Premenopause or perimenopause can be a confusing and difficult time for women, so it’s important to understand the associated symptoms and treatment options.
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In this article:
- What Is Perimenopause?
- When Does It Begin and End?
- What Are the Different Perimenopause Symptoms?
- When Should You See a Doctor?
- How Does Perimenopause Impact Fertility?
- How Do Doctors Diagnose Perimenopause?
- What Are the Treatment Options for Perimenopause?
Everything You Need to Know About Perimenopause
What Is Perimenopause?
Perimenopause or premenopause occurs when a woman’s body is transitioning into menopause. During this period, the ovaries begin to produce less estrogen.
What is menopause? This is a period when women stop menstruating because the ovaries cease to release eggs.
At the beginning of perimenopause, the decrease in the production of estrogen is gradual. Towards the end of perimenopause, women experience a dramatic drop in estrogen over a period of 1-2 years.
It’s during those last two years when most women begin experiencing the uncomfortable symptoms of menopause.
When Does It Begin and End?
The onset and duration of perimenopause will vary from woman to woman. Most women enter the perimenopause phase in their 40s, but it can begin as early as one’s 30s or even 20s.
While some women report experiencing perimenopause symptoms for a few months, others experience the symptoms for 10 years. The average reported duration of perimenopause is 4 years.
Perimenopause officially ends when a woman has gone 12 consecutive months without having her period—not even light spotting. After a full year without menstruating, perimenopause ends and menopause begins.
What Are the Different Perimenopause Symptoms?
Perimenopause and menopause share similar symptoms. These symptoms include:
- Fatigue
- Sleep issues
- Hot flashes
- Tender breasts
- Decreased sex drive
- Vaginal discomfort during sex
- Vaginal dryness
- Frequent and urgent need to urinate
- Urinary incontinence
- Mood swings
During the perimenopause phase, women may also experience more severe premenstrual syndrome and irregular periods. Due to hormonal fluctuations, women in perimenopause may notice the following changes in their periods:
- May be shorter than usual
- May be longer than usual
- Menstrual cycle may be longer than usual (often described as delayed periods)
- Menstrual cycle may be shorter than usual (often described as early periods)
- May be lighter than usual
- May be heavier than usual
When Should You See a Doctor?
While irregular periods may be one of the symptoms of perimenopause, it’s also a symptom of other medical conditions. It’s best to consult your doctor if any of the following occurs:
- Very heavy periods
- Expelling blood clots while menstruating
- Spotting in between periods
- Spotting after sex
- Periods that last for more than 7 days
- Shorter than usual menstrual cycles (periods that closely follow one another)
If you are experiencing these symptoms because of perimenopause, your doctor should be able to rule out other possible causes such as pregnancy, hormonal issues, contraceptive medication issues, blood clotting issues, uterine fibroids, or even cancer.
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How Does Perimenopause Impact Fertility?
There’s a decline in fertility during perimenopause, but pregnancy is still a possibility. If you don’t want to get pregnant, then it’s important to keep using some form of birth control until you have officially entered into menopause.
Women who plan on getting pregnant during this phase may find it challenging. Fortunately, there are doctors who specialize in fertility treatments that can help these women.
How Do Doctors Diagnose Perimenopause?
If a patient reports experiencing menopause symptoms and having irregular periods, a doctor may request for a series of blood tests to confirm their diagnosis.
A series of blood tests are done over a period of time to check hormone levels. It’s best to perform a series of tests in order to determine the baseline hormone levels and to check if it changes over time.
What Are the Treatment Options for Perimenopause?
There are lifestyle changes that can help manage the symptoms of perimenopause. These include:
- Quit smoking
- Avoid drinking
- Start a regular exercise routine
- Improve quality of sleep
- Maintain a healthy BMI
- Add calcium-rich foods to diet
- Take a daily multivitamin
Over-the-counter medication may also be prescribed to help ease some of the symptoms. For women who are struggling with hot flashes, certain types of birth control medication may help.
Antidepressants may also be prescribed to help manage mood swings. It’s important to consult with your doctor before starting any new medication or supplement.
Perimenopause may also impact your intimate relationships. If you have a lower sex drive, it may be helpful to use vaginal lubrication during sex to compensate for vaginal dryness.
Therapy or counseling sessions with your partner may also help. Meeting with a trained therapist gives you and your partner the opportunity to openly communicate your issues in a safe space.
It’s important to understand that women experience perimenopause in different ways. Some women may breeze through it, while others might need some help.
That’s why it’s important to talk to your doctor about it. There is no one-size-fits-all treatment plan for perimenopause.
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