Perimenopause vs. menopause: What to know

As we age, changes in our bodies may come without warning — and oftentimes, without explanation. This is especially true for women who may be entering their post-childbearing years. You might notice your sleep feels off, your mood shifts more easily, you have random aches and pains. So, what’s going on?

For many women, these changes are part of perimenopause — the transition leading up to menopause. It’s a natural stage of life, but until recently, it hasn’t always been talked about openly. Understanding what’s happening — and what’s normal — can help take some of the guesswork out of the experience.

Perimenopause² is the transition leading up to menopause. It’s part of a broader menopause journey that begins with early hormonal changes and continues after periods stop.

During this time, the ovaries gradually produce less estrogen. As hormone levels fluctuate unpredictably,  some women begin noticing changes they can’t quite pin down or a sense that something isn’t quite right.

Perimenopause doesn't always announce itself with hot flashes or irregular periods. For some, the first signs are changes in sleep, focus, energy, or mood.

Every woman’s experience is unique. Some notice only mind changes, while others face symptoms that can feel frustrating, disruptive and, at times, overwhelming. For some women, perimenopause lasts only a few years; for others, it can continue for more than a decade.¹

Symptoms² may include:

• Irregular periods
• Hot flashes and night sweats
• Sleep disruptions
• Fatigue or low energy
• Vaginal dryness
• Headaches or joint discomfort
• Mood changes or irritability
• Anxiety or low mood
• Difficulty concentrating (“brain fog”)

Menopause is defined as the point when a woman hasn’t had a menstrual period for 12 consecutive months.¹ It marks the end of reproductive years. It can be a whole-body process that impacts multiple systems, including cardiovascular, metabolic and cognitive health. These changes unfold over time and can influence long-term health, not just reproductive health.

While everyone’s experience is unique, there are general patterns:

• Perimenopause: Can begin as early as your mid-30s or as late as your mid-50s²
• Menopause: Most commonly¹ occurs in your early 50s
• Duration of perimenopause: Can last from a few years to more than a decade¹

It’s a good idea to check in with a health care provider if you:

• Have symptoms that disrupt daily life or sleep
• Notice significant changes in your period (very heavy bleeding or long gaps)
• Experience mood changes that feel difficult to manage
• Have questions about treatment options or hormone therapy

Getting guidance early can help you understand your options and feel more in control.

Although most women experience menopause-related symptoms, many don’t seek medical care.

• 84% of women experience menopause-related symptoms and physical changes³
• And yet, 87% of women don’t engage with the health care system⁴
   

Perimenopause and menopause are natural life stages — but that doesn’t mean you have to “just deal with it.” From lifestyle adjustments to medical support, there are ways to feel more comfortable and confident through the transition.

UnitedHealthcare supports the diverse needs of women during the menopause transition by helping provide access to treatments, guidance and support tailored to individual needs.

Eligible members may have coverage for a range of hormone therapy options — such as commonly prescribed generics — as well as non-hormonal medications that can help manage symptoms like hot flashes, sleep disruption and mood changes.

Depending on their employer benefits, eligible members may also be able to connect with specialized programs like:

• Maven Clinic, which offers 24/7 virtual access to menopause care support and guidance
• Visana Health, a virtual women’s clinic to help assess symptoms and provide solutions
• Calm Health, which provides whole-person virtual support across mental and emotional health needs

By understanding what’s happening in your body and knowing what support is available, you can navigate perimenopause and menopause with greater confidence — and feel empowered to take care of your health at every stage.