Submitted by Dele Ogunleye, MD, Advanced Women’s Healthcare
Perimenopause, often referred to as “the change before the change,” usually begins five to ten years before menopause is reached. Once a woman has gone 12 consecutive months without a period, then she can be fairly sure that she has been through menopause. The years leading up to menopause are a gradual transition, and it is a common mistake to use the word menopause to describe this entire phase of a woman’s life. Some women begin experiencing menopausal symptoms as young as the mid-thirties, while others may be closer to 50. Because symptoms usually come on very gradually, women often don’t recognize the symptoms or realize that they are connected.
During perimenopause, levels of estrogen and progesterone — two female hormones made in the ovaries — go up and down irregularly. This leads to changes in menstrual periods, which is often the first and most noticeable symptom. Periods may become very heavy or very light, last for a longer or shorter time, and occur less regularly, even skipping a month here and there. In addition to irregular periods, the fluctuation in hormone levels that begins during perimenopause can also cause a wide range of menopausal symptoms including hot flashes, night sweats, mood swings, vaginal dryness, difficulty sleeping, intense premenstrual syndrome, and fatigue. Many of the symptoms continue until a woman is officially “post-menopausal,” typically by her mid-fifties.
Perimenopause often arrives sooner than most women expect. There is no one-size-fits-all age and women will experience the symptoms differently. Many women go through this transition with very mild symptoms that are only a minor annoyance, but for some, hot flashes and other symptoms can be so severe that it interferes with daily activities. If this happens, be sure to see your physician, who can evaluate your symptoms and first rule out any abnormalities that may be more serious. Most women don’t require medications or treatment, rather they need help identifying ways to alleviate the symptoms and find relief in order to restore balance in their lives.
Fortunately, there are many ways to seek relief. Lifestyle changes, such as exercise, healthy nutrition, getting enough sleep, or reducing stress, often help. Medications, especially hormone therapy, can be very effective in reducing symptoms. Hormone therapy is available in many different hormone combinations and in a variety of forms and doses. It is important to work very closely with your physician to determine the best treatment plan for you; each woman is different, and so therapies must be personalized to each and every woman.
During perimenopause, it is still very possible to become pregnant! So do not stop birth control until you have not had a period for 12 consecutive months. However, it is important to note that reproductive potential declines as a woman ages. So if you are planning to begin a family in your 30s and 40s, be sure to discuss family planning with your physician.
Perimenopause can be difficult to identify and experience. The important thing is to educate yourself about the transition, consult with your doctor, and make an informed decision about what treatment — if any — is best for you.
Dele Ogunleye, MD, provides a full range of obstetric and gynecologic services including hormone therapy and fertility issues. You may contact him at 309-808-3068 or www.awhcare.com. Advanced Women’s Healthcare is located at 2111 East Oakland Avenue (Next to the Jewel-Osco Plaza).