Perimenopause
The Changes Before the Change

HOT FLASHES, MOOD SWINGS, IRREGULAR PERIODS … IF YOU'RE "A WOMAN OF A CERTAIN AGE," YOU MAY BE EXPERIENCING THESE OR OTHER SYMPTOMS OF PERIMENOPAUSE.

Jan Liston-Pontious, mammogram specialist. Our Radiology Department makes sure you are as comfortable as possible during your mammogram.

Perimenopause is the normal transitional period before menopause and is caused by fluctuating and declining levels of hormones. Although most women start to experience perimenopause in their mid-40s, some women may begin as early as their 30s or as late as their 50s.

"Technically, menopause occurs when a woman has gone 12 consecutive months without a period, but there is no way to predict how long the perimenopausal stage will last," Nicholas Thanos, MD, obstetrician/gynecologist, says. "Some women experience perimenopause for just a few years. For others, it can last 10 years or longer."

Symptoms of Perimenopause
Not every woman is troubled by symptoms of perimenopause, but one of the earliest signs is a change in menstrual cycle. "Cycles can become irregular, and bleeding can become heavier," Robert Borrowdale,MD, obstetrician/gynecologist, says."Many women have more frequent cycles, and others have longer cycles. Hot flashes – a sudden feeling of warmth to intense heat in the upper part of the body – are also common."

Other perimenopause symptoms may include:

• Vaginal dryness
• Diminished libido
• Mood swings or depression
• Fatigue
• Difficulty falling or staying asleep
• Weight gain

According to the National Institutes of Health, women may also be at higher risk for osteoporosis and heart disease as protective levels of estrogen decline.*

There's No Need to Suffer
Perimenopause is perfectly natural, but that may be little comfort when you're having a hot flash during a meeting or waking up several times during the night. Fortunately, there are steps you can take to help ease symptoms:

• Exercise. The endorphins released during aerobic exercise can help improve mood. In addition, regular exercise can promote restful sleep and help control weight.
• Watch your diet. Eating foods rich in calcium, like low-fat dairy products, can help protect your bones. Fruits, vegetables and whole grains can help prevent heart disease. Also consider cutting down on caffeine.
• Practice stress reduction techniques. Meditation, yoga, breathing exercises or even spending time laughing with friends and family may help take your mind off bodily changes.

"If lifestyle changes do not bring relief, there are several herbal remedies that may alleviate symptoms for some women," Dr. Thanos says. "If herbal supplements don't work or are not a good option, we may consider natural bioidentical estrogen or progesterone. We generally do not recommend hormone replacement therapy prior to menopause," he adds.

For women who are troubled by heavy or unpredictable periods, a low-dose birth control pill may help. "For nonsmokers, this may be a good short-term solution, as long as we keep monitoring their health," Dr. Borrowdale says. "It's important to keep in mind that it is still possible to get pregnant during perimenopause, so sexually active women should consider some type of birth control if they want to avoid pregnancy."

Embrace the Change
Many women find that the "change of life" is positive, bringing more freedom and new challenges. Taking care of your health is the first step toward embracing the change, so be sure to see your doctor for regular checkups and if you have questions about perimenopausal or other symptoms. For more information, please call our toll-free number at 1-800-554-7879 or visit our web site at www.placentialinda.com/womenpartners. PL

* Source: U.S. National Institutes of Health, National Institute on Aging, www.niapublications.org.

Partners in Health>