Perimenopause

Overview

The term “perimenopause”, which translates to “around menopause”, describes the period of time when your body naturally enters menopause, signaling the end of the reproductive years also known as the menopausal transition.

Women begin the perimenopause at various ages. Sometime in your 40s, you may start to experience menstruation irregularities or other indicators that the menopause is approaching. However, some females start noticing changes as early as their mid-30s.

During perimenopause, the amount of estrogen, the primary female hormone, fluctuates irregularly in your body. Your menstrual cycles may extend or shorter, and you can start experiencing menstrual cycles without an egg release from your ovaries (ovulate). In addition, you could suffer menopause-like symptoms like vaginal dryness, sleep issues, and hot flashes. There are treatments that can help reduce these symptoms.

Perimenopause lasts on average for four years. While some will spend more than four years in this phase of transition, some people may only be in it for a few months.

Menopause follows the perimenopause, which is a phase of transition. Your periods have stopped during the menopause. You have entered menopause once you have gone without a period for a complete 12 months.

Symptoms

During the menopausal transition, your body may go through various subtle and not-so-subtle changes. You might encounter:

• Irregular periods. The interval between periods may be longer or shorter, your flow may be mild to strong, and you may skip some cycles as ovulation becomes more unpredictable. You might be in the early stages of perimenopause if the length of your menstrual cycle consistently changes by seven days or more. You are most likely in late perimenopause if the space between periods has been more than 60 days.
• Hot flashes and sleep problems. During the perimenopause, hot flashes are frequent, varying in frequency, length, and intensity, which further cause sleep problems.
• Mood changes. Perimenopause may cause mood fluctuations, irritation, or an increased risk of depression. These symptoms may be brought on by hot flashes that interrupt sleep. The hormonal changes of perimenopause are not the only causes of mood disturbances.
• Vaginal and bladder problems. Your vaginal tissues may become less lubricated and elastic when your estrogen levels drop, making sexual activity painful. You can be more susceptible to vaginal or urinary infections if your estrogen levels are low. Urinary incontinence may be brought on by a loss of tissue tone.
• Decreasing fertility. Your chance of getting pregnant falls as ovulation becomes erratic. However, pregnancy is still possible as long as you are still getting your period. Use birth control until you haven’t had a period in 12 months if you want to avoid getting pregnant.
• Changes in sexual function. Sexual arousal and desire may fluctuate during perimenopause. However, if your sexual relationship was adequate prior to menopause, it will probably remain so into perimenopause and beyond.
• Loss of bone. Developing osteoporosis, a condition that causes weak bones, rises when your estrogen levels decline because you begin to lose bone faster than you can replace it.
• Changing cholesterol levels. Your blood cholesterol levels could be negatively impacted by declining estrogen levels, including an increase in Low-density Lipoprotein (LDL) cholesterol, sometimes known as “bad” cholesterol, which raises your risk of heart disease. In addition, as women age, their levels of High-density Lipoprotein (HDL), or the “good” cholesterol, fall, which raises their risk of heart disease.

Some women who experience perimenopausal symptoms may visit a doctor. However, some people endure the changes or don’t develop symptoms that are bothersome enough to need medical treatment.

Consult your doctor if you experience symptoms like hot flashes, mood swings, or changes in sexual function that affect your life or wellbeing.

Causes

Your body’s production of progesterone and estrogen, two important female hormones, fluctuates while you go through perimenopause. A large portion of the changes you go through during perimenopause are brought on by a drop in estrogen.

Risk factors

Menopause is a typical life stage. However, some women could experience it earlier than others. Even while it’s not always definitive, some research points to a few factors that may increase your likelihood of beginning perimenopause earlier, such as:

• Smoking. Women who smoke experience the menopause 1 to 2 years earlier than women who don’t smoke.
• Family history. Women who have experienced early menopause in their families may do so again.
• Cancer treatment. Early menopause has been connected to chemotherapy and pelvic radiation therapy for cancer treatment.
• Hysterectomy. Typically, menopause is not brought on by hysterectomy that only remove the uterus but leave the ovaries in place. Your ovaries continue to produce estrogen even when you are no longer menstruating. However, such procedure can result in menopause starting earlier than usual. In addition, removing one ovary may cause the remaining ovary to stop producing eggs earlier than intended.