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If there’s one thing to know about menopause, it’s that it can be different for every person who experiences it. Some women may not have any symptoms, while others have symptoms severe enough to disrupt their daily quality of life.

“The journey through perimenopause is never the same for two people,” says Flow Advisor and OB-GYN Jessica Shepherd. It’s important to talk about all of the symptoms, she adds, so women can understand what to expect and how to navigate all of the options for treatment.

As a reminder, valsartan jubilant 80mg menopause occurs when you’ve gone a full year without having a period, on average at age 51. Perimenopause occurs during the years leading up to menopause, lasting an average of four years, but can be as long as a decade. If you’re experiencing symptoms you think may be a result of perimenopause, reach out to your health care provider. They can rule out other medical causes of your symptoms, such as thyroid issues or anemia.

If your symptoms appear to be due to perimenopause, it’s important know that you don’t need to suffer through them. There are a range of treatments available, from lifestyle changes and over-the-counter remedies to prescription medication and menopausal hormone therapy (MHT), sometimes called hormone replacement therapy (HRT). Talk to your provider to find out what the best options are for you. And if your provider minimizes your symptoms, seek out another provider who will listen and respond to how you’re feeling.

We’ve included the most common 34 symptoms of menopause here, but your symptoms may be due to perimenopause even if it’s not on this list.

“There are a vast number of symptoms that you can have,” says Flow Advisor and OB-GYN Heidi Flagg, co-founder and partner of Spring Ob/Gyn, who says there may as many as 500. So reach out to your provider to find relief.

The 34 Symptoms of Menopause

1. Irregular periods

During perimenopause, nearly all women will experience changes in their menstrual cycle. Over time a woman’s period may become heavier, lighter, and less or more frequent as levels of the reproductive hormones estrogen and progesterone start to drop. There may also be spotting between cycles. “Universally, people will have some sort of period changes,” says Dr. Flagg. It’s important to stay on top of birth control during perimenopause since there’s still a risk of pregnancy.

2. Hot flashes

Hot flashes are a sudden and intense warmth in the face, neck, and chest area. Together with night sweats, they belong to a class of symptoms known as “vasomotor symptoms” of menopause. With declining levels of estrogen, the hypothalamus, a brain area that acts as your body’s thermostat, has episodes during which it goes haywire and tries to cool your body down even when you’re not actually hot. This includes expanding blood vessels and increasing blood flow to get rid of body heat, causing sweating and a flushed look. About 75 percent of American women experience hot flashes, making it one of the most common symptoms of perimenopause.

Lifestyle changes, such as avoiding alcohol and caffeine or reducing stress, may help alleviate hot flashes. Hormone therapy, supplements, or antidepressants may help as well. There is also a new medication to treat hot flashes that was recently approved by the FDA.

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