Defining Perimenopause

by Cindy Gray

As women age, their bodies begin to change and transition toward menopause. Dubbed 'perimenopause,' this phase typically occurs in the 40s, but sometimes earlier.  Although the average duration of perimenopause is four years, it can last from a few months up to 10 years.  This chapter of a woman's life officially ends when she has gone 12 months without menstruating.

Production of less estrogen, progesterone, and testosterone eventually leads to perimenopause symptoms.

Perimenopause Symptoms

As a woman’s body transitions, it begins to produce less estrogen, progesterone, and testosterone.  This can lead to an array of perimenopause symptoms, which become more pronounced toward the end of the phase.

  • Breast tenderness
  • Fatigue
  • Hot flashes and/or night sweats
  • Leakage of urine and urinary urgency
  • Mood swings
  • Reduced sex drive
  • Sleep disturbance
  • Vaginal dryness and discomfort during sex
  • Worsened PMS

Irregular Periods

In addition to these symptoms, women in perimenopause experience fewer periods, with longer intervals in between.  While bleeding gradually diminishes over time for most women, some experience bouts of heavy bleeding.  Women who have unusually heavy bleeding, clots, or spotting after sex or between periods should consult with a health care professional to rule out hormone issues, fibroids, or other medical problems.  Eventually, monthly periods cease altogether, and women transition into menopause. 

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Perimenopause Diagnosis

While doctors often diagnose perimenopause on the basis of symptoms, blood tests can provide information about hormone levels.  Because levels often fluctuate wildly during this time, women may wish to have several blood tests taken for comparison.

Perimenopause and Pregnancy

Although women become less fertile during perimenopause, pregnancy is still possible.  Women who do not want to become pregnant at this time should use birth control until menstruation has ceased for 12 months.

Ways to Reduce Perimenopause Symptoms

Low-dose birth control pills keep hot flashes and night sweats at bay for some women during perimenopause, as do vaginal rings and progesterone injections.  Women who wish to go a more natural route can add foods containing phytoestrogens to the diet like soy, flaxseed, yams, and wheat germ.  Adequate amounts of calcium, vitamin D, magnesium, and zinc promote a good night's sleep and offer women support for healthy bones.  Daily exercise, no smoking, limited alcohol use, and practicing relaxation techniques also help women maintain quality of life through perimenopause and beyond.  

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