Perimenopause is the transition to menopause. This phase usually begins several years before a woman reaches the period of menopause or at around her early to mid-40’s. In some women, it can start at as early as their 30’s. A woman’s period becomes irregular due to the hormonal level decline. Although a woman’s menstrual cycle is irregular, she can still bear offspring. If a woman no longer wants to get pregnant at this age, she needs to continue using birth control that will prevent it.
Perimenopause comes from the Greek words perí (meaning near, about, around), mēn (meaning month), and pausis (meaning pause). With these we can literally define this as “at around the end of the monthly cycle”, which is about right. It is defined as “around menopause” and is referred to as the time in a woman’s life wherein her body undergoes a natural, biological transition to infertility, or menopause. It is also known as “transition to menopause”.
During this phase, a woman’s estrogen and progesterone (the female sex hormones) levels rise and fall erratically. A woman can have either a shorter or a longer period, and a lighter or a heavier menstrual flow. There will be changes to the menstrual cycles as well wherein instead of the 28-day cycle, a woman may experience shorter cycles of 24 to 25 days.
Some of the symptoms of perimenopause are irregular menstruation, hot flashes, sleep disturbances, mood swings, vaginal problems, bladder problems, sexual function changes, decrease in fertility, bone loss, and change in cholesterol levels.
Due to the erratic change in a woman’s sex hormones, she can have irregular periods which may be shorter or longer. A woman may also experience lighter or heavier menstrual flow. If a woman is experiencing a difference in her menstrual cycle of seven or more days, then she is in the early phase of perimenopause. But if the difference is two months or more, then she is already in the late stage and is nearing the menopause stage.
A lot of women experience hot flashes during this time. This may be linked to the change in a woman’s body circulation. Hot flashes also cause night sweats.
Due to hot flashes and night sweats, a woman may experience sleep disturbances. Although sleep disturbances is not restricted to hot flashes and night sweats, a woman in this phase can experience sleep disturbances for no exact reason. She can just find herself awake at night and may have difficulty returning to sleep.
Mood swings may be attributed to the fact that a woman during this phase experiences sleep disturbances which make her irritable.
Due to the decrease in estrogen levels, a woman’s vagina may lose elasticity and lubrication. In this case, intercourse may be painful. A woman is also at risk of vaginal infections.
A woman’s estrogen levels also affect a woman’s urinary tract system. Due to the loss of the vagina’s elasticity, a woman may experience incontinence and there is a higher risk or urinary infection.
A woman’s sexual function changes during this time. Because of the decrease in the female’s sexual hormones, there is a change in the sexual urge and arousal. It can also be attributed to the fact that due to the loss of lubrication, a woman may find intercourse a painful experience.
There will be a decrease in a woman’s ability to conceive as ovulation becomes irregular. But this does not mean that a woman can no longer get pregnant. As long as a woman is still getting her period, she is still able to conceive.
There is an increase risk of osteoporosis as women enter the perimenopause phase. Estrogen is responsible in replacing the bones so with the decrease of its production, a woman is likely to acquire osteoporosis.
Because of the decline in the levels of estrogen production, there is also a critical change in the level of blood cholesterol. The decline in estrogen level leads to the increase in the low-density lipoprotein (LDL) or bad cholesterol level. With this increase in bad cholesterol, there is also an increased risk of heart disease.
This phase occurs years before a woman’s menopause and it has several phases. On the average, the length of time that a woman is in this stage is four years, but some women may experience it in as short as a few months to as long as 10 years.
Phase A is when a woman’s estrogen levels become unusually high which causes breast soreness, unevenness, and swelling. Due to this change, a woman could experience longer or heavier periods. Premenstrual syndrome (PMS) could also occur at this time which includes mood swings and irritability. A woman could also start to get migraines, night sweats, and sleep disturbances. Others also become anemic due to the heavy flow accompanied by cramps.
Phase B is almost the same as Phase A but with the addition of the hot flashes. A woman may also experience shorter menstrual cycles. Instead of a 28-day cycle, a woman can have her next cycle in the next 24 to 25 days.
Phase C is determined by a woman’s irregular periods. A woman could either have a shorter period or longer period alternately.
Phase D is characterized by the time a woman skips her period. This is when a woman has not had her period for two months. During this time, breast soreness begins to get better. The only time that a woman will experience soreness of breast is when her next period is about to begin.
Phase E is simply explained as a woman’s final period. It is from this time that a woman can start counting up until she reaches the 12th or 13th month that she does not have her period. And when that happens, she can finally declare that she has entered the stage of menopause.
If the symptoms of perimenopause are no longer tolerable, a woman can seek medical attention. However, for those whose symptoms are manageable, a change in lifestyle and diet could ease the discomforts of this phase in a woman’s life.