What’s Perimenopause?

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Perimenopause is the time in a woman’s life surrounding menopause, the end of her periods. While this time in life is sometimes referred to as menopause, menopause is technically a specific date, the day after a woman’s last menstrual period. The years surrounding this date and the transitions a woman undergoes at this time are more accurately referred to as perimenopause, literally “around menopause.”

In the Western world, most women experience menopause between the ages of 45 and 55, with the average age being 51. However, it can occur anywhere between the ages of 40 and 60. Some women experience “premature menopause” before the age of 40. but it’s rare.

For most women, perimenopause is a change similar to menarche, the onset of the menstrual cycle, albeit in reverse. Just as menarche symbolizes entry into femininity, perimenopause marks the entry into a new phase of life. The psychological symptoms of each life event are similar.

Perimenopause causes a variety of physical symptoms, as a woman’s body produces hormones erratically before completely ceasing to produce progesterone, estradiol and estriol. Estrone is the only female hormone that is still produced in postmenopausal women. There is great variation in the physical and psychological symptoms that women undergoing perimenopause experience, and the event can take anywhere from a couple of years to over ten. During premenopause, the years leading up to menopause, most women have increasingly irregular menstrual periods and frequent missed periods.

Some symptoms associated with perimenopause include fatigue, hot or cold flashes, night sweats, and insomnia. Urogenital atrophy, inflammation due to changes in the female genitalia, is a common symptom of decreased estrogen. The skin all over a woman’s body can change during perimenopause, losing elasticity and becoming thinner, and she can experience a tingling, crawling sensation on the skin. The breasts can also atrophy. Osteopenia, decreased bone density, and joint pain are other possible symptoms.

Women experiencing perimenopause may also experience psychological symptoms due to the hormonal fluctuations and lifestyle changes that accompany menopause. These can include irritability, mood swings, memory loss, depression, anxiety and a decrease in sex drive.
If perimenopause symptoms are severely disruptive or bothersome, a woman can seek medical attention. Hormone replacement therapy (HRT) can be effective in relieving hot flashes and treating osteoporosis. There are many different types of HRT, each with its own possible side effects and risks. Antidepressants and blood pressure medicines are also sometimes prescribed to treat hot flashes.

Vaginal lubricants or low-dose estrogen creams can relieve symptoms of urogenital atrophy. Perimenopausal women who suffer from depression often benefit from counseling. Alternative therapies, especially acupuncture, are becoming more common to treat perimenopause symptoms.

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