Many individuals are familiar with the term menopause (also called ‘change of life’), but the term perimenopause is not widely known and is frequently misunderstood. Perimenopause is also called the menopausal transition and it starts in women at different ages, further making it very difficult to diagnose and manage.
What is perimenopause?
Perimenopause means “around menopause”, and refers to the time during which a woman’s body makes the natural transition to menopause, marking the end of the reproductive years. Perimenopause can begin several years before menopause. It is the time when the ovaries gradually begin to make less oestrogen. It usually starts in women’s 40s, but can start in their 30s or even earlier. 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 women have gone 12 months without having their period. Symptoms of perimenopause might be subtle and some not-so-subtle.
What are some signs and symptoms of perimenopause?
Most women will experience some form of perimenopausal symptoms prior to the menopause. The type and severity might vary tremendously in women. During this transition, the woman might experience the following:
• Irregular periods. When you have a normal period, the levels of oestrogen and progesterone increase and decrease in a regular pattern. During the perimenopause the fluctuating hormone levels can result in irregular periods.
• Vaginal dryness and changes in sexual function.
• Hot flashes and sleep problems. Hot flashes are common during perimenopause. The intensity, length and frequency vary. Sleep problems are often due to hot flashes or night sweats, but sometimes sleep becomes unpredictable even without them.
• Mood swings, irritability or increased risk of depression may happen during perimenopause. The cause of these symptoms may be sleep disruption associated with hot flashes. Mood changes may also be caused by factors not related to the hormonal changes of perimenopause.
• Sexual arousal and desire may change.
• Weight gain.
• Headaches.
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 I Get Pregnant If I Am Perimenopausal?
Yes. Despite a decline in fertility during the perimenopause stage, a woman can still become pregnant. It is important for women to use a reliable form of contraception during perimenopause if they do not want to become pregnant. They should discuss various options with their gynaecologist. Women should use some form of birth control until you reach menopause (you have gone 12 months without having your period).
Dealing with symptoms of perimenopause
There are several options available to helping to deal with the symptoms of perimenopause. Your gynaecologist would first rule out other causes for your symptoms and once you explain your symptoms – and goals a management plan can be developed. Your doctor might also recommend certain things you can do to enhance your general well-being which might also help your perimenopausal symptoms. These include the following:
• Exercise regularly.
• Stop smoking.
• Get more sleep, and try going to sleep and waking up at the same time each day.
• Drink less alcohol.
• Get to a healthy weight – and stay there.
• Get enough calcium in your diet.
You should talk to your doctor if you are having problems with your sex drive. He or she may be able to recommend a counsellor or therapist to help you and your partner work through this problem. Vaginal lubricants may also be recommended – if vaginal dryness is a problem. Make sure you tell your doctor about specific symptoms you are concerned about. Some women suffer with severe symptoms and do not seek medical advice. If a woman has symptoms that interfere with her life or well-being, such as hot flashes, mood swings or changes in sexual function that concern her, she should see a doctor.
Conclusion
Perimenopause is the transitional time around menopause. Perimenopause is a natural process caused when your ovaries gradually stop working. Perimenopause is marked by changes in the menstrual cycle, along with other physical and emotional symptoms. This period might last two to ten years and the severity of symptoms varies widely. If symptoms are severe, and are interfering with your life, you should seek professional help. There are many treatment options available for perimenopausal symptoms.
Ask Your Doctor 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 is ongoing, it is possible that new findings may supersede some data presented.
Dr Brett Hodge is an Obstetrician/Gynaecologist and Family Doctor who has over thirty eight years in clinical practice. Dr Hodge has a medical practice in The Johnson Building in The Valley (Tel: 264 4975828).
