Health impacts and management during perimenopause

During perimenopause, the menstrual cycle becomes irregular due to changes in the hypothalamus and pituitary gland, which attempt to stimulate the ovaries as the ovarian reserve diminishes. While the chance of pregnancy decreases, experts note a remaining risk of approximately 3% to 5%. Additionally, the intense stimulation from the pituitary gland during this transition can lead to a higher likelihood of twins.

As estrogen production declines, women may face physical changes such as bone mass loss, reduced muscle strength, and shifts in body fat distribution. Regular physical activity is recommended to mitigate these effects, specifically to improve cardiorespiratory fitness and maintain muscle strength. The American Heart Association highlights this transition as a critical period for cardiovascular prevention, as changes in lipid profiles and abdominal fat accumulation can increase metabolic risks.