I’m in My 40s and Am Having Irregular Periods - Am I in Perimenopause?

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By: Alloy Staff|Last updated: March 4, 2024|Medically reviewed by: Sharon Malone
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At some point in their 40s, women begin to notice changes in their menstrual cycle. These changes—especially combined with menopause symptoms like hot flashes and changes in mood—usually mean they’ve entered perimenopause. 

Beginning perimenopause may seem like an overwhelming prospect, especially with the host of changes and symptoms it brings with it. However, just because perimenopause is an inevitable consequence of aging doesn’t mean you have to let your symptoms overwhelm you. There are solutions available to help alleviate your symptoms so you can focus on learning from and enjoying this new phase of life.  

If you’re experiencing menopause symptoms such as hot flashes and mood changes, Alloy can help. Take our online assessment and a menopause-trained doctor will find the solution that will work best for you.

What Is Considered an Irregular Period?

Perimenopause causes ovulation to become more unpredictable, which may cause menstrual irregularities including:

  • Longer or shorter length of time between periods

  • Heavier or lighter flow

  • Skipped periods

The Mayo Clinic also states that a consistent change of seven days or more in your menstrual cycle (e.g., from 28 days to 35 or 40 days) indicates that you’re in perimenopause’s early stages. Gaps of 60 days or more between periods mean you’re probably in the later stages.

What Is Perimenopause?

Perimenopause is the gradual transition from your reproductive years into menopause. Your estrogen and progesterone levels begin to fluctuate wildly, and you may start to experience changes in your body associated with shifting hormone levels. 

The main difference between perimenopause and menopause is that, though your reproductive hormones are declining, you’re still fertile and menstruating during perimenopause. By the time you reach menopause, you have ceased having periods and are no longer fertile. 

What Is the Average Age for Perimenopause?

Most women begin perimenopause in their mid-40s, but some women may experience symptoms as early as their late 30s. 

What You Can Expect During Perimenopause

As your reproductive hormones decline, quite a few changes begin to happen in your body, resulting in a host of challenging and uncomfortable symptoms. Though the following list may seem intimidating, remember that these symptoms can be treated. 

Irregular Periods

This is usually the first symptom perimenopausal women notice because it’s the most obvious. We’re intimately familiar with our cycles out of necessity, so it can be jarring when something changes. 

As mentioned above, irregular periods may be heavier or lighter than expected, closer together or further apart, and you’ll likely begin skipping cycles. 

Hot Flashes & Night Sweats 

Hot flashes feel like a sudden, overwhelming wave of warmth flooding your body. How often or intensely they occur may vary, and about 80% of perimenopausal women experience them. When they occur while you’re sleeping they’re called night sweats—sudden, intense bouts of sweating most likely to occur at night.

Trouble Sleeping

Being hot and sweaty in the middle of the night isn’t exactly restful. Add to that the possibility of 

heightened anxiety caused by fluctuating hormones, and it’s no wonder you’re having trouble getting enough sleep. Patterns of disturbed sleep can also cause fatigue, which leads to your body producing more cortisol to try and keep you alert. This results in an even greater lack of restful sleep.

Don’t worry—we’ll talk about treatments for all of these symptoms later.  

Mood Changes

Mood swings like sudden bouts of irritability or depression are common symptoms of perimenopause. Estrogen also plays a role in the production of serotonin in the brain. As estrogen levels taper off they can disrupt serotonin production and cause steep, unexplained rises and drops in your mood.

Vaginal Dryness 

During menopause, diminishing estrogen levels cause vaginal tissue to lose lubrication and elasticity, which may lead to pain during sex.  

Bladder Problems

Lower estrogen levels can cause a weakening of the bladder, urethra, and vagina that results in increased UTIs, frequent urination, and incontinence

Low Libido 

Changes in your libido during perimenopause may come from several sources, including hormone fluctuations (which are the root cause of most symptoms), changes in mental health, and physical discomfort due to vaginal dryness. 

One or more of these factors may diminish your sexual desire or ability to become aroused. 

Bone Changes

Estrogen plays an essential role in a woman's physiology, including maintaining the strength and density of her bones. Lower estrogen levels cause bone to break down more rapidly, resulting in thinner and more fragile bones and placing women experiencing perimenopause and menopause at greater risk of developing osteoporosis.

Changing Cholesterol Levels

Blood cholesterol is also affected by diminishing estrogen. This hormonal change increases LDL or “bad” cholesterol and lowers HDL or “good” cholesterol levels in the bloodstream. These changes place women in their mid-40s and beyond at a higher risk of developing heart disease. 

How to Treat Perimenopause Symptoms

Perimenopause may be inevitable, but experiencing prolonged symptoms isn’t a foregone conclusion. There are treatments and lifestyle changes you can employ to help alleviate or eliminate most symptoms of perimenopause. 

Get Treatment for Your Perimenopause Symptoms from Alloy

As we’ve seen, perimenopause comes with a number of symptoms that can disrupt your life and make you feel like a stranger to yourself. 

We know, because we’ve been there. You deserve relief from your symptoms, and we’re here to help you find the solution that’s right for you.

Here’s a breakdown of the products we offer. 

Low Dose Birth Control Pill

Available via prescription, this oral contraceptive pill contains ethinyl estradiol and progestin that, although not bioidentical, are effective in treating the symptoms of perimenopause.  Low-dose birth control pills regulate unruly periods and provide birth control for those who require contraception.  As soon as the menopausal transition is complete, you will transition to the bioidentical plant-based hormones in MHT. Oral contraceptives are just a waystation on the road to menopause hormone therapy. They bridge the gap from perimenopause to menopause when much lower doses of hormone can be prescribed for symptoms.   

Our low-dose birth control pill is suitable for women experiencing symptoms of perimenopause while still having menstrual periods. It helps alleviate hot flashes and night sweats and regulates irregular menstruation and erratic hormones. 

The Alloy Synbiotic

Our synbiotic contains a custom blend of probiotic spores, gold kiwifruit prebiotic fiber, and citrus flavonoids (antioxidants) designed to support a healthy gut microbiome, robust immune system, and balanced hormones.

In perimenopausal women, a healthy gut microbiome helps to balance hormones and manage weight gain. As we age, the biodiversity of good bacteria in our digestive system ebbs, so it’s important to nourish those good bacteria and help them thrive. 

There’s no prescription needed to get the synbiotic, and it’s safe for anyone to use. You can find it on our Solutions page. 


Paroxetine is a low-dose selective serotonin reuptake inhibitor (SSRI) used to decrease hot flashes. Commonly used as an antidepressant or anti-anxiety medication, paroxetine is a non-hormonal solution for women who cannot or prefer not to take hormonal treatment for menopause. It is prescribed in much lower doses for menopause and perimenopause symptoms than typically administered for depression or anxiety. 

These lower doses are considered safe for most women. To make sure it’s right for you, one of Alloy’s menopause-trained doctors will review your medical history before issuing a prescription. 

Estradiol Cream

Estradiol is a plant-based, bio-identical hormone treatment, meaning it’s molecularly identical to the estradiol already in your body. Estradiol cream is most effective in treating the bothersome symptoms of the genitourinary syndrome of menopause.  Because the cream is applied locally and in very small doses, it does not treat the systemic symptoms of menopause such as hot flushes and mood swings.

Our estradiol vaginal cream is FDA-approved to provide relief from vaginal symptoms associated with fluctuating hormones, such as vaginal dryness, itching, burning, UTIs, and painful sex. It’s been shown to improve the vaginal microbiome and pH, increase moisture, and improve elasticity. Most women experience the most relief within 4 to 6 weeks.

Available through prescription, one of our menopause-trained doctors will help you decide if this treatment is the best option for you. 

Get Regular Exercise 

Exercise is good for the body and mind. Beyond weight management, regular exercise offers perimenopausal women numerous benefits, including: 

  • Building muscle and strengthening bones. Activities like weight training, yoga, and swimming are excellent for toning muscles, keeping your joints strong, and maintaining bone density.

  • Stabilizing mood swings. Exercise reduces stress by lowering cortisol levels and increasing endorphins (feel-good hormones) in the brain. 

  • Lowering stress. Lower stress levels and a tired body may help you sleep better. 

Stop Smoking

It’s always a good time to quit smoking, but reaching perimenopause may be one of the best times to stop the habit. Regular nicotine use can launch you into early perimenopause. It also dramatically increases your risk of developing cardiovascular disease and can worsen symptoms like hot flashes and night sweats. 

Nixing cigarettes may not only ease your transition into menopause, it can also improve your overall health—and the healthier you are, the easier perimenopause may be.

Should I Get Tested for Perimenopause?

Short answer: no. There are no hard-and-fast tests that show whether or not you’ve entered perimenopause, and revered organizations such as The North American Menopause Society and The American College of Obstetricians and Gynecologists do not recommend testing for perimenopause or menopause. 

When to See a Doctor 

If you’re experiencing severe symptoms that interfere with your daily life, or complications like excessive bleeding, blood clots, spotting between periods, or vaginal bleeding after sex, you should contact your doctor immediately. 

If You Are Experiencing Perimenopause, Alloy Can Help Relieve Your Symptoms 

Perimenopausal symptoms can impact your daily life in a host of negative ways. Alloy’s products are designed to help stabilize and replenish the fluctuating hormones that cause those symptoms, providing you with the relief you need to feel like yourself again. 

Visit our Solutions page for more information. 


Mayo Clinic. “Perimenopause.” https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666

Cleveland Clinic. “Perimenopause.” https://my.clevelandclinic.org/health/diseases/21608-perimenopause

Johns Hopkins Medicine. “Introduction to Menopause.” https://www.hopkinsmedicine.org/health/conditions-and-diseases/introduction-to-menopause

Camila Hirotsu,⁎ Sergio Tufik, and Monica Levy Andersen. “Interactions between sleep, stress, and metabolism: From physiological to pathological conditions.” Sleep Sci. 2015 Nov; 8(3): 143–152. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4688585/

Juan Pablo Del Río, María I. Alliende, Natalia Molina, Felipe G. Serrano, Santiago Molina and Pilar Vigil. “Steroid Hormones and Their Action in Women's Brains: The Importance of Hormonal Balance.” Public Health, 23 May 2018. https://www.frontiersin.org/articles/10.3389/fpubh.2018.00141/full

Mayo Clinic. “Fitness tips for menopause: Why fitness counts.” https://www.mayoclinic.org/healthy-lifestyle/womens-health/in-depth/fitness-tips-for-menopause/art-20044602#:~:text=Regular%20physical%20activity%20can%20help,Strengthening%20your%20bones.

Harvard Medical School. “How does exercise reduce stress? Surprising answers to this question and more.” Harvard Health Publishing. https://www.health.harvard.edu/staying-healthy/exercising-to-relax

Qi X, Yun C, Pang Y, Qiao J. “The impact of the gut microbiota on the reproductive and metabolic endocrine system.” Gut Microbes. 2021;13(1):1-21. doi:10.1080/19490976.2021.1894070. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7971312/

Paweł Milart,corresponding author Ewa Woźniakowska, and Wojciech Wrona. “Selected vitamins and quality of life in menopausal women.” Prz Menopauzalny. 2018 Dec; 17(4): 175–179. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6372850/

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