When we say a woman is going through menopause, what she is actually "going through" is perimenopause. This is the transition period before menopause. And you reach menopause after 12 consecutive months without a menstrual period.
1) What causes perimenopause?
Perimenopause occurs because of changes in hormone levels. Estrogen levels are rising and falling in an irregular fashion.
Even if you used to have predictable menstrual cycles in the past, cycles can become longer or shorter then before, they may even disappear sporadically, and your period can change as well. More cramping, less cramping, more blood or less, no matter what your experience has been for the last decade or so, it's up for grabs during perimenopause.
2) When does perimenopause start?
There's a wide variety as to when it will start and when it will end for individual women. Some may start noticing some changes as early as their 30s, others won't see anything until their 40s.
Perimenopause can begin eight to 10 years before menopause, according to the Cleveland Clinic. Dr. Christian Northrup said that it can even last from five to 13 years.
3) How do you know when perimenopause is over?
Perimenopause is over 12 months after your last menstrual period. This is menopause.
4) What happens to hormones during perimenopause?
Levels of estrogen, progesterone and androgens such as testosterone will be altered. Effects of these hormone changes will vary from woman to woman.
Lower estrogen levels can contribute to pain during intercourse, or vaginal infections, because of decreased elasticity and lubrication. This may seem like a logical result, but lesser known is the fact that urinary problems, like urinary infections or incontinence, can also arise.
As testosterone decreases, this can cause low sex drive or sexual response, less erogenous zone sensitivity, lower sense of well-being, lack of energy.
5) Can I get pregnant during perimenopause?
Even though periods may become irregular, and your estrogen levels are going down, pregnancy may still be possible until menopause.
6) What is artificial menopause?
Artificial menopause affects 25 percent women, from surgical ovary removal, surgical disruption of ovaries' blood supply, from chemotherapy, radiation, or from certain drugs. Coming to menopause this way can be really intense because the transition time is so short.
7) What is premature menopause?
Premature menopause occurs in the 30s or early 40s. Autoimmune diseases, nutritional deficiencies or chronic stress issues often accompany this early menopause. Here too, the transition time is short and hard.
8) What is natural menopause?
Natural menopause will usually occur between 45 and 55 years of age, with a milder transition period.
9) What's the downside of perimenopause?
Symptoms like hot flashes, night sweats, sleep dysfunction and vaginal dryness are well-known.
Mood swings affects some women, to varying degrees. Depression is more common during this time.
You may be more prone to headaches and muscle aches. Your heartbeat may become more rapid. You may have a decrease in your ability to concentrate and an increase in memory loss.
The risk for arthritis, breast cancer, heart disease and osteoporosis increase as perimenopause progresses.
Other symptoms of perimenopause can include weight gain, water retention, PMS and breast tenderness. Hair may become thinner and dryer. Skin can be drier too.
10) What's the upside?
Sound intimidating? In some ways, perhaps. But life goes on after menopause, and in some ways things are easier.
For the first time since your teens, monthly fluctuating hormones will not be a factor. No longer will you need to keep track of periods or ovulation, no more will you wonder if you might be pregnant.
You will have entered a brand new phase of life. Embrace it.
Reviewed July 26, 2016
by Michele Blacksberg RN