Menopause

What Every Woman Needs to Know About Perimenopause

Menopause is when your period stops permanently, and you are no longer able to get pregnant. But it isn’t like flipping a switch. Your ovaries wind down their production of hormones slowly over time, usually several years. Perimenopause is the transition to menopause.  Most women experience symptoms during this time as hormone levels fluctuate. Let’s unpack what the menopausal transition means for you and what you need to know.

What is Perimenopause?

Perimenopause is when your ovaries gradually start making less estrogen and progesterone and lasts until you haven’t had any periods for 12 months in a row, which is defined as menopause. Perimenopause usually starts 8-10 years before menopause.  It usually begins in your mid-40s, but it can start during your 30s. Premature menopause happens if you go through menopause before age 40. The average length of perimenopause is 4 years, but it can be shorter or as long as 10 years. The average age of menopause in the US is 52. Estrogen drops sharply during perimenopause. Estrogen levels can fluctuate more than they do during a typical menstrual cycle, which causes most menopausal symptoms. During the final phase of perimenopause your ovaries produce less and less estrogen, until they finally stop releasing eggs. This causes your periods to permanently stop.

Common Symptoms of Perimenopause

For many people, irregular periods are the first sign of perimenopause. Your periods may not come as often, may skip a month or two then start up again, be longer or shorter, or be heavier or lighter. They may vary from month to month. Other common symptoms are hot flashes, flushing, and night sweats. These vasomotor symptoms are experienced by 4 out of 5 women. A hot flash feels like your body temperature is rising rapidly. You may feel a wave of heat, start sweating, flush, and feel your heart rate go up. Hot flashes usually last 1-2 minutes but they can last as long as 5 minutes. Once the hot flash passes, you may feel a chill. Night sweats are hot flashes that happen at night. They often come with heavy sweating and disrupt your sleep.  Other perimenopause symptoms include vaginal dryness, painful sex, loss of interest in sex, and urinary incontinence. Some symptoms are invisible, like weakening bones and muscles or increased risk of heart disease, while others are easy to see, like weight gain and a wider waistline. All of these are due to declining levels of estrogen. Perimenopause can also impact on your emotional well-being. Sleep disruption can make you feel tired and contribute to feelings of anxiety and depression, as well as brain fog. You may experience mood swings or be irritable. Some people find it hard to concentrate or have problems with short-term memory.

Managing Perimenopause Symptoms

Perimenopause isn’t a disease; it’s a natural transition to a different time of life. There is no cure for perimenopause.  However, there are effective treatments for the symptoms. Lifestyle changes like eating a healthy diet, regular physical exercise, stopping smoking, drinking alcohol in moderation, and practicing stress-relieving techniques like yoga or meditation can help alleviate many of the symptoms and help prevent weight gain and heart disease.  If your symptoms are severe or lifestyle changes are not enough, there are over-the-counter treatments and prescription medications that can help. OTC or prescription vaginal creams can relieve dryness and help with painful sex. Antidepressants can provide relief from mood swings, depression, and hot flashes in some cases. Taking birth control pills can help stabilize your estrogen levels, which typically relieves symptoms. Gabapentin alleviates hot flashes for some women.  Hormone replacement therapy (HRT) has been proven to be the best treatment for hot flashes and night sweats and can safely benefit some women if started before age 60. The duration of hormone therapy is personal and depends on how you respond to treatment. Barring any health preclusions, women can use hormone therapy beyond the age of 65 if menopause symptoms persist. You don’t have to suffer menopause symptoms in silence.  Talk to your health care provider about the severity of your symptoms and appropriate treatments.

Conclusion: Empower Yourself with Knowledge

Perimenopause affects each woman differently. Some have symptoms that don’t bother them very much, while others have a tougher time with the menopausal transition. Knowing the facts arms you to take care of yourself and get the support you need. Making healthy lifestyle changes improves your well-being at any time of life but is especially important now.  As a WIN member, your Nurse Care Advocate is knowledgeable about perimenopause and can help you find a provider who can help you manage menopause symptoms.

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