Perimenopause

Perimenopause is the time when your body begins to move into the menopause (no menstrual period for 12 straight months). It is a natural process. Perimenopause can begin 2 to 8 years before the menopause and usually lasts for one year after the menopause. During this time, your ovaries may or may not produce an egg. The ovaries vary in their production of estrogen and progesterone hormones each month. This can cause irregular menstrual periods, difficulty in getting pregnant, vaginal bleeding between periods and uncomfortable symptoms.

CAUSES

  • Irregular production of the ovarian hormones, estrogen and progesterone, and not ovulating every month.

  • Other causes include:

  • Tumor of the pituitary gland in the brain.

  • Medical disease that affects the ovaries.

  • Radiation treatment.

  • Chemotherapy.

  • Unknown causes.

  • Heavy smoking and excessive alcohol intake can bring on perimenopause sooner.

SYMPTOMS

  • Hot flashes.

  • Night sweats.

  • Irregular menstrual periods.

  • Decrease sex drive.

  • Vaginal dryness.

  • Headaches.

  • Mood swings.

  • Depression.

  • Memory problems.

  • Irritability.

  • Tiredness.

  • Weight gain.

  • Trouble getting pregnant.

  • The beginning of losing bone cells (osteoporosis).

  • The beginning of hardening of the arteries (atherosclerosis).

DIAGNOSIS

Your caregiver will make a diagnosis by analyzing your age, menstrual history and your symptoms. They will do a physical exam noting any changes in your body, especially your female organs. Female hormone tests may or may not be helpful depending on the amount and when you produce the female hormones. However, other hormone tests may be helpful (ex. thyroid hormone) to rule out other problems.

TREATMENT

The decision to treat during the perimenopause should be made by you and your caregiver depending on how the symptoms are affecting you and your life style. There are various treatments available such as:

  • Treating individual symptoms with a specific medication for that symptom (ex. tranquilizer for depression).

  • Herbal medications that can help specific symptoms.

  • Counseling.

  • Group therapy.

  • No treatment.

HOME CARE INSTRUCTIONS

  • Before seeing your caregiver, make a list of your menstrual periods (when the occur, how heavy they are, how long between periods and how long they last), your symptoms and when they started.

  • Take the medication as recommended by your caregiver.

  • Sleep and rest.

  • Exercise.

  • Eat a diet that contains calcium (good for your bones) and soy (acts like estrogen hormone).

  • Do not smoke.

  • Avoid alcoholic beverages.

  • Taking vitamin E may help in certain cases.

  • Take calcium and vitamin D supplements to help prevent bone loss.

  • Group therapy is sometimes helpful.

  • Acupuncture may help in some cases.

SEEK MEDICAL CARE IF:

  • You have any of the above and want to know if it is perimenopause.

  • You want advice and treatment for any of your symptoms mentioned above.

  • You need a referral to a specialist (gynecologist, psychiatrist or psychologist).

SEEK IMMEDIATE MEDICAL CARE IF:

  • You have vaginal bleeding.

  • Your period lasts longer than 8 days.

  • You periods are recurring sooner than 21 days.

  • You have bleeding after intercourse.

  • You have severe depression.

  • You have pain when you urinate.

  • You have severe headaches.

  • You develop vision problems.