Perimenopause — Frequently asked questions
Perimenopause is the multi-year transition before menopause. Common questions: early symptoms, FSH/AMH testing, mood/anxiety, when to start HRT, weight changes.
5 questions answered by our editorial team and checked against medical literature.
Can I take GLP-1 medications with HRT?
YesYes, GLP-1 medications (semaglutide, tirzepatide) and hormone therapy can generally be taken together with no known interactions. Many perimenopausal and postmenopausal women take both safely.
Why does perimenopause cause anxiety?
Fluctuating estrogen disrupts serotonin and norepinephrine — both involved in mood regulation. Anxiety in perimenopause is biological, not just "stress."
Can I get pregnant on HRT?
YesPregnancy is technically possible during perimenopause up to menopause confirmation (12 cycle-free months). HRT is NOT contraception. Continue contraception up to menopause confirmed.
Why does perimenopause cause weight gain?
Three factors: estrogen-mediated fat redistribution from hips to abdomen, ~1%/year muscle loss from sarcopenia, and 30-50% drop in insulin sensitivity. Same calorie intake = more weight.
When should I start tracking perimenopause symptoms?
Start tracking when cycle length shortens by 7+ days OR you notice new sleep/mood/VMS changes. Most useful between age 35-50. Bring 3-month log to clinician visit.
Other FAQ topics
HRT
Frequently asked questions about hormone replacement therapy for menopause + perimenopause.
GLP-1
Frequently asked questions about GLP-1 medications (Wegovy, Ozempic, Zepbound, Mounjaro) for weight management.
PCOS
Frequently asked questions about polycystic ovary syndrome — diagnosis, treatment, fertility, lifestyle.