If you thought hormonal ups and downs ended in your teenage years, surprise! Perimenopause, the time leading up to your final menstrual cycle, can also be a hormonal roller coaster.
But don't despair – while it's true perimenopause brings along a smorgasbord of unpleasant symptoms, it doesn’t have to control your life. There are steps you can take to feel your best during this phase.
What Is Perimenopause?
Perimenopause occurs during the 40s for most women, but some notice changes as early as their mid-30s. As estrogen hormones rise and fall, periods grow longer or shorter and women experience menopause-like symptoms. Perimenopause is a natural part of the aging process, although some medications, cancer treatments and ovary surgery can speed up the process or cause menopause sooner.
"Your ovaries are shutting down, but the process takes some time. That process is called perimenopause," explains Kourtney Morris, MD, a Franciscan Physician Network OBGYN in Lafayette, Indiana. "For some women, perimenopause is barely noticeable, but for others, the symptoms make them miserable."
Perimenopause lasts for four years on average but sometimes only a few months. In the last one or two years of perimenopause, the drop in estrogen speeds up, and women experience menopause symptoms while still having a period.
Dr. Morris discusses this stage of life and how to deal with uncomfortable perimenopausal symptoms.
What Are The Stages Leading Up To Menopause?
After puberty, there are three other phases of female fertility:
- Pre-menopause: Women have full ovarian function, regularly produce estrogen and ovulate.
- Perimenopause: The ovaries begin to fluctuate in their ovulation and production of estrogen, which can result in unpredictable menstrual cycles and symptoms.
- Menopause: When the ovaries have shut down. Someone would be in menopause after 12 months without menses.
When Does Perimenopause Start?
The average age of menopause is 51, and perimenopause symptoms typically begin about four years before your final period. Most women start to notice perimenopause symptoms in their 40s. But perimenopause can happen a little earlier or later, too. The best predictor of when your final period will be is the age at which your mother entered menopause (if she didn't have a hysterectomy).
What's The First Sign Of Perimenopause?
The first perimenopause sign is typically a disruption of your menstrual cycle. For many women, your period starts earlier or later than normal. For example, if your menstrual cycle has always been 28 days, during perimenopause, your period could come as early as 21 or as late as 35 days. Some women start skipping months entirely and then experience heavier-than-normal periods when they do have them.
What Are The Symptoms Of Perimenopause?
During perimenopause, you can experience a variety of symptoms. The reason: Your ovaries have been making estrogen since your first period. During perimenopause, the estrogen production decreases substantially. Your body has to adjust to functioning with less of the hormone, putting you into estrogen withdrawals. The type and intensity of symptoms vary greatly among women – some just feel a little off or don't notice anything at all.
Others can experience perimenopausal symptoms including:
- Trouble sleeping
- Feeling irritable, anxious or depressed
- Night sweats
- Hot flashes
About 80 percent of women will experience some form of a hot flash during perimenopause or menopause. Hot flashes happen when your brain has trouble regulating your internal temperature, which is a common response to having less estrogen. The shift in temperature may not be noticeable. Or, it may feel like someone cranked up the thermostat on your core body temperature. You suddenly feel uncomfortably hot and sweaty, or you may wake up drenched in sweat (called night sweats).
How Can You Alleviate Perimenopausal Symptoms?
Some women deal with the symptoms of perimenopause, and some women seek treatment for specific health concerns. Women with heavy bleeding, periods that last longer than seven days, spotting between periods or cycles that are less than 21 days should contact a doctor.
Typically, perimenopause is a gradual transition, and no particular test indicates what is happening to the body. Hormone therapy, vaginal estrogen treatments and antidepressants can help treat perimenopausal symptoms.
Start by identifying what's bothering you most and then working with your doctor to address it. There are steps you can take to feel better. Lifestyle changes that can make a big impact in easing perimenpausal symptoms and improving your overall health include:
Your gynecologist can help develop a treatment plan to tackle symptoms, like:
- Erratic bleeding: Hormonal medications can create a predictable menstrual cycle.
- Depression: A low-dose antidepressant can improve a mood disorder.
- Irritability: An exercise plan can improve mood.
But sometimes, what comforts women most is knowing that they're not alone – and that perimenopause doesn't take away vitality. Your body is moving toward not having babies anymore. It's completely normal and natural. You're just preparing for the next stage in life.
Find a gynecologist near you or learn about Franciscan Health's gynecology services.