What is Perimenopause?
Perimenopause, also referred to as premenopause, is one of the stages of menopause and is defined by the time surrounding menopause. It is the length of time before and one year after the final menstrual period, during which ovarian hormonal patterns change. Perimenopause occurs as a direct result of the ovaries gradually producing less estrogen with the passage of time. The average age at which irregular cycles develop is approximately age 47 but in many cases can start as early as 35 years old. Like menopause, perimenopause is a normal part of a woman’s life cycle. Generally, the ages at which your mother and older sisters began menopausal transition are a good indication of when you might expect to start experiencing perimenopausal symptoms. If you smoke, it is likely that you will start perimenopause a year or two earlier than you would have if you didn’t smoke.
Although the length pf perimenopause varies for each woman, the average length is 4 years (but can be as short as a few months), and can begin either just a few months before menopause or even several years before being menopausal. Perimenopausal women can experience many of the same signs of menopause as menopausal women do and can also find relief with bio-identical hormone therapy.
What are the Signs and Symptoms of Perimenopause?
- Irregular Periods
- Diminished Libido
- Night Sweats
- Heavy Bleeding
- Weight Gain (which can lead to heart disease)
- Dry Eyes
- Hot Flashes (aka Hot Flushes)
- Vaginal Changes
- Bone Loss
- Mood Swings
- Hair Loss
- Memory Loss
Since perimenopause, or premenopause, is considered the transitional stage between normal menstrual periods to menopause, women often experience a combination of symptoms from PMS to other common menopause symptoms. Try keeping a record of your menstrual cycle and your daily perimenopausal symptoms for a couple months to get a better idea of whether you are experiencing PMS or symptoms of perimenopause. You should notice patterns of physical and emotional symptoms in coordination with your cycle. If you are not noticing a pattern of ups and downs with your cycle or find yourself experiencing irregular periods, then it is likely that you may be perimenopausal.
Testosterone is not just a male hormone. Women also have some of this sex-drive-controlling hormone in their bodies. If you are losing interest in sex and struggling with decreased libido, lower testosterone levels could be the culprit. Occasional vaginal dryness is common in most women who are struggling with perimenopause and menopause, but if you notice this is becoming a regular occurrence, your hormones may be imbalanced. This can also hurt your sex drive.
Perhaps the most notorious perimenopausal side effect is insomnia. No one likes to have issues sleeping because it throws off your day. If you are having issues falling asleep or wake up not feeling rested after a good night’s sleep, you could be suffering from the ill effects of hormonal imbalance (night sweats and hot flushes are two of the most common contributors to sleep loss) . If your estrogen and progesterone levels are lower than normal, you can experience issues sleeping. Sleep affects your entire well-being, so keep track of your sleep issues to determine if there is a cause for concern.
Hot flashes, an unexpected sensation of warmth washing over your face and upper body, just may be the symptom most commonly associated with a woman starting to feel perimenopausal. These hot flushes, also known as vasomotor symptoms, can last anywhere from a few seconds to nearly an hour and quite often appear with a host of other symptoms that include nausea, increased heart rate, sweating, dizziness, anxiety, and headaches. This sudden, overwhelming rush of warmth and other symptoms will often cause your face to turn red and sometimes even finishes with an equally sudden chill. Like the other symptoms of menopause and early menopause, hot flashes are caused by hormonal imbalance. In this case, the root issue is an imbalance in a woman’s estrogen levels and how that imbalance affects the hypothalamus, which is the part of the brain that regulates body temperature, sex hormones, appetite, and sleep. Inadequate natural estrogen levels lead the hypothalamus to believe that the body is too hot. The hypothalamus then attempts to rid the body of this nonexistent excess heat by producing a hot flash.
Vaginal changes are another of the most common menopausal symptoms, specifically vaginal dryness. This negative effect of hormonal imbalance occurs as a result of dropping or fluctuating levels of estrogen, and it creates a general sense of discomfort as well as causing pain during sex. Vaginal dryness is most often treated with estrogen therapy, which can come in the form of a pill, topical cream, and injections.
A decrease in bone density (or bone loss) can also result from a drop in estrogen levels, because estrogen works in tandem with other minerals (such as calcium and Vitamin D) to keep bones strong. A loss in bone density can cause bones to become more brittle and fragile, which can lead to more breaks and fractures.
Out of all the symptoms of perimenopause and menopause, weight gain is probably the biggest factor that leads women to investigate whether or not they are experiencing perimenopause. Once again, low estrogen is the main culprit when it comes to gaining weight. Aside from the negative impact on the cosmetic level, weight gain can lead to a host of more serious medical issues, including heart disease and diabetes. Estrogen therapy combined with a healthy diet and consistent exercise is the most effective way to treat weight gain on the hormonal level.
Hot flashes, low libido, trouble sleeping and weight gain are the most common symptoms of perimenopause as a woman ages. Weight gain during premenopause, one of the most outwardly noticeable symptoms, is oftentimes misdiagnosed and is one of the first signs of hormonal imbalance. These signs of early menopause and related conditions are also connected to your stress levels, poor nutrition (diets high in simple carbohydrates and low in quality protein), lack of exercise and the environmental toxins your body is exposed to on a daily basis.
How is Perimenopause Diagnosed?
Perimenopausal women often experience a change in their menstrual cycle. In this stage, it is common for menses cycles to occur sooner than 21 days or, more likely, later than 45 days. A woman does not enter menopause until she has not had a period for twelve consecutive months; up until that time, pregnancy is still possible. To ascertain whether or not you are in the perimenopausal stage, you would need a full physical evaluation with some form of hormone testing. Blood and saliva testing are the two most common ways of testing the various hormone levels in your body, but urine testing has emergedas an accurate and convenient way to gain an assessment of your assorted hormone levels. If your hormone levels are determined to be imbalanced, then you may find relief in hormone therapy.
What is the Best Treatment for the Symptoms of Perimenopause?
The best treatments to combat the symptoms of perimenopause depend entirely on each individual’s various hormone levels and which symptoms they are struggling with. In this transitional stage, your estrogen, testosterone and progesterone levels are constantly fluctuating. Environmental factors, stress, exercise, and diet also shift the hormone levels. Hormone replacement therapy (HRT) provided by the BodyLogicMD-affiliated practitioners measures these hormone levels to create a customized treatment and lifestyle plan consisting of bioidentical hormones that can be combined with steady exercise and advanced nutritional plans. This therapy allows for immediate relief from the symptoms that the hormonal imbalance caused. Premenopausal life does not have to mean living with undesirable symptoms or accepting the inevitable. The use of bioidentical hormones for perimenopause symptoms are likely to help women live better, longer.