Perimenopause

Perimenopause is the transition to menopause. It is a period of two to eight years leading up to menopause. It is a natural part of aging that marks the end of your reproductive period. During this period, levels of the reproductive hormones estrogen and progesterone fluctuate up and down. Your menstrual bleeding becomes irregular. Menstruation occurs without ovulation. When perimenopause starts, how long it lasts varies. You can recognize the approach of menopause by certain signs, such as irregular periods. Sometimes this happens in the forties, sometimes in the mid-thirties.

What are the Symptoms?

Perimenopause will lead to more or less changes in your body. Some of these are as follows;

Menstrual irregularity: The intervals between menstrual periods may be longer or shorter. Sometimes she may even skip a bleeding. Since ovulation is also irregular, less progesterone is released, which prolongs the menstrual period.

Hot flashes and sleep problems: Between 75% and 85% of perimenopausal women complain of hot flashes. However, the intensity, frequency and duration vary from person to person. Sleep problems are usually due to hot flushes or night sweats. But sometimes sleep can be a problem even without these.

Change in emotional state: Some women become more sensitive during the perimenopause and may even become depressed. This may be due to hormonal changes, but more often it is due to sleep problems or other signs of menopause.

Vagina and bladder problems: When estrogen levels fall too low, the vaginal tissue loses its wetness and elasticity. This leads to pain during sexual intercourse. Low estrogen levels also increase susceptibility to urinary and vaginal infections. Weakening of muscle strength may add to the incontinence problem.

Decreased fertility: Since ovulation is irregular, fertilization will also be problematic. However, remember that pregnancy is still possible as long as you are menstruating. For 12 months, you need to use contraception until you stop menstruating.

Changes in sexual function: Changes in sexual desire can occur during perimenopause. However, most women who had no problems with sexual intercourse before menopause do not have many problems.

Decrease in bone density: A decrease in bone density occurs due to a decrease in estrogen levels. This increases the risk of osteoporosis.

Change in cholesterol levels: Blood cholesterol levels increase due to a decrease in estrogen levels. There is an increase in bad cholesterol and a decrease in good cholesterol. This leads to an increased risk of heart disease.

Why Does It Happen?

During the transition to menopause, your body experiences fluctuations in estrogen and progesterone levels. These fluctuations are also responsible for the changes in your body during perimenopause.

What are the Risk Factors?

Menopause is a normal period in a woman’s life. However, it may start earlier in some women than in others. For example, menopause starts one or two years earlier in women who smoke than in women who do not smoke. Genetic factors also play a role in the early onset of menopause. Although controversial, other factors that cause early onset of menopause are as follows;

Family history : In general, women tend to go through menopause at an age when their mothers and sisters go through menopause.

Never having given birth to a child: Some studies show that women who have not given birth to children go through menopause earlier.

Heart disease : Recent studies show that people with heart disease go through menopause earlier. But more research is needed to be able to say this with certainty.

Being treated for cancer during childhood: Receiving chemotherapy or radiotherapy to the groin area for cancer as a child can cause early menopause.

Removal of the uterus : Removal of only the uterus without removing the ovaries does not cause menopause. Although there is no menstrual bleeding, ovulation still continues from the ovaries. However, having undergone this type of surgery still leads to earlier menopause than the average.

Menopause can also start for certain medical reasons: For example, removal of both the uterus and ovaries and chemotherapy and/or radiation therapy can cause menopause. After surgical removal of the ovaries, menopause occurs without a perimenopausal period. Your menstrual bleeding stops immediately and hot flashes or other symptoms begin. After cancer treatment, sometimes the ovaries start working. Sometimes they go through menopause because they are completely damaged.

When to see a doctor?

Some women go to the doctor for perimenopausal complaints, others tolerate these changes or do not have many complaints anyway. Because the symptoms increase gradually, you may not notice them at first. However, if these complaints are affecting your life too much, it is time to see your doctor.

How is the diagnosis made?

Since perimenopause is a transitional period, it is not possible to diagnose it with a single test. Many factors will be taken into account. Age, menstrual status, changes in your body and symptoms will be assessed. Sometimes hormone levels can also be checked.

What It Can Lead To

Irregular menstruation is a symptom of perimenopause. Most of the time, however, this is normal and does not require investigation. However, you should consult your doctor in the following cases.

– Excessive bleeding that requires you to change pads or tampons every hour.

– Bleeding lasting more than eight days.

– Bleeding between menstrual periods.

– Menstrual cycle lasting less than 21 days.

In such cases, a gynecological problem is assumed to be the underlying cause and treatment should be initiated once a diagnosis has been made.

How is the treatment done?

Birth control pills are often used to treat perimenopausal symptoms, even if you do not need family planning. These low-dose pills regulate your menstrual cycle and reduce symptoms such as hot flashes and vaginal dryness.

What to do?

When you are in perimenopause, some of your symptoms will be relieved if you pay attention to healthy living.

Eat well : With the increased risk of osteoporosis and heart disease, a healthy diet will become even more important. It is important to choose a low-fat, high-fiber diet with lots of vegetables, fruits and grains. Don’t forget to consume calcium-rich foods. Avoid alcoholic and caffeinated drinks because they can trigger hot flashes.

Exercise regularly: Regular exercise will prevent weight gain, regulate your sleep, relieve tension in your muscles and reduce mental distress. Try to do 30 minutes almost every day of the week.

Avoid stress: Practice stress-reducing techniques such as meditation and yoga. These techniques are useful at any stage of life. However, they will benefit you even more, especially during the transition to menopause.