Once a woman has not had a menstrual period for 12 consecutive months, she is medically considered to be in menopause. However, some women are unaware that the time preceding menopause is referred to as perimenopause.
There is no strict medical definition of perimenopause, but it typically refers to the time approaching menopause during which a woman starts to develop symptoms of declining estrogen levels. During this time, the ovaries begin to decline in function and this continues until menopause is reached.
Perimenopause usually begins in the 40s, but may start as early as the late 30s. During this time, a woman may exhibit a number of symptoms that are largely due to abnormal hormonal fluctuations.
Some of the symptoms of perimenopause include:
- hot flashes
- night sweats
- weight gain
- mood changes
- vaginal dryness
- vaginal pain
- pain with sexual intercourse
Not all women experience all the symptoms of perimenopause to the same degree, and symptoms vary among women.
Treatment of perimenopausal symptoms includes hormone therapy and lifestyle changes such as diet, exercise, and smoking cessation. Estrogen therapy may decrease the severity of symptoms of perimenopause.
Management of the perimenopause is largely dependent on the severity of symptoms. However, there are certain risk factors which may indicate that a woman is prone to more serious problems. If you are in one of these high-risk groups, you should seek care as soon as any of the symptoms of perimenopause begin.
1. Cigarette smoking: Carbon monoxide from cigarette smoke is found in the bloodstream in high concentrations during the act of smoking. This compound causes net loss of bone calcium. If a woman smokes and is perimenopausal, she should seek professional care from a health-care professional who can assist her with efforts at smoking cessation.
2. Steroid usage: Many patients use steroids chronically for the treatment of many diseases (for example, asthma). Steroids affect the bones by depleting calcium. Such individuals are at high risk of osteoporosis if their overall estrogen production is erratic or low.
3. Family history: If there is a family history of early menopause, it may be prudent for a woman to seek medical care shortly after experiencing the onset of perimenopausal symptoms.
4. Small body frame: If a woman is thin with small bones, her bone mass is, for practical purposes, deficient in calcium. She should see her doctor in order to formulate a plan to proactively prevent further skeletal deterioration.
In addition to the high-risk groups listed above, a woman should consult a health-care professional if she experiences extremely heavy or irregular vaginal bleeding. Occasionally uterine cancer is found in a woman whose ovaries are not working optimally.
If you believe you are experiencing symptoms of perimenopause, talk to any of our doctors. We can help you as you enter this new phase of womanhood.