Understanding “The Change”: Perimenopause Explained
Most often referred to as “The Change” or menopause transition, perimenopause is the period in a woman’s life that begins a few years before menopause itself begins. This developmental period is where the body is beginning to decrease its estrogen production and symptoms of menopause may begin to manifest. Here’s everything you need to know on perimenopause.
Will perimenopause affect me?
Perimenopause tends to begin in a woman’s 40s, though it’s possible for it to begin in the 30s or even earlier in some cases. A woman is considered to be in perimenopause until the time when the ovaries stop releasing eggs to be fertilized—at this point, menopause itself starts.
Average perimenopause length is four years, though the length varies between people. It can be as short as a few months or as long as a decade in some cases. You’ll know it has ended for good when you’ve gone a full year straight without getting your period.
What if I have other questions?
While perimenopause affects people so differently, it’s a natural process that many will experience. Here are a few common questions that people have asked:
- What are the signs and symptoms? Symptoms may include hot flashes, tender breasts, fatigue, headaches, lower sex drive, hot flashes, night sweats, heart palpitations, vaginal dryness, irregular periods, urine leakage (often after coughing or sneezing), urinary urgency, mood swings, issues with sleep, acne complications and severe premenstrual syndrome.
- When should symptoms concern me? If you have heavy periods or blood clots included in periods, spots between periods or after sex, periods too close together, or periods lasting longer than usual, you should see your doctor.
- Is it the same as premenopause? No. The terms are often used to mean the same thing, but this is incorrect. Per the North American Menopause Society, premenopause is the time between your first period and the onset of perimenopause, while perimenopause is a transition phase into menopause.
- Does it happen to everyone? No. Some women may have sudden induced menopause, including women who have had ovaries removed or damaged through cancer treatments. These women will not go through perimenopause.
- Can I get pregnant? Yes. While rates of fertility are lower during this stage and becoming pregnant is less likely, it is still possible. You should still use birth control until menopause if you want to be sure you avoid pregnancy. If you’re in this age range and struggling to get pregnant, speak to your doctor about treatments that might help.
- Will it make me more emotional? Mood swings can be a part of perimenopause, likely due to hormone changes and factors like stress, aging or infertility anxiety.
- Will it affect my sex life? In some cases, this can happen. Things like vaginal dryness and limited sex drive can affect women in perimenopause, but there are treatments you can use to combat this as well.
- How is it diagnosed? In many cases, reported symptoms will be enough for your doctor to diagnose perimenopause. If not, they may order a blood test to check hormone levels.
- How can I ease symptoms? In some cases, low doses of birth control can help with hot flashes or other perimenopause symptoms. In others, basic lifestyle and well-being elements may help, including the following:
- Quit smoking
- Get better exercise and sleep
- Maintain a healthy weight
- Take antidepressant medications for mood issues
- Reduce alcohol intake
- Take calcium supplements or multivitamins (if your doctor recommends it)
In general, speaking to your doctor about how to prepare for menopause is important. Don’t be afraid to ask questions.
Other Health Risks
Menopause and perimenopause are not causes of heart disease, but your risk may rise during this period due to the decrease in estrogen levels and changes to cholesterol or blood pressure levels. These changes can impact heart disease risks, but you can also take steps to lower these risks and balance this out.
Your doctor can offer further recommendations for perimenopause and how to manage it.
The obstetricians/gynecologists, nurse practitioners and certified nurse midwives at Revere Health OB/GYN provide a full range of healthcare services to women throughout all stages of their lives including; puberty, child-bearing years, menopause, and beyond.
“Perimenopause.” WebMD. https://www.webmd.com/menopause/guide/guide-perimenopause#1
“The Change Before the Change: 9 Questions About Perimenopause.” Penn Medicine. https://www.pennmedicine.org/updates/blogs/womens-health/2016/december/the-change-before-the-change