Perimenopause

Estrogen levels during perimenopause rise and fall unevenly. Thus, your menstrual cycles may become both longer and shorter. In addition, there may be menstrual cycles in which your ovaries don’t release an egg.

Perimenopause in Detail

Some gynecologists call premenopause as steroid dancing. Because such manifestations as irregular menstrual cycles caused both by very high and very low levels of the follicle-stimulating hormone deteriorate the overall well-being of a woman and make her face changes in the health. To make it clear, let’s understand the main cycles occurring in the female body during the onset of menopause. 

First off, the anovulatory process starts slowly showing itself. It deals with reduced production of progesterone that will then lead to a complete absence of ovulation. Hyperestrogenism (an excessive amount of estrogen), in turn, results in an increase in body weight, tenderness of the mammary glands, an increase in signs of fibrocystic mastopathy, endometriosis, the development of fibroids, and the formation of polyps. And the reason for this whole picture is precisely the imbalance of hormones.

However, 5-10% of women do not notice any clinical manifestations of the premenopausal transition: they have regular menstruation until menopause and there are no signs of estrogen deficiency or excess.

Symptoms of Perimenopause

Perimenopause manifests itself in different ways. However, you should not think that you will definitely have to feel all the unpleasant signs on yourself. More than half of women admit that they experience only minor inconvenience, one in ten does not cope with the typical signs of perimenopause at all. The discomfort associated with the approach of the early climax affects only a third of all women. However, it is necessary to know how perimenopause mainly manifests itself.

You might experience the following perimenopause symptoms:

• Night sweats and sleep disorders. A lot of women have to deal with hot flashes during perimenopause. There are different levels of intensity, duration, and frequency. They are also the reason for sleep disorders.
• Mood changes. Sleeping disorders associated with hot flashes may be the cause of mood changes and can cause depression.
• Vaginal and bladder problems. Due to the drop in estrogen, the vaginal tissue loses its elasticity and make sex painful. This makes women more vulnerable to vaginal and urinary infections. In addition, tissue loss can lead to urinary incontinence.
• Irregular periods. Once ovulation becomes more erratic, the length of time between perimenopause periods can be longer or shorter, and some cycles may be missed.
• Bone loss. You start losing bone faster than you replace it with decreasing estrogen levels, raising the risk of osteoporosis.
• Change in cholesterol levels. Due to a decrease in estrogen, your cholesterol may change, and that increases the risk of cardiovascular disease.

It would seem that the signs are quite obvious, but most women cannot say for sure whether they are associated with the approach of menopause or is it just a coincidence. In the end, all menopause symptoms are atypical. People suffer from insomnia for a variety of reasons, a bad mood is also characteristic not only of women during perimenopause, and fatigue with the modern rhythm of life is a completely natural thing. 

In order to track the onset of menopause and take action in time, any woman after 40 should regularly visit an endocrinologist. Make sure to do it at least one time per six months. 

Besides, today, there is a special perimenopause test for the level of follicle-stimulating hormone, which is also often called the “menopause test.” It is relatively accurate and it can definitely tell if menopause has begun or not. Such a test strip can even be bought at a pharmacy, but its accuracy is not so high compared to laboratory research methods.

Perimenopause Treatment

The physiological process under consideration causes great inconvenience to a woman and not only in terms of well-being. Sweating, dizziness, and headaches interfere with the usual active lifestyle, and in some cases even “force” to stop working. To solve the problem, it is worth listening to the recommendations of gynecologists.

Drug therapy is the most common type of treatment used to deal with perimenopause symptoms.

Hormone therapy. Undoubtedly the best treatment choice for relieving perimenopausal symptoms up to this day. Based on your personal and family history, your doctor can prescribe estrogen at the lowest dose possible to alleviate symptoms.

Premenopausal hormone therapy is one of the most popular ways to deal with the manifestations of the early stage of menopause. In the world, about 45% of women use such drugs in order to delay the onset of this health condition. The essence of the method is to take small doses of the missing hormones – estrogen and progesterone. It is with their deficiency the majority of unpleasant and dangerous conditions for women’s health are associated. The main principles of therapy are the use of synthetic substitutes similar to natural hormones, as well as low dosages of these substances.

Indications for an appointment. Violations of the vascular system (hot flashes, sweating), psychological instability with identified hormonal causes, osteopenia, genitourinary syndrome. The decision on the relevance of menopausal hormone therapy is made by the doctor on the basis of detailed data – the age and duration of postmenopause, medical history, symptoms, the need for prevention, tests, etc. 

Contraindications: сancer, liver or kidney failure, thrombosis, thromboembolism, uterine bleeding, severe diabetes mellitus, and so on. 

Side effects. Bleeding, breast engorgement, headaches, fatigue, nausea, and a feeling of heaviness in the legs may occur. Admission Rules Dosages and a schedule of medications for menopause, as well as their form (tablets or gels, patches), are prescribed individually. On average, the duration of menopausal hormone therapy is about 5 years.

Other solutions are:

• Antidepressants. Some antidepressants associated with the class of drugs can minimize hot flashes. This is especially helpful both for women who can’t take estrogen because of their health condition and for women who have a hard time dealing with mood swings.
• Vaginal estrogen. It comes in many different forms, including vaginal pills, tubes, or creams, and can help relieve vaginal dryness. This treatment produces only a small quantity of estrogen that the vaginal tissue absorbs. It can be used to alleviate vaginal dryness, sex pain, and certain urinary symptoms.

While perimenopause supplements are also commonly used to relieve perimenopause symptoms, I haven’t mentioned them, because there is no consistent evidence of risk-free benefit. For example, black cohosh can result in liver toxicity. Thus, you should first consult a doctor.

Average Age for Perimenopause

According to the statistics provided by the North American Menopause, perimenopause may last from 4 to 10 years, which means that perimenopause age on average in the mid to late 40s. However, in some cases, women may notice signs of perimenopause as early as the late thirties and early forties.

The best indicator about when your final phase will be is your mom’s age when she has reached menopause (in case she didn’t have a hysterectomy).

All in all, visit gynecologists and follow a healthy lifestyle to moderate side effects of perimenopause.

FAQ

What is perimenopause?

Perimenopause usually occurs a few years prior to menopause. It’s the time when ovaries barely produce any estrogen.

How long does perimenopause last?

About four years on average. However, it may last from a few months to 10 years for some women. Perimenopause comes to an end when a woman has gone a year without having her period.

How long is too long for a period during perimenopause?

If you have irregular periods you may be in early perimenopause. If you have a space of 65 days or more between periods, you’re likely in late perimenopause.

How to lose weight during perimenopause?

Perimenopause weight gain is a big problem for many women, but it is possible to fix it. Follow these simple steps – Increase your activity, eat a great amount of nutrient-dense food, get enough sleep, clear your mind of stress.

 

Sheri Goddard

Expert on menopause. Woman Consultant at Menopause Coach.
I will help you look at menopause in a "new light", and empower you to make healthy, alternative choices rather than thinking you MUST use unsafe traditional methods as you make your transition to menopause and beyond.