Life's Transitions
Preparing for Perimenopause
The average age of menopause is 54 years, but prior to this, there are many years of premenopausal changes that occur. Perimenopause is another stage of a woman's reproductive years characterized by hormone level fluctuations. The effect of these fluctuations are symptoms related to low estrogen levels, like hot flashes, alternating with symptoms of excess estrogen, like heavier and unpredictable periods.
What is Perimenopause?
Perimenopause is the two to eight years before menopause. "This natural transition usually starts sometime in your 40s, but some women notice changes as early as their mid-30s," says Lynde Knowles-Jonas, MD, a member of the medical staff of Alamance Regional Medical Center and Grace Women's Clinic.
Hallmarks of perimenopause include:
- Irregular periods. "As your estrogen and progesterone hormones start to rise and fall unevenly, your periods may be longer or shorter, lighter or heavier, and you may skip some periods," says Knowles-Jonas.
- Hot flashes. About 65 to 75 percent of perimenopausal women experience hot flashes, or sudden rushes of heat in the upper body.
- Sleep problems. Tossing and turning at night are common during perimenopause.
- Mood changes. Some women experience mood swings, irritability or depression during perimenopause.
- Vaginal and bladder problems. Low estrogen levels can lead to vaginal dryness, urinary or vaginal infections. Loss of tissue tone may contribute to urinary incontinence.
- Decreasing fertility. Your ability to conceive decreases as ovulation becomes irregular, but you can still get pregnant as long as you're having periods.
- Changing cholesterol levels. Low estrogen may lead to increased low-density lipoprotein (LDL) or "bad" cholesterol and decreased high-density lipoprotein (HDL) or "good" cholesterol. These changes increase your risk of heart disease.
Positive Transformations
Ease the symptoms of perimenopause and stay healthy by:
- Eating healthy. Adopt a low-fat, high-fiber diet rich in fruits, vegetables, whole grains and calcium-rich foods such as dairy products. Avoid alcohol, caffeine or spicy foods that can trigger hot flashes.
- Staying active. Regular exercise helps prevent weight gain, improves sleep, strengthens bones and elevates your mood.
- Reducing stress. Practicing meditation, breathing techniques or yoga, and taking time out for yourself can promote relaxation and good health, and reduce hot flashes and insomnia.
- Staying connected. Social support and laughing with friends are key to health and happiness.
- Staying mindful. Do you view the glass as half full or half empty? The absence of positive thoughts can have a greater negative impact on your health and well-being than the presence of negative ones. Try writing down three things every night for which you are grateful.
"Not all changes at this time of life are negative," says Knowles-Jonas. "Women with endometriosis, fibroid tumors, polycystic ovaries and other benign gynecologic processes usually experience a significant improvement in their symptoms."
When to See a Doctor
Not all women are bothered by their perimenopausal symptoms. However, see your doctor if you experience menstrual bleeding that occurs between periods, is extremely heavy, lasts longer than eight days, or if your periods regularly occur less than 21 days apart. Your doctor can also provide guidance and tips for handling perimenopausal symptoms.
"Recent innovations in hormonal therapy are making hormone replacement for women easier and safer to use," says Knowles-Jonas. "Options now include a wide range of topical gels, creams, rings, suppositories, troches, implants, sprays, patches and pills. Bio-identical formulas can be compounded to individualize therapy, and many commercial pharmaceutical companies are making bio-identical products due to renewed interest in hormonal therapy."
For women who are experiencing heavy periods, minimally invasive surgical options that require no overnight hospital admission are now widely available. "Some procedures take less than 10 minutes to complete, require no incision, and no removal or alteration of the uterus, ovaries and tubes," says Knowles-Jonas. "These options can provide long-lasting relief from symptoms."
For more information about treatment options for perimenopause symptoms, consult with your gynecologist.
