Perimenopause: 7 Signs Of Early Menopause And What You Can Do About It

What Is Perimenopause? Is it happening Honey?  Missing periods when you know you’re not pregnant. Moodier than usual? Sleeplessness? Sudden weight gain, bloating? Drier than … Read More

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What Is Perimenopause?

Perimenopause_1_Shrug Shoulders

Is it happening Honey? 

Missing periods when you know you’re not pregnant. Moodier than usual? Sleeplessness? Sudden weight gain, bloating? Drier than you want at the wrong time? Bladder problems? Hot flashes?

Don’t fret mama you might be experiencing perimenopause. All “perimenopause” means is that you’re “around” menopause. 

When does Perimenopause start?

Perimenopause typically begins in your 40s. A small percentage of women experience early menopause in their 20s and 30s. 

Get ready for a rocky road during the months or years your hormones are going haywire, getting your body ready for menopause. 

Don’t worry, science has discovered several effective treatments to ease you into menopause (more on those later). And, when it’s all over, say goodbye to pads, tampons, and periods. Better yet, no more worrying about pregnancy!

Signs That Perimenopause Has Started


Although perimenopause or early menopause require medical diagnosis, these symptoms indicate you may have arrived. Look for these seven signs. 

Missing periods

Missing two or three periods when you aren’t pregnant is a good sign you’re experiencing perimenopause or early menopause.

Menopausal Spread

If you’re gaining weight around your tummy, hips, and thighs, and your diet and exercise routine hasn’t changed, you might have menopausal spread. Fluctuating hormones during perimenopause and menopause often lead to sudden weight gain and difficulty managing weight. Besides the unwanted appearance changes, weight gain stresses the heart, joints, and can cause diabetes and vascular problems. 



Haywire hormones can cause perimenopausal estrogen levels to increase by an average of 30%2! Meanwhile progesterone levels decline. Bloating occurs with high estrogen and low progesterone levels because estrogen increases fluid retention while progesterone, a natural diuretic, helps you relieve fluid. 

Restlessness and Trouble Sleeping


According to the National Sleep Foundation, a staggering 59% of perimenopausal women experience insomnia at least a few nights per week. Unexplained sleeplessness without recent lifestyle changes could be perimenopause knocking on your door. 


All of the other fun symptoms associated with perimenopause are often accompanied by persistent low energy levels. Lack of sleep causes many women to feel mentally and physically exhausted. Experiencing unexplained fatigue? Perimenopause may be your tormentor. 

Dreaded “Hot Flashes”

Hot flashes are a telltale sign menopause is nearing. By day you’ll notice a flush of heat over your face, neck, and chest. At night, you wake up sweating. No fun, and they can happen sporadically over months or years. Not to worry, we’ll describe some of our favorite hot flash remedies below. 

Dry Vag

We can’t write about the seven signs of early menopause without mentioning vaginal dryness. If you notice a change in your baseline moisture level, itchiness or discomfort you may be…well, you know. Sadly, you’ll notice vaginal dryness most when you want it least — during intercourse. But again, we’ll discuss some great ways of keeping you moist and comfortable. 

I Just Want to Feel Better, What are My Options?

Gone are the days when women have to grin and bear it — all. Although science can’t reverse menopause, several options can help you alleviate symptoms, mitigate hormone fluctuations, and feel more like yourself. 


Perimenopause_Probiotics benefits

Trillions of microbial cells called the Human Microbiome line your gut, vagina, colon, and intestinal tract. These tiny living organisms support nearly every bodily function including vaginal health, weight management, mood, blood pressure (hot flashes), skin, hair, and immunity. Recent years have seen a surge in the popularity of probiotics to support a variety of conditions for good reason.

Probiotics have been studied for over 100 years. A brilliant scientist working for the Pasteur Institute discovered them while researching why a group of people from the Caucasus Mountains with the highest known concentration of people aged 100+. The answer lay in a fermented probiotic drink. 

Previously however, science lacked the technology to fully understand probiotics' role. Not until a research project of unprecedented scale, The Human Microbiome Project, did scientists fully understand the benefits of probiotics. 

Since then numerous clinical trials have studied the role of probiotics in menopause and vaginal health. One well known study found, “treatment was effective at alleviating menopausal symptoms and was safe, with no adverse effects. And…suggested the efficacy of lactobacillus acidopholis as a dietary supplement for women experiencing menopausal symptoms, such as hot flashes, paresthesia, nervousness, melancholia, fatigue, arthralgia, headache, heart palpitation, formication, and vaginal dryness.”

Hormone Replacement Therapy (HRT)


HRT is the most common treatment for menopausal and perimenopausal women. HRT is widely promoted and proven effective in relieving many menopausal symptoms. Hormone replacement makes sense since symptoms are caused by fluctuating estrogen and progesterone levels. Many women choose to avoid HRT due to safety concerns. A massive, landmark clinical trial of 27,347 women conducted by the Women’s Health Initiative concluded abruptly in 2002, when researchers discovered “women taking a combination of estrogen and progestin had an increased risk of breast cancer, heart attacks, stroke, and blood clot.”

DIM Therapy


Diindolylmethane is a compound made in the body during digestion of cruciferous vegetables such as kale, cauliflower, cabbage, and other leafy greens. Some studies suggest diindolylmethane may play a role in estrogen modulation and metabolism. In short, makers of DIM perimenopause supplements claim the compound helps balance estrogen levels and alleviate perimenopausal symptoms. In our review of the literature we found most studies were unrelated to perimenopause. Instead they focused on the treatment of breast and thyroid cancers. We conclude the effectiveness of these supplements for perimenopausal symptoms requires further research.  

Herbs and Traditional Medicines

Soy beans and Soy Isoflavone 

Soy has mild estrogenic effects. A systematic review of 19 clinical trials showed soy reduced the severity of hot flashes 11%-26%. Another study found that while soy was beneficial to hot flashes, time to experience benefits ranged from several weeks to months. Notably, reviewers of the systematic clinical trial review are affiliated with the Soy Nutrition Institute and could have vested interest. Soy may help with hot flashes but doesn’t seem to have any effect on other perimenopausal symptoms like weight gain and reduced bone density.

Moringa Leaf

Known as the “Miracle Tree,” and largely unknown in the west, the moringa tree is the most nutrient-dense food on the planet. Moringa leaf contains a host of antioxidants, polyphenols, vitamins and micronutrients. Besides powerful antioxidant effects and improving cellular function, moringa leaf boosts energy and metabolism by lowering blood glucose levels. Moringa leaf is especially effective at combating perimenopausal weight gain. 

Two large clinical studies confirm moringa leaf’s weight loss benefits. One 8 week study found subjects taking a combination of moringa, turmeric, and curry lost 6.4 pounds compared with the placebo group. Another study reported weight loss of 9.9 pounds compared with the placebo group. Moringa leaf has also shown promise in reducing hot flashes and improving sleep.

Black Cohosh

Black Cohosh is a traditional medicine with a long history of use among Native Americans and European settlers for treating menstrual irregularities, musculoskeletal pain, and women’s reproductive issues. And although it has been widely studied for menopause relief over 70 years, no studies ever reported a conclusive mechanism of action.

One study of 351, 45-55 year old women reported black cohosh had no effect on reducing hot flashes or night sweats compared with the placebo group. In fact, after 12 months, women taking a black cohosh multibotanical formula with soy foods reported a significant increase in symptom intensity.

Dong Quai 

Known as the “Female Ginseng,” dong quai is a Chinese traditional medicine used for thousands of years for treating women’s health issues. Clinical studies are mixed with no conclusive outcomes. One study observed no statistically significant reduction in hot flashes. Another reported a 73% decrease in hot flash symptoms at three months. Mount Sinai medical center warns women with bloating, digestive problems, or with higher risk of cancer should avoid dong quai. May cause rashes and women on blood thinners or hormone therapies should avoid dong quai.

Editor’s Picks for Best Perimenopausal Symptom Relief Supplements

Our team independently reviewed 29 perimenopause relief brands using data from independent consumer testing laboratories, Labdoor and ConsumerLab, combined with our internal ratings system to determine the top 5 supplements for early menopausal symptoms

Editor’s Choice: Provitalize

first choice Provitalize

Why We Like Provitalize

As of July 2022, over 1.2 million women worldwide have tried Provitalize, making it the most popular perimenopause probiotic supplement in the world.

In addition to a unique blend of thermogenic probiotics that help to address menopause-related symptoms, Provitalize contains a herbal blend with demonstrated benefits for premenopausal, menopausal, and postmenopausal women including turmeric root extract, moringa leaf extract, and curry leaf extract. Together these have been shown to combat inflammation and bloating, decrease hot flashes, joint pain, and support healthy blood sugar and cholesterol levels. 

Bioperene (black pepper extract) and sunflower lecithin are proven to enhance absorption of vitamins, minerals, and other beneficial properties of herbal formulas. 


  • Made by a NSF GMP registered, MOSA certified organic, and FDA registered manufacturing facility in the USA
  • Vegan, keto, paleo friendly
  • 100% natural, safe ingredients
  • Thermogenic herbal assisted probiotic formula
  • 16,190 Amazon reviewers report 84% positive results
  • Reported benefits include reduced bloating, hot flashes, weight gain, night sweats, and higher energy levels
  • 4.1 Star Trustpilot rating
  • 62 Billion CFUs
  • Clinically proven probiotic strains
  • Vegan DR CapsTM ensure the probiotics reach your gut safely
  • Independently verified by Eurofins Testing Laboratory
  • 90 day money-back guarantee
  • Featured by DailyMail, Bustle, Mirror, and several top publications


  • No free trial
  • Some report no weight loss

#2: MenoKit Bundle (Value for Money)


Why We Like The MenoKit Bundle

We listed the Menokit bundle second because it costs slightly more than Provitalize alone, but we believe it is a better value for money.

Get all the benefits of Provitalize, plus Previtalize. Previtalize is a prebiotic blend that increases the likelihood of beneficial probiotics in Provitalize colonizing your gut.

Previtalize contains healthy plant fiber that probiotics need to thrive including, fructooligosaccharides, galactooligosaccharides, and inulin. Previtalize also aids digestion and stabilizes mood naturally. Some customers recommend taking Previtalize first for 5-10 minutes, before taking Provitalize, to see maximum impact.

Finally, Menokit Bundle includes Inergy Plus, a revolutionary energizing formula without sugar, stimulants, or caffeine. Inergy Plus is a vitamin, amino acid, and herbal formula that provides lasting energy at the cellular level without peaks and valleys. Perfect for perimenopausal women suffering from fatigue. 


  • Made by a NSF GMP registered, MOSA certified organic, and FDA registered manufacturing facility in the USA
  • Vegan, keto, paleo friendly
  • 100% natural, safe ingredients
  • Thermogenic herbal assisted probiotic formula
  • 800+ Amazon reviewers report 84% positive results
  • 4.1 Star Trustpilot rating
  • 62 Billion CFUs
  • Clinically proven probiotic strains
  • Vegan DR CapsTM ensure the probiotics reach your gut safely
  • Independently verified by Eurofins Testing Laboratory
  • 90 day money-back guarantee


  • No free trial
  • Slightly more expensive than Provitalize alone. 

MenoKit is currently available at a 20% discount at just US$87.20 for 3 bottles (save 40% per bottle with a minimum commitment of 60 days). As with any natural supplement, customers usually see the best results when they keep to it for at least 60-90 days. 

#3: Remifemin


Why We Like Remifemin

Remifemin is a Nature’s Way product and available in major retailers. The main ingredient in Remifemin is Black Cohosh. 

Remifemin has been shown in clinical trials to reduce the severity of perimenopausal symptoms on the Kupperman Scale by 17 points after 12 weeks.

We listed Remifemin third due to its effectiveness at reducing the severity of hot flashes, though it seems to have negligible effect on other perimenopausal symptoms. 


  • Clinically studied
  • 40 year history
  • Made in the USA
  • 70% five-star Amazon ratings
  • Complies with FDA regulations
  • No salt, yeast, gluten, corn, soy, colourings or preservatives.


  • No money-back guarantee.
  • Single active ingredient

#4: Menoquil


Why We Like Menoquil

Menoquil is a proprietary formula containing many of popular perimenopausal symptom relief ingredients such as soy isoflavones, black cohosh, dong quai, red clover extract and vitamins together with bioperine for bioavailability. 

We listed Menoquil fourth because despite containing herbs traditionally used in perimenopause relief the individual amounts of the ingredients are not clearly listed. 


  • 60 day money back guarantee
  • Made in the USA
  • 51% five-star Amazon ratings
  • Complies with FDA regulations


  • Proprietary formula does not reveal individual ingredient quantities
  • Claimed clinical studies but no links to those studies
  • Costs nearly as much as Provitalize but has lower customer satisfaction of 3.7 stars

#5: Equelle


Why We Like Equelle

Equelle uses a unique ingredient called S-equol, a plant-based ingredient derived from soy that is clinically proven to relieve a range of menopause symptoms, according to their website. It mimics estrogen and it is Generally Recognized as Safe and proven safe with no association with breast or other cancers, changes in sex or thyroid hormones, and negative effects on endometrial health.

We listed Equelle as fifth because soy-based ingredients have weak scientific evidence of alleviating pre-menopause symptoms.


  • Has conducted a few clinical trials with generally positive results
  • 90 day money-back guarantee
  • 57% 5-star reviews on their website
  • Free shipping in the US
  • Ingredient comes from Japan and made in the US


  • Only 600+ reviews on their website and not available on Amazon, which suggests they may be rather new
  • Not sold outside the US
  • Only available on their website

The last word…

If you’re experiencing one or more of the above symptoms and feeling you may be nearing menopause, consult your doctor. If you’re ready for symptom relief but aren’t ready for anything as costly and drastic as hormone replacement therapy we recommend trying our Editor’s Picks.

Perimenopausal supplements are a safe, clinically proven, natural path to symptom relief for many women. If you’re tired of hot flashes, weight gain, vaginal dryness and restlessness give one of our choices a try — let us know how things workout. 

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Courtney D'Angelo, MS, RD

Courtney D'Angelo, MS, RD, earned her masters degree in Nutrition and Foods from the University of Georgia. She's a Registered Dietitian at Morrison Healthcare and has a strong passion in helping people improve their wellness!

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