Natural menopause, the complete cessation of the menstrual cycle, usually occurs sometime between a woman's mid forties and her mid fifties. The years leading up to that event are called perimenopause. Perimenopause is a transitional time when a woman's hormones may fluctuate wildly as her body shifts into menopause from regular cycles of ovulation and menstruation.
Perimenopause is different for every woman. Although it typically begins in a woman's fifties, perimenopause can start as early as the mid-thirties and last for ten years or longer. It is a natural, normal part of aging that takes place when a woman's body no longer needs large amounts of the sex hormones estrogen and progesterone for child bearing. The problem is that these hormones perform other functions. Estrogen, for example, helps to regulate mood, body temperature, blood pressure, blood sugar levels and organ lubrication.
During perimenopause, spikes and drops of estrogen and progesterone levels can cause a host of unpleasant physical, emotional and cognitive symptoms, including: hot flashes, night sweats, heart palpitations, insomnia, fatigue, aching joints, forgetfulness, headaches, depression and anxiety
Menstrual periods can be irregular - shorter, longer, heavier or lighter than normal. 1 However, as long as a woman is menstruating, she can still become pregnant and should take precautions to avoid unwanted conception.
Decreased libido is another side effect of perimenopause. As estrogen levels drop, the tissue lining the vagina becomes thinner, drier and less elastic. As a result, women may experience irritation, itching or pain during intercourse as well as an increased risk of vaginal infections. The lining of the urethra also becomes thinner, drier and less elastic. This can mean an increased risk of urinary tract infection and urinary incontinence.
Perimenopause can be diagnosed using blood and urine tests that detect changes in the levels of three important reproductive hormones:
- Estradiol, which is responsible for the growth of the uterus, fallopian tubes and vagina.
- Follicle-stimulating hormone (FSH), which stimulates the production of eggs and estradiol.
- Luteinizing hormone (LH), which increases to cause ovulation.
A woman who is experiencing any of the symptoms described above should consult her physician for testing to determine if she is close to menopause and to eliminate anything potentially dangerous.
Perimenopause Symptoms Treatment
Hormone replacement therapy (HRT), using artificial estrogen and progesterone, is often prescribed to alleviate perimenopausal symptoms. However, not all women are good candidates for HRT. Women with a current or past history of breast, ovarian or endometrial cancer, blood clots in the legs or lungs, stroke or liver disease, and women who smoke should avoid HRT.