Written by Rachel Hudson
Have you felt a sudden warmth in your body, even if you are healthy? Have you woken up sweating, even when the room temperature is chilly? If you're a woman in your late 30s, 40s, or even 50s, you may be experiencing perimenopause.
What is perimenopause?
As the name suggests, perimenopause means ‘around menopause’; it refers to the time when your body starts making a natural transition to menopause. It's sometimes known as the menopausal transition, and can last anywhere from 2 to 12 years. While menopause marks the end of your reproductive years, you're still potentially fertile through perimenopause. Entering perimenopause is a natural process, and it happens to every woman in the world.
Often women who chart their menstrual cycles first notice a shorter luteal phase length and lower follicular phase temperatures, both of which can be indicators of perimenopause. Other easier-to-spot symptoms are irregular cycles, anovulatory cycles, and decreased sex drive. After going 12 months without a menstrual period, you have officially reached menopause, which also means that your perimenopause period is over.
Before diving into the many symptoms of perimenopause, we need to understand how perimenopause starts. Though it comes while you're aging, it isn't actually caused by age. It's often referred to as second puberty, and we can say that it's caused by age just as much as teenage puberty is caused by age. Perimenopause occurs when progesterone stops being produced, and estrogen produced by the ovaries slowly dwindles and eventually stops being produced as well.
What are some symptoms of perimenopause?
Most symptoms discussed below are caused by the changing levels of hormones. While estrogen is higher, you may notice symptoms similar to period symptoms. On the other hand, if your estrogen levels are low, you may experience hot flashes and night sweats. The perimenopause treatment(s) your provider recommends to you will be determined by your symptoms. So what are possible symptoms?
1. Hot Flashes And Night Sweats
One of the most common symptoms of perimenopause is hot flashes. As you can guess by the name, hot flashes can be described as sudden waves of body heat that are often accompanied by reddening of the skin, sweating, and rapid heartbeat, mainly occurring in the chest, head, and face. Hot flashes are often followed by chills, which can happen during the day or night. When you get these chills at night, they typically cause night sweats. They can disrupt your sleep cycle and may make it difficult to get a good night’s sleep.
2. Menstrual Cycle Changes
Since the hormones in your body are fluctuating at a different rate and pace than before, you may experience premenstrual syndrome (PMS) more regularly. The erratic production of estrogen experience throughout perimenopause can cause breast tenderness. As mentioned above, the ovaries start declining in function during perimenopause, and ovulation often starts behaving erratically. This can change the length of time between periods - even make them irregular - and the heaviness or length of your menstrual flow.
3. Mood Swings and Headaches
Approximately 20-30% of perimenopausal women experience mood swings and/or hormonal headaches. Mood swings are generally accepted as a symptom of perimenopause, but they are actually more likely a symptom of a symptom - caused by life stress, PMS, poor sleep, etc. Both of these symptoms (mood swings and headaches) can typically be treated by a doctor, so you likely won't have to suffer through them too much if you receive treatment.
As estrogen decreases, low-density lipoproteins (LDL) cholesterol increases and high-density lipoproteins (HDL) cholesterol decreases. The combination of these two factors can lead to fat and cholesterol building up in the arteries, which are contributing factors to heart attack, stroke, and other heart diseases.
5. Vaginal Dryness And Libido
In the later stages of perimenopause, as your estrogen levels continue to decrease, cervical mucus production also decreases. This can show as a symptom in the form of itching and irritation in the vagina, or even pain during intercourse. This alone may cause a lower sex drive, but other factors like fatigue, lifestyle changes, and hormones can also decrease your sex drive. If low libido is something you're experiencing and worried about, your provider may be able to help.
Estrogen is a key factor in bone metabolism, and the loss of estrogen throughout the perimenopausal period is accompanied by a decline in bone mineral density. It also affects your metabolic rate in general, and as your estrogen decreases you may feel that some of your energy is disappearing. One way to help with this can be to exercise, and if it affects your daily life, your doctor may suggest estrogen hormone therapy.
When should you see your doctor?
Perimenopause is a natural part of life, but some symptoms may decrease your life quality. Luckily, most of these symptoms are treatable, often by hormone or drug therapy. If you find that your quality of life has gone down, consider bringing it up at your next yearly exam or scheduling an appointment sooner.
Other easy-to-spot symptoms to watch for and bring to the attention to your doctor immediately are
- periods happening more frequently than every 3 weeks,
- extremely heavy blood flow, and
- bleeding lasting more than 7 days.
What to look forward to
For many women, there's a honeymoon phase of perimenopause: cycles become shorter and periods become lighter before seeing irregularities and major changes. It's a great indicator that perimenopause is starting, and it's also a good experience for many, especially those who may have had particularly long or painful periods earlier in life.
Many women find the step into menopause confidence building and freeing, and that can start with perimenopause for you! Symptoms you experience can usually be eased to enjoy this time period via simple changes like exercising regularly, drinking less alcohol, eating nutritional foods, and maintaining a regular sleep pattern.
Perimenopause is a great reminder to take care of your body and decrease stress, since decreasing stress has been known to lessen symptoms. Many women find themselves gravitating toward more mindful practices during perimenopause: meditation, yoga, scenic walks, and more! It's a wonderful time of life to rediscover who you are and spend some time reflecting on what you've accomplished and what you would still like to accomplish.
Rachel Hudson is a therapist, and currently lives in California with her husband and their two kids. Rachel and her friend Elizabeth Barletta are experts on Top Mom. They have been studying menopause and try to share their knowledge and experience with others. Their articles helped a lot of people.