Perimenopause

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Perimenopause facts

  • Menopause is the time of life at which a woman's menstrual periods stop. The medical definition of menopause is the time at which a woman has not had a menstrual period for 12 consecutive months.
  • The time around this point of menopause has been referred to as the perimenopause. There is no strict medical definition of perimenopause, but it typically refers to the time approaching menopause during which a woman starts to develop symptoms of declining estrogen levels.
  • Some of the symptoms of perimenopause include
  • Not all women experience all the symptoms of perimenopause to the same degree, and symptoms vary among women.
  • Treatment of perimenopausal symptoms includes hormone therapy and lifestyle measures such as diet, exercise, and smoking cessation.
  • Estrogen therapy may decrease the severity of symptoms of perimenopause.

How does the menstrual cycle work?

Every woman is endowed at birth with a set number of eggs within each ovary. As she enters adolescence, the higher brain centers that are responsible for the onset of puberty begin to mature and function in a coordinated fashion. Menstrual cycles begin and once a month, one of the ovaries releases an egg, which may be fertilized if intercourse occurs during the days when the egg is viable. If fertilization does not occur, the egg, which is composed of a single cell, degenerates and dies within the abdominal cavity. Without fertilization of the egg, the uterine lining is shed off approximately two weeks after ovulation (i.e. release of an egg by the ovary). This cycle is repeated monthly unless a pregnancy is conceived. As a woman ages, her ovaries begin to run out of eggs. At this point ovulation may become erratic. This results in irregular bleeding episodes that may be heavy and unpredictable.

Throughout the normal menstrual cycle, hormones are produced from the ovaries in a rather precise sequence. This can cause numerous side effects (for example, menstrual cramps,) which may or may not be predictable. As the ovaries become depleted of eggs and bleeding episodes become more erratic, there are alterations in the quantity and frequency of ovarian hormone production, which can lead to numerous physical manifestations. The time period when the depletion of ovarian eggs results in irregular bleeding and other related symptoms has been termed "perimenopause."


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Menopause Symptoms

Some of the most commonly reported symptoms include hot flashes and night sweats. These can be associated with flushing and may be followed by intense sweating. Other symptoms that are related to lowering of estrogen levels include

  • vaginal dryness,
  • painful sexual intercourse (dyspareunia), and
  • vaginal irritation or itching.

Other symptoms include

  • Frequent urination
  • Changes in skin texture
  • Mood swings and changes