Me No Pause. But first, Perimenopause
You know what we don’t talk about enough - perimenopause. Well, we don’t talk enough about menopause either. In fact, 45% of women didn’t know the difference between menopause and perimenopause before they had symptoms. So let’s get started!
What is perimenopause?
As part of the transitioning of your body into menopause, perimenopause starts as the production of hormones in the ovaries declines. The starting age and duration of perimenopause vary. Some women start experiencing symptoms as early as their mid-30s and others are into their mid-50s before it starts. The transition lasts on average four to eight years. Periods become more erratic and other symptoms start to arise.
According to Johns Hopkins the symptoms the list of symptoms varies from the expected (hot flashes) to the “wait, that’s a perimenopause symptom?!?” (trouble concentrating or joint and muscle aches).
Symptoms you might expect
Irregular periods
Changes in duration of periods
Hot flashes
Vaginal dryness
Night sweats
Changes in mood including depression, anxiety, and mood swings
Symptoms you might find surprising
Trouble concentrating
Memory problems
Weight gain
Sleep disruption
Needing to urinate more often or with more urgency
Headaches
Breast tenderness
Fatigue
If you are in your 40s and experiencing these symptoms, talk to your provider, talk to family members, and talk to your friends. You don’t have to tough it out. 40% of women reported that menopause got in the way of their work performance at least weekly. Symptoms can interfere with daily life and they don’t have to.
Common questions
How long does perimenopause last?
This varies from person to person. Most people are in perimenopause from four to eight years. There is some indication that women’s experiences are similar to their biological relatives. That’s another reason it’s important to talk with family about what they have experienced.
When is it “over”?
The entire menopausal transition time can be from seven to fourteen years. Perimenopause is over when you haven’t had a period for 12 consecutive months - that is the definition of menopause. Then you enter postmenopause.
What should I be talking with my healthcare provider about?
You don’t have to tough it out. Talk with your doctor about your symptoms and possible treatment for them. Be clear and honest about your symptoms. If you have symptoms that aren’t normal, definitely set up an appointment.
Treatments can include antidepressants to help with mood swings, vaginal creams for painful sex or vaginal dryness, and estrogen therapy for stabilizing hormones. There are a variety of other options like cooling sheets or dietary changes that can help as well.
What can l look for to know if the symptoms might indicate a more serious issue?
If you are having spotting after sex or in between periods or your periods become heavy or have clots, you should let your healthcare provider know.
Can I still get pregnant?
Simply, yes. While the chances are lower, it can happen.
Does perimenopause affect other areas of my health?
Yes, it can. For example, when estrogen begins declining in menopause there is an effect on other areas of our health such as:
We don’t replace bone as quickly as we replace it. If you have a family history of osteoporosis, ask your doctor about preventative care
Production of LDL (“bad cholesterol”) and HDL (the “good” kind) change. If you have a personal or family history of high cholesterol, this is a good time to start tracking cholesterol levels or track them more frequently.
Some risk factors for cardiovascular disease may increase.
Resources to learn more:
Cleveland Clinic Perimenopause information
Johns Hopkins Perimenopause information
Modern Fertility Blog -Hey Mom, When did you go through menopause?
Overview from the Mayo clinic of symptoms, risk factors and complications.
Bonafide Health 2022 State of Menopause Report
The North American Menopause Society Primer for Perimenopause