, night sweats, and anxiety.

During menopause, the body has to adapt to reduced hormone levels, resulting in changes such as vaginal dryness, decreased sexual desire, and urinary concerns. These changes occur due to thinning of the tissues in the urinary and genital areas.

Some health issues may arise during this phase, such as loss of bone density and heart problems. This happens because decreased estrogen levels make bone weak, increasing the risk of fracture, and may also lead to higher cholesterol levels, affecting heart health. During menopause, it's essential to prioritize bone, heart, and general wellness.

Once the menopause phase is complete, the body enters the postmenopausal phase. During this time, symptoms gradually fade but may persist at lower intensities for some.

How to tell that you have entered menopause

To find out that you've reached the menopause phase can be challenging, as symptoms can vary widely from person to person. One clear sign is not having menstrual periods for 12 full months, which is usually the end of the perimenopausal phase. 

However, other common symptoms, such as hot flashes, night sweats, sleep disturbances, and mood shifts, can also be signs of menopause.

To confirm whether you are having menopause, it is better to consult a doctor. They may recommend tests to evaluate your hormone levels, especially follicle-stimulating hormone (FSH), which usually rises as estrogen levels decline in menopause.

Noting your symptoms and changes in menstrual cycles and combining these observations with medical evaluation can help you confirm you’ve entered menopause.

Tips for managing perimenopause and menopause symptoms

Some useful tips for managing perimenopause and menopause symptoms include:

• Lifestyle modification: Lifestyle changes such as regular exercise, yoga, and walking can help reduce hot flashes and mood swings. Keeping yourself physically active can help you cope with symptoms associated with perimenopause and menopause.
• Stress-reducing techniques: Cognitive-behavioral therapy, meditation, and mindfulness can help in reducing anxiety conditions and sleep disturbances.
• Healthy diet: Eating a healthy diet rich in multivitamins, such as fruits, can support bone health and reduce heart issues. Avoid consuming alcohol and caffeine to reduce symptoms like hot flashes.
• Hormone therapy: If the symptoms are severe, consult your doctor. They may suggest hormone therapy, such as estrogen-based hormone replacement therapy (HRT), to reduce vasomotor symptoms.
• Non-hormonal treatment: This includes selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) for reducing hot flashes and improving mood.
• Vaginal moisturizers and lubricants: Vaginal lubes or moisturizers can help to reduce dryness and discomfort. They provide relief for sexual and urinary symptoms without hormonal intervention.

Questions to ask your doctor

Here are some questions to ask your doctor about perimenopause and transitioning into the menopause phase:

• What symptoms should I expect during perimenopause and menopause?
• How do I know if my symptoms are related to menopause or another health condition?
• What lifestyle modifications or treatments could help manage my symptoms?
• What non-hormonal options do you recommend for treating symptoms?
• Could hormone replacement therapy (HRT) be useful?
• Are there specific vitamins or supplements I should consider taking?
• How does menopause affect my risk for heart disease, and what can I do to lower it?
• How often should I schedule check-ups or screenings as I go through menopause?
• Are there signs or symptoms that would need immediate medical attention?