Most women are aware of the signs and symptoms of menopause, but many others are not aware of the signs and symptoms of perimenopause. While symptoms are usually less severe than menopause, they can still cause much suffering and distress if not managed correctly.
What is perimenopause?
Menopause occurs when the ovaries stop releasing eggs. By definition, menopause is diagnosed in hindsight – the absence of periods for one year is diagnostic of menopause. For a few years preceding menopause, the ovaries start releasing eggs less regularly. Hence irregular periods are very common before menopause. This period is known as perimenopause. There is no specific age when perimenopause starts as it is more of a gradual process.
How Long Does Perimenopause Last?
The majority of women go into perimenopause less than five years before menopause. The average length of perimenopause is 4 years, but for some women this stage may last only a few months or continue for 10 years. Perimenopause ends when a woman has gone 12 months without having her period.
What are some signs and symptoms of perimenopause?
Signs and symptoms of menopause might be similar to other medical disorders. They are also similar to those of menopause. Some common symptoms and signs of perimenopause include the following:
• Irregular periods: this is the most common sign of perimenopause.
• Insomnia: sleepless nights may be as a result of hot flushes, but can also be caused by emotional changes.
• Decreased libido: lower levels of oestrogen during this time can mean you lose your appetite for sex.
• Uncomfortable sex: this is due to a decrease in oestrogen levels which means the vagina does not lubricate well.
• Changes in mood: lower oestrogen levels mean less serotonin (one of the ‘feel-good’ hormones) which can lead to your emotions being thrown off balance.
• Hot flushes: these are not as common as they are in menopause, but they can still happen.
• Breast tenderness.
• Urinary urgency.
If you experience unusually heavy periods, bleeding in between your periods, or bleeding after having sex, visit your gynaecologist for advice.
How is perimenopause diagnosed?
Often your doctor can make the diagnosis of perimenopause based on your symptoms. A blood test to check hormone levels may also help, but your hormone levels are changing during perimenopause. It may be more helpful to have several blood tests done at different times for comparison.
Can you get pregnant if you are perimenopausal?
Yes. Despite a decline in fertility during the perimenopause stage, you can still become pregnant. If you do not want to become pregnant, you should use some form of birth control until you reach menopause (you have gone 12 months without having your period).
Treatment
If you have severe symptoms associated with the perimenopausal period you should see your gynaecologist, but there are several things that you can do to help relieve symptoms. Just a few simple lifestyle adjustments can prove helpful:
Regular exercise, staying fit and healthy, and avoiding refined sugars can help with symptoms. Meditation can also be beneficial. If you smoke, stop. Many herbal medications are available over the counter, but caution should be taken before using them – as some may contain unopposed oestrogen. If your symptoms are severe and do not improve with lifestyle changes, and if you feel your symptoms are having a negative effect on your daily life, you should make an appointment to see your gynaecologist who might prescribe various medications.
Conclusion
The perimenopausal period in a woman’s life can be very difficult for some women. Symptoms vary from one woman to another. If your symptoms are severe seek professional help. In addition to lifestyle changes, treatments are available to help with the various symptoms of perimenopause.
Ask Your Dr is a health education column and is not a substitute for medical advice from your physician. The reader should consult his or her physician for specific information concerning specific medical conditions. While all reasonable efforts have been made to ensure that all information presented is accurate, as research and development in the medical field are ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge MB BS DGO MRCOG is an obstetrician/Gynaecologist and Family Doctor with over thirty-five years in clinical practice. Dr Brett Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 497 5928).
