Q: Where does the pendulum of perimenopause symptoms stop?

Given all of the unpredictability of perimenopause, you're wondering which symptoms carry over into menopause and which are resolved: Will you feel your best all the time? Or your worst?

I so wish I could give you a solid answer. The reality is that multiple factors are at play, and your genetics, overall health, and lifestyle will affect how they combine.

What's happening during perimenopause is that your hormone levels fluctuate wildly. Symptoms will vary, from person to person and from week to week. The key issue with the transition into menopause is the drop in estrogen. At the time of that change, in early menopause, many women experience the most symptoms: hot flashes, irritability, sleep issues, memory and concentration, dry skin, joint pain, and weight gain.

Most of those symptoms "resolve," as we medical people say, which means they diminish or go away entirely. The two areas where the loss of estrogen has continued effect for post-menopausal women are bone health and genital tissue (especially what we recognize as vulvar and vaginal dryness).

So back to those other symptoms: If it's irritability you're wondering about, you're likely to come "back to center" on mood, assuming that there aren't other unresolved (or, heaven forbid, new) issues in your life. For memory and concentration, remember that staying mentally engaged and challenged is important for brain health for both men and women!

And, because I'm a physician, I need to reiterate: A healthy diet and regular exercise minimize symptoms at any point.