What is Perimenopause?

Perimenopause is the stage in a woman’s life when the ovaries gradually begin to make less estrogen, lasting through menopause.  The perimenopausal transition usually starts in a woman’s 40s but can start in her 30s or earlier.

Perimenopause lasts up until menopause, when the ovaries stop releasing eggs. In the last couple years of perimenopause, the drop in estrogen speeds up. Around this time, women experience menopause symptoms.

Perimenopause lasts on average four years but for some women it can last only a few months or continue for 10 years.  Approximately 90 percent of women experience four to eight years of menstrual cycle changes before natural menopause.  Perimenopause ends when a woman has gone 12 months without having her period.

Women in perimenopause have at least some these symptoms:

  • Hot flashes
  • Breast tenderness
  • Sexual function changes
  • Fatigue
  • Irregular periods
  • Vaginal dryness; discomfort during sex
  • Urine leakage when coughing or sneezing
  • Urinary urgency (an urgent need to urinate more frequently)
  • Mood changes
  • Trouble sleeping

A doctor can make the diagnosis based on symptoms. There is no single test of ovarian function that will predict or confirm menopause. Usually, a woman’s medical and menstrual history and symptoms are sufficient to confirm menopause. Sometimes, a doctor will check certain hormone levels to evaluate for other potential causes of perimenopausal symptoms. 

Treatments can reduce the symptoms of perimenopause. For instance, many women get relief from hot flashes after taking low-dose birth control pills or the birth control skin patch, vaginal ring, or progesterone injections. Talk to a doctor to decide if some type of birth control or hormone therapy is right for you. 

Most importantly, take care of general well-being through:

  • Exercise
  • Stop smoking
  • Keeping a regular sleep schedule, try going to sleep and waking up at the same time each day
  • Drink less alcohol
  • Get to a healthy weight and stay there
  • Get enough calcium and vitamin D in your diet or with supplements.

Other treatments help with the various symptoms of perimenopause, such as antidepressant medications for mood swings.  These medications can also be helpful in reducing hot flashes and night sweats. Talk to a family doctor about specific symptoms and goals of treatment.

By Dr. Ellen Wenberg, MD, ThedaCare Physicians-Waupaca.