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Perimenopause- Common Questions

Updated on March 25, 2012

What the #%&* is perimenopause?

It is the storm before the calm. A hormonal roller coaster. A mystery wrapped in an enigma. This is perimenopause. If you are anywhere in your late 30s to late 40s, give or take then you may be there. But how do you know? Is there a blood test for this? The quick answer is no. This is not a disease. It is a transition. You know because you notice your body changing and this is the age it changes. Just as a teenager notices her body changes as she goes through adolescence, so do you. Menstrual periods get longer, or shorter, more frequent or less frequent, heavier or lighter. Hot flashes, cold flashes, headaches, cramping, constipation, diarrhea, insomnia, palpitations, skin changes and more have been attributed to the changes during perimenopause. The point is, you are changing. Your hormones begin to fluctuate wildly. Any hormone testing is merely a snapshot of that moment in time and cannot tell you when this process will end with menopause, the stop of menstruation. That moment remains a mystery that even the most educated expert cannot predict. The years before that final menstrual period is termed perimenopause. And yes, I do mean years. The average age of menopause is 51 and changes begin 6 or more years before. Furthermore, you will not know you have reached menopause until you have not had a period for 12 whole continuous months. You may go 8 months then, boom! A period. Then the count starts over at 0. You may know someone who never had any symptoms and just stopped having periods and that was that. You have my permission to hate those people. Truth is, most of us struggle at least a bit as we forge through the hormonal haze of perimenopause.

What is normal?

Although changes in menstrual periods during perimenopause are common there are some changes you need to get checked out. Report If your periods are lasting longer than 7 days, become exceptionally heavy or are less than 21 days apart, from start of one period to next. Spotting between periods or after intercourse should also be evaluated. After 12 months without a period, for which there is not other medical reason than menopause, any vaginal bleeding should be investigated by a health care practitioner. That is termed post-menopausal bleeding. All these variations are usually just hormonal glitches, but occasionally can be signs of more serious conditions.

Although testing for normal hormonal changes is not usually helpful, blood tests to check for other diseases can be useful since some perimenopausal symptoms mimic thyroid disease or other treatable conditions.

Commonly depression, weight gain, decreased sex drive and memory loss are also attributed to the hormone changes during perimenopause. The truth is that scientific studies do not support this relationship. Studies suggest that these symptoms are more commonly related to lifestyle, stress and aging. Unfortunately, right about the time most of us reach the perimenopausal years our kids are teenagers, our careers are in full swing and our own parents are aging and need more help. Stress? Oh yes.

Having said all that, any changes, worries and symptoms effecting your ability to function should be discussed with your health care provider. You deserve to understand what is going on in your body, get it checked out or get reassurance.


What do I do about my symptoms?

Simple as it sounds, the holy trinity of exercise, sleep and proper diet goes a long way toward helping. Look at your life style and make adjustments. Care for yourself and your body will thank you. This is an excellent time to reevaluate your health and renew your commitment to self care. Better habits now will serve you well as you enter menopause where lurks the dangers of increased risk for heart disease, cancer and osteoporosis

Beyond lifestyle, heavy long menstrual cycles can be regulated with birth control pills or other hormonal treatments. Most healthy women can safely take hormones, so talk to your health care provider about your options. Hormonal birth control provides the double duty of providing protection against an unwanted pregnancy as well as regulating cycles. Remember, pregnancy is still possible up until that final period, and until you have not had a period for 12 months straight that magic moment remains a mystery.

No matter how crumby you might feel, keep in mind, things will get better. Once those periods finally stop, symptoms often ease. For many women , menopause signals a new beginning and a feeling of freedom. With it new challenges come as well. But every phase of life has its challenges and you already know this. You have the power of experience. That makes you wiser. Be wiser.


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