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Perimenopause: Age, Symptoms & Treatment

Perimenopause is the natural transition that signals the upcoming end of the childbearing years and the beginning of menopause
Khushi Khare
October 19, 2023

Research states that 73% of women don’t feel prepared or don’t know much about perimenopause or menopause.

But its time to break shackles around perimenopause and menopause.

This article intends to help you understand perimenopause. It will help you make sense of what is happening to your body, dispel some myths and misunderstandings, and move on in confidence through this exciting but sometimes tough time.

Difference between Menopause and Perimenopause

Menopause is the permanent cessation of menses due to a depletion of the ovarian follicles. It is marked by 12 consecutive months of no menstrual bleeding.

Whereas, perimenopause, also known as the climacteric, is the transitional stage that comes before actual menopause. This stage, which can last from 2 to 8 years, is marked by menstrual irregularity along with some or all the symptoms of menopause. It signals the upcoming end of the childbearing years and the beginning of menopause. Perimenopause can be a time of confusion, concern, and even fear. 

Hormonal changes during perimenopause

Perimenopause signifies the decreased secretion of the ovarian hormone 'Estrogen'. Estrogen plays a very important role in our body. It is not just important for reproductive function, but also acts on the brain, the skin, the heart and vascular system, the urinary system and on your bones. The symptoms of perimenopause and menopause are due to low levels of this Estrogen.

There is a rise in the hormones- FSH (follicle stimulating hormone) and LH (luteinising hormone), which are secreted by a small gland called the pituitary gland in your brain.

These hormones are important for ovulation, or the release/ rupture of a mature egg from the ovaries. With no follicles left in the ovary, the brain releases more and more FSH and LH to stimulate the ovary- leading to higher levels of these hormones.

Does no ovulation mean no pregnancy? Yes!

But remember that there could be some erratic ovulation happening throughout your perimenopause. So although, the chances of pregnancy are extremely low, you do need to keep using contraception to avoid an accidental pregnancy!

Symptoms of Perimenopause

1. Changes in periods: The lower number of eggs in the ovaries and the erratic ovulation, makes your periods irregular. While some women tend to skip their cycles, some may also have more frequent cycles. The amount of bleeding may slowly decrease, but you may even have a few cycles of heavier bleeding.

2. Hot flashes:  Hot flashes are the sudden feeling of intense warmth that tend to begin behind your head and spread over your face and down your neck and chest and sometimes into your arms and back.  These may be accompanied by profuse sweating and even palpitations and may be followed by a sudden chill.

3. Sleep disturbances:  Perimenopause may find you struggling to get some good sleep. Hot flashes occuring at night (night sweats) can sometimes be so uncomfortable that you're unable to fall asleep or stay asleep (insomnia)

4. Urogenital symptoms: These include symptoms of vaginal dryness and atrophy leading to painful sex and frequent vaginal or urinary tract infections.

How to deal with perimenopause symptoms

Some lifestyle modifications should be made to take care of yourself in perimenopause. 

1. Regular exercise- can be a daily walk or yoga or any form of exercise that you can sustainably follow.

2. Food- Your body may not react to food the same way as before. Switching to whole grains, good amount of protein and fiber in your diet and reducing the amount of processed foods can be a welcome change!

3. Sleep- Although sleep may elude you around this time, resting for a good amount of time, following sleep hygiene, avoiding screens before bed can go a long way in making you feel fresh and active.

Last but not the least, feel free to go and talk to a doctor about your issues.

A doctor will give you customized advice and suggest the treatment that is appropriate for you. It may include non hormonal or hormonal therapy, and surgery if required. At Elda Health, you will find the most qualified doctors specializing in mid-life women's health issues and in menopause. They will help you to treat your perimenopausal symptoms and help you make the best of these golden years of your life!

Reviewed by Dr. Ameya Kanakiya