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Perimenopause is the time when women start to experience menopause-related changes and it extends up to one year of menopause. Perimenopause is also called ‘going through menopause’ and ‘being in menopause’.

What is perimenopause?

Perimenopause marks period in which the body begins its transition from reproductive phase to menopause. It is natural and inevitable part of aging.
 

When does perimenopause start?

There is no fixed age at which the symptoms of perimenopause start in all women. Perimenopause problem normally starts between ages 45 and 55 years, but it may start early in some women, when they are still in their mid 30s, and late in others. It may extend anywhere from 2-8 years and a year after the last menstrual period when menopause starts.
 

What happens in the body during perimenopause?

It is the time when a lot of changes take place in the body. The fundamental changes occur in ovaries which start to shut down. Production of hormones like estrogen and progesterone from ovary is not consistent and the level of these hormones in the body fluctuates. This inconsistency and fluctuation is the root cause of all the problems during perimenopause. Further, the ovaries do not develop mature ova during the all the menstrual cycles and women gradually loses power to become pregnant.

What are the signs and symptoms of perimenopause?

Perimenopause affect different women differently. In some women stopping periods may be the only symptoms while in the others a lot of symptoms of menopause may be present during perimenopause and add to Perimenopause problems such as:

  • Menstrual irregularity: The periods may be shorter or longer, and bleeding may be less or more during perimenopause. The cycles gradually become anovulatory that means the ovaries do not produce ova and gradually lose fertility.
  • Hot flashes and night sweats: Hot flashes are sudden rush of heat in upper body: These are very common and about 65 to 75 percent of women experience them during perimenopause. Intensity, duration and frequency of hot flashes vary in different women. Hot flashes may become very disturbing in some women and interrupt in sleep as well.  The hot flashes which occur during sleep are called night sweats.
  • Sleep disturbance: Night sweats often disturb sleep during perimenopause, but sleep may become erratic even without them.
  • Mood changes: Irritability, mood swings and depression are common during perimenopause. These may result from disruption of sleep and other annoying symptoms of menopause rather than hormonal changes.
  • Vaginal dryness: Vaginal tissues may become less elastic. The amount of secretions decreases. These lead to menopause induced vaginal dryness leading to painful intercourse.
  • Urinary incontinence: Some women may experience loss of control over passing urine.
  • Breast tenderness
  • Joint and muscle pain
  • Extreme sweating
  • Lack of concentration and feeling mixed-up or confused
  • Loss of bone strength
  • Loss or thinning of hair on scalp

How sex life is affected during perimenopause?

One of the main concerns of aging women is how Perimenopause problems affect her sexual life.  Sexual intimacy for most women continues through perimenopause and beyond provided they had sexual intimacy before perimenopause started. Sexual arousal and desire may change during perimenopause which coupled with dryness in vagina may cause sexual experience unpleasant. In such a situation over the counter lubricants may be useful.

Treatment for the symptoms of perimenopause

Life style changes

Perimenopause is a time when the body prepares to undergo menopause. It may be the right time to make changes in the lifestyle, to live a healthy and satisfying second half of life. If your lifestyle is already healthy, it is good otherwise make it healthier!

Diet

During perimenopause the risk of osteoporosis and heart disease increases which may become worse with as time passes. Small modifications in diet at this stage go a long way. The diet should be well balanced, rich in fruits, vegetables and whole grains. It should be high-fiber and low-fat. Junk food and deep fried food should be avoided. There are some foods which have shown benefits in controlling perimenopause symptoms such as soy and flax. These should be included in the diet.

Alcohol, caffeine and smoking

Alcohol, caffeine and smoking should be avoided because, besides being unhealthy, they may act as triggers for hot flashes and may exacerbate them.

Exercise physical activity

Regular exercise and physical activity are helpful in many ways. They prevent weight gain, improve sleep, strengthen bones and elevate mood. Exercise to be effective should be done for 30 minutes or more on most days of the week.

Stress reduction techniques

Stress reduction techniques like meditation and yoga are more useful during perimenopause, though they help throughout the lifetime.

Medical and Alternative treatment

Treatment may not be necessary in all the cases, but when the symptoms become troublesome medicine may be required.

Oral contraceptives pills

Oral contraceptives pills especially low dose pills help to regulate periods. Low dose pills contain only 20 micrograms of estrogen, whereas regular birth control pills which contain 30 to 50 micrograms of estrogen. Therefore there are fewer side effects with low dose pills if at all they are. These pills are prescribed to relieve perimenopausal symptoms, though the women may not need them for birth control. It reduces hot flashes and vaginal dryness.

Progestin hormone: it may regulate the periods when oral contraceptives are not recommended or women choose not to use. A progestin-containing intrauterine device may be useful in some women with heavy bleeding during perimenopause.

Antidepressants may be required in some case to stabilize mood swings.

Endometrial ablation: The lining of the uterus called endometrium is destroyed with the use of LASER, electrical energy or heat. It reduces menstrual flow or may stop menstruation and may be useful in heavy bleeding. It may not be suitable for everyone.

Read More: Premature Menopause: Causes, Symptoms, And Beyond

Alternative treatment

There are many herbs claimed to be effective for Perimenopause problems, But their effects has not been properly evaluated. Some of the herbs are ginkgo biloba, evening primrose oil, and black cohosh. These should be used after discussing with the physician.

  • www.womenshealth.gov/faq/perimenopause.cfm
  • www.mayoclinic.com/health/perimenopause/DS00554/DSECTION=
  • www.bhj.org/journal/2010-5201-jan/download/pg69-72.pdf
  • www.healthsystem.virginia.edu/UVAHealth/adult_gyneonc/peri.cfm