Perimenopause is the time in a woman's life when changes of approaching
term, which literally means “around the menopause,” refers to the
“menopausal transition.” Just like the menopause, the perimenopause
is usually a gradual process. The ovaries begin to produce lower
amounts of hormones. The reduced amounts of hormones cause menstrual
periods to become irregular. The hormonal changes often cause other
symptoms as a result of fluctuations in the hormone levels produced
by the aging ovaries.
women go through the perimenopause between ages 42 and 50. In the
US the average age for menstrual periods to stop completely is 50.
are the symptoms?
may have both physical and psychological symptoms during the perimenopause.
Symptoms may occur for a few weeks, a few months, or sometimes over
several years. Your symptoms may come and go, or they may occur
physical symptoms are common during the perimenopause:
dryness and shrinkage of genital tissues, sometimes resulting
in discomfort or pain during sexual intercourse
more frequent urination or leakage of urine (urinary incontinence)
frequent minor vaginal and urinary infections.
perimenopause usually occurs at a time in life when other dramatic
changes take place. Some of these changes may include loss of parents,
adjustment to children growing up and leaving home, becoming a grandparent,
retirement, or career changes. These changes, in addition to the
changes in your body, may result in psychological or emotional stress.
symptoms of perimenopause may include:
desire for sex
trouble remembering things.
changes that may occur during the perimenopause include:
heavier menstrual flow
more painful menstrual cycles
is it diagnosed?
perimenopause can often be diagnosed through your medical history.
Your health care provider will then examine you. He or she may order
blood tests. Often, blood tests for “hormone levels” will be interpreted
as “normal.” However, just because these levels are evidence that
“menopause” has not yet arrived, fluctuations of ovarian hormones
still take place with the resultant symptoms you might be experiencing.
A pelvic exam and Pap smear may show effects of decreased estrogen.
assume that hot flashes and other changes during the perimenopause
are caused by approaching menopause. Many perimenopausal changes
can also be caused by something else, such as thyroid disease or
disorders and some can be signals of serious disease. Report any
changes to your healthcare provider so serious causes can be ruled
is it treated?
perimenopause is a natural part of a woman's life cycle. It is not
a disease and does not necessarily require any treatment. However,
certain health problems, such as osteoporosis and increased heart
disease, are associated with low estrogen. To help prevent such
problems, many women choose to take birth control pills at this
time to replace what their body is no longer producing. This treatment
is called “hormone supplemental therapy.”
and your health care provider should discuss the pros and cons of
hormone supplemental therapy for you. Factors such as your age,
race, family history, and health history will be considered in the
discussion. This supplemental is the most effective treatment for
preventing the symptoms associated with this time period as well
as reducing menstrual irregularity and worsening cramps associated
with menses. However, it is not the right treatment for every woman.
Women who have had some types of breast cancer or other cancer,
blood clots, certain liver disease or smoke heavily should not take
birth control pills.
your health care provider about any side effects or special precautions
you should know about while you are taking hormones. Make sure that
your provider knows about any other medications you are taking.
long will the effects last?
of the perimenopause usually last for several years. Unlike the
menopause, this transitional period continues until loss of estrogen
is low enough to inhibit menses altogether.
you have had no menstrual periods for several months and then have
bleeding from the vagina, check with your health care provider promptly.
Vaginal bleeding in a woman, who has not had periods for months,
or especially years, can be a symptom of cancer.
can I take care of myself?
See your health care provider annually for your exam and to review
any concerns you might have dealing with the perimenopause.
Have a mammogram every 2 years between the ages of 40 and 50,
and every year after age 50.
Eat more foods that are high in calcium, such as dark green vegetables
and nonfat (skim) milk and dairy products.
Obtain an adequate intake of dietary calcium (1,200-1,500 mg per
Obtain an adequate intake of vitamin D (400-800 IU per day).
Reduce saturated fats in your diet. Check labels for product contents
before you buy them.
Get regular physical exercise. Exercise will help you fight depression
and maintain good circulation, mobility, bone density, and a sense
Use birth control during sexual intercourse until your health
care provider says that you may stop. It is not possible to know
exactly when you will stop being able to get pregnant and it is
important to avoid high-risk pregnancies.
Take one baby aspirin (81 mg) per day to decrease the blood’s
ability to clot.
Supplement your diet with fresh fruits and antioxidants (e.g.,
vitamin C and E).
may also choose to:
Wear cotton sleep ware to reduce discomfort from night sweats.
Use a vaginal lubricating cream or jelly if intercourse is painful.
This problem is usually caused by a lack of estrogen and should
be discussed with your health care provider.
Talk and share feelings with a friend or family member who understands
what you are experiencing.
Join a support group for women who have been or are going through
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