Perimenopause: Changes, Treatment, Staying Healthy
Perimenopause is the period of time before menopause when a woman’s body changes.
Perimenopause is a normal transition in a woman’s life. Although each woman’s
experience can be different, most women experience a decreased ability to become
pregnant, and irregular and sometimes heavy menstrual periods.
When does perimenopause occur?
Perimenopause can last from two to ten years. It occurs before menopause. Menopause
usually occurs between the ages of 45 and 55.
How will I recognize perimenopause?
Possible changes you might expect during perimenopause include:
? Changes in menstrual cycle
? Vaginal dryness
? Decreased bone density
? Unpredictable breast tenderness
? Skin changes
Changes in menstrual cycle
The most common early sign of perimenopause is a change in your menstrual cycle.
Often, the amount of time between bleeding becomes shorter and the bleeding becomes
heavier. You should talk to your health care professional (doctor, nurse practitioner,
physician assistant, midwife) if you are experiencing heavy vaginal bleeding, long
intervals of spotting, or have gone more than two months without a period.
Variations in breast tenderness or fullness are common in all women throughout the
menstrual cycle and pregnancy. During perimenopause, you may be unable to predict
breast tenderness or fullness as your cycle changes. Any lumps in your breast or fluid
leaking from the nipple should be evaluated by your health care professional.
Will I experience emotional changes?
During mid-life, emotional swings can occur in everyone, both men and women. They are
often about issues such as children leaving home, parents growing older, or career changes.
They are not usually due to hormonal changes that come with perimenopause.
Hormonal shifts during perimenopause can cause sleep disturbances. Lack of sleep can lead
to fatigue and a decreased sense of well-being. Hormonal shifts can also cause mood swings,
similar to what some women experience during a menstrual cycle, only less predictable.
Should I still use birth control?
It is possible to become pregnant during perimenopause. Most women in their early to
mid 40s still ovulate regularly and are at risk for an unintended pregnancy. The medical
risks associated with pregnancy increase a lot during this time in a woman’s life. To avoid
unintended pregnancy, contraception is an important part of health planning.
Health Matters is a
publication of ARHP
for the general
public that provides
a brief overview of
existing facts and
data on various
topics related to
Perimenopause – The time
before menopause a woman’s
Menopause – The last monthly
period you have. Ovaries stop
functioning after menopause.
Perimenopause: Changes, Treatment, Staying Healthy Updated November 2008
Low-dose birth control pills are one option during
perimenopause. Low-dose birth control pills can
correct irregular bleeding, help with hot flashes
and night sweats, and reduce the risk of ovarian
and uterine cancer. They can also serve as a
transition to hormone therapy after menopause.
Contraceptive hormonal implants, transdermal
patches, or injectables may also offer other health
benefits. The intrauterine device (IUD), including
the hormone-releasing IUD, can be a good
method during this time. Male and female
condoms, cervical caps, the sponge, the
diaphragm, and spermicides can also be good
contraceptive options. Condoms (both male and
female) can also help you reduce the risk of
contracting a sexually transmitted infection.
No one method is perfect for every person, so talk
to your health care professional to find out which
method is best for you. If unprotected sex should
occur, emergency contraception is always an
option Visit www.not-2-late.com for more
information about emergency contraception.
Will my sex life change?
Most women do not experience major changes in
their sex lives during perimenopause. You may notice
more vaginal dryness. This is your body’s normal
response to a decreased level of the hormone
estrogen. Your health care professional can discuss
the options available to deal with vaginal dryness,
such as use of over-the-counter lubricants. Once you
reach menopause, you may also want to discuss a
prescription hormone therapy or vaginal estrogen
cream to help alleviate vaginal dryness.
Some women experience a decrease in sexual desire
during perimenopause or after menopause. This may
be due to a number of different factors that are not
physical. If you experience a loss of sexual desire
which concerns you, there are a number of hormonal
treatments available that can help. Consult your
health care professional on available options.
What therapies can help?
Menopausal hormone therapy is considered safe
for healthy women in the first five years after
menopause. Menopausal hormone therapy is
recommended only as a short-term treatment of
moderate to severe symptoms such as hot flashes
or night sweats. Long-term use of menopausal
hormone therapy is not usually advised as it may
increase risk of heart disease and breast cancer
for some women. Consult with your health care
professional to balance the benefits and risks of
hormone therapy to make the best decision for
your health and well-being.
A number of alternative therapies—in the form of
herbal supplements, special diets, and exercise
and relaxation techniques such as yoga and
meditation—have shown promise and are gaining
popularity among women in perimenopause.
There are also a number of herbal remedies that
may help some women with perimenopausal
symptoms. However, the majority of these herbs
and supplements have not yet been adequately
studied, researched, or regulated, and there is no
assurance about the content of the products.
What else should I do to maintain my health?
Perimenopause is a good time to plan for a
vigorous, healthy second half of your life. That
means establishing a healthy lifestyle, which
includes activities such as regular weight-bearing
exercise, a healthy diet, and stopping smoking. If
you are not already maintaining a healthy
lifestyle, now is a good time to start.
See your health care professional to schedule a
regular mammography and blood tests that will
screen for diabetes and high lipids (cholesterol).
Without these tests, diabetes and high cholesterol
can go unchecked for long periods of time and
damage your body without symptoms. Early
treatment can prevent major complications later in
life. You may also want to consider a bone density
test, which is recommended for women under 65
who have one or more risk factors for
osteoporosis. Risk factors include a close relative
with osteoporosis, smoking, and a slender build.
For more information about perimenopause, please
ask your health care professional, or contact:
Association of Reproductive Health Professionals
Sex & A Healthier You program:
The North American Menopause Society
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Dr(Mrs) Somefun Esther Oluwatosin
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