What Is Perimenopause?
Perimenopause, or menopause transition, is when your ovaries gradually begin to make less estrogen. It lasts until menopause, the point when your ovaries stop releasing eggs. In the last 1-2 years of perimenopause, this drop in estrogen speeds up. At this stage, you may have menopause symptoms.
When Does Perimenopause Start?
It usually starts 8-10 years before menopause. It usually happens when you’re in your mid-40s, but it can start in your 30s or earlier.
If you go through menopause before age 40, that’s called premature menopause. It can be caused by some medical conditions or procedures. If there is no medical or surgical cause for premature menopause, it’s called primary ovarian insufficiency.
Early menopause can be caused by:
- Smoking or using other tobacco products
- A family history of early menopause
- A history of cancer treatment
- Having your uterus or ovaries removed
Perimenopause vs. Premenopause
You might hear the terms perimenopause and premenopause used interchangeably, but they mean different things:
- Premenopause is the time between your first period and the onset of perimenopause.
- Perimenopause is when you transition into menopause.
How Long Does Perimenopause Last?
The average length of perimenopause is 4 years, but this stage may last only a few months or continue for 10 years. Perimenopause ends when you’ve gone 12 months without having a period.
Perimenopause Symptoms
Perimenopause symptoms may include:
- Hot flashes and night sweats, or vasomotor symptoms (VMS)
- Breast tenderness
- Worse premenstrual symptoms
- Lower sex drive
- Fatigue
- Irregular periods (also called perimenopause periods)
- Vaginal dryness or discomfort during sex
- Leaking pee when you cough or sneeze
- Having an urgent need to pee more frequently
- Mood swings
- Trouble sleeping
- Short-term memory problems
- Trouble concentrating
Are My Perimenopausal Symptoms Normal or Something to Be Concerned About?
Irregular periods are common and normal during perimenopause. But other conditions can cause changes in menstrual bleeding. If any of the following situations apply to you, see a doctor to rule out other causes:
- Your periods are very heavy, or they have blood clots.
- Your periods last several days longer than usual.
- You spot between periods.
- You have spotting after sex.
- Your periods happen closer together.
Causes of abnormal bleeding include hormone problems, birth control pills, pregnancy, blood clotting problems, or rarely, cancer. It can also be a sign of fibroids. Symptoms of fibroids, which can worsen during perimenopause, include heavy cycles, backaches, pelvic pain and pressure, frequent urination, and anemia. See your doctor if you have these symptoms.
Perimenopause Tests
Your doctor can often make the diagnosis of perimenopause based on your symptoms. A blood test to check hormone levels may also help, but your hormone levels keep changing during perimenopause. It may be more helpful to have several blood tests done at different times for comparison.
At-home perimenopause tests are available over-the-counter to measure follicle-stimulating hormone (FSH) in your pee. But health experts aren’t sure taking these tests is a good idea. That’s because your FHS levels fluctuate, and your doctor considers other things such as your health history and overall condition when diagnosing perimenopause.
Can I Get Pregnant if I Am Perimenopausal?
Yes. Despite a decline in fertility during the perimenopause stage, you can still become pregnant. If you do not want to become pregnant, you should use some form of birth control until you reach menopause (you have gone 12 months without having your period).
For some women, getting pregnant can be difficult once they are in their late 30s to early 40s due to a drop in fertility. If becoming pregnant is the goal, there are treatments that can help you get pregnant.
Perimenopause Treatments
You may get relief from hot flashes and night sweats, or VMS, after taking low-dose birth control pills for a short time. Other options that may control hot flashes include the birth control skin patch, vaginal ring, and progesterone injections. Certain women should not use birth control hormones, so talk to your doctor to see if they are right for you.
Credit: Webmd
