Every woman experiences this during her prime – Perimenopause an uncomfortable transition period leading to the latter years of their lives. Because little is known about it, women are caught unprepared, more often than not, by this sudden, bewildering change in their bodies. This period is called the perimenopause.
What is perimenopause? – Perimenopause
Basically, perimenopause is the time of physical and hormonal changes that lead to actual menopause. Think of it as puberty in reverse. During the early years of their menstrual cycles, young girls have light bleeding because an egg is not produced by the ovary (called an “anovulatory cycle”).
Because of this, the body does not release the hormone progesterone, which promotes the buildup and shedding of the uterine lining each month.
During the reproductive years, the production of estrogen and progesterone follows a regular cycle. However, as a woman ages, her ovaries begin to slow down, not only running out of eggs, but also ceasing to produce estrogen. Since ovulation is no longer achieved, a woman’s menstruation becomes less and less, which is a sign of perimenopause.
When does perimenopause occur?– Perimenopause
Most women reach perimenopause at the age of 46. However, in some cases, it may begin as early as age 35 or as late as age 55. This period lasts from three to seven years. Smoking can hasten the occurrence of perimenopause by two years.
Is it possible to have children during perimenopause?
Pregnancy is possible during perimenopause, although it is not likely to happen as compared to the reproductive years of the 20s and 30s. Two-thirds of women ages 40-44 still ovulate regularly, increasing the chances for pregnancy.
In fact, the so-called “menopause babies” are born during this period. Unfortunately, the medical risks of such pregnancy during this period increase dramatically, thus making it inadvisable.
How will you know if you are in your perimenopause stage?
While most women breeze through perimenopause with a minimum of discomfort, 10 percent of women will experience the following:
1. Menstrual irregularities. For one cycle, there might be little bleeding and then heavy flow in the next month. On and off spotting may sometimes occur.
2. Hot flashes may be felt in the head or face or in the entire body. These warm sensations may disrupt daily activity. Hot flashes that develop at night are called “night sweats.”
3. Unpredictable breast tenderness or fullness
4. Decreased bone density, resulting in osteoporosis
5. Sleep disturbances, like insomnia or sleep disruption, which could lead to feelings of fatigue
6. Heart palpitations
7. Weight gain or feelings of bloatedness
8. Dryness of the skin and mucosa, especially the vaginal mucosa. Dry vaginal mucosa could cause dyspareunia or painful sexual intercourse, which could result in postcoital bleeding
9. Anxiety, mood swings or irritability
10. Headaches, dizziness, forgetfulness and/or difficulty in concentrating
11. Diminished sexual desire
How can I cope with perimenopause symptoms?
First of all, most US doctors advise women not to get pregnant during this period because of the increased medical risks. They are advised to take low-dose oral contraceptives, with estrogen content of 30 mcg. This also serves as a smooth transition to long-term hormone replacement therapy (HRT) after menopause.
HRT alleviates perimenopausal symptoms, and it has been shown to reduce the risk of developing ovarian cancer and rheumatoid arthritis. However, studies have also revealed that there is an increased risk of breast and uterine cancer.
Because of this, women who are at high risk of developing breast cancer or have a history of blood clots are not advised to take estrogen.
Hot flashes could also be treated with synthetic progesterone called Megace, which is being used in breast cancer treatment, or by clonidine, an antihypertensive drug. For those women who cannot take hormones, selective serotonin reuptake inhibitors (SSRIs) like Prozac are recommended.
To date, many contradictory studies on the pros and cons of HRT have been conducted. It is therefore best to consult your family doctor or specialist, and get a second medical opinion, if you so desire, before deciding on having HRT.
If you don’t like to take hormones, are there other treatment options?
In general, perimenopause is a sign for women to begin a healthy lifestyle, especially those who are experiencing their symptoms. Diet adjustment is recommended.
Taking vitamin E can help reduce hot flashes, although it is not advisable for women with hypertension, diabetes, rheumatic heart disease, vision disturbances, or those taking anticoagulant and digitalis drugs.
Soy, a plant estrogen, can also provide short-term relief symptoms. Exercise and relaxation techniques, such as yoga and meditation, can also ease perimenopausal discomforts. A woman should also stop smoking.
What is most important is to have a competent doctor who will help you to go through this period. Ironically, only one-third of obstetricians/gynecologists are considered menopause clinicians.
To help you in your choice of a good menopause clinician, look for one who is a good listener, is patient enough to monitor your changing symptoms, and is trained in the latest therapies.