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What is Perimenopause?

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Perimenopause, or menopause transition, begins several years before menopause. It’s the time when the ovaries gradually begin to make less estrogen. It usually starts in a woman’s 40s, but can start in her 30s or even earlier.

Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last 1 to 2 years of perimenopause, this drop in estrogen speeds up. At this stage, many women have menopause symptoms.

Perimenopause occurs during the 40s for most women, but some notice changes as early as their mid-30s. As estrogen hormones rise and fall, periods grow longer or shorter and women experience menopause-like symptoms. Perimenopause is a natural part of the aging process, although some medications, cancer treatments and ovary surgery can speed up the process or cause menopause sooner.

What Are The Stages Leading Up To Menopause?

After puberty, there are three other phases of female fertility:

  • Pre-menopause: Women have full ovarian function, regularly produce estrogen and ovulate.
  • Perimenopause: The ovaries begin to fluctuate in their ovulation and production of estrogen, which can result in unpredictable menstrual cycles and symptoms.

Menopause: When the ovaries have shut down. Someone would be in menopause after 12 months without menses.

What Are The Symptoms Of Perimenopause?

During perimenopause, you can experience a variety of symptoms. The reason: Your ovaries have been making estrogen since your first period. During perimenopause, the estrogen production decreases substantially. Your body has to adjust to functioning with less of the hormone, putting you into estrogen withdrawals. The type and intensity of symptoms vary greatly among women – some just feel a little off or don’t notice anything at all.

Symptoms of perimenopause may include:

  • irregular periods
  • periods that are heavier or lighter than normal
  • worse premenstrual syndrome (PMS) before periods
  • breast tenderness
  • weight gain
  • hair changes
  • heart palpitations
  • headaches
  • loss of sex drive
  • concentration difficulties
  • forgetfulness
  • muscle aches
  • urinary tract infections (UTIs)
  • fertility issues in women who are trying to conceive

About 80 percent of women will experience some form of a hot flash during perimenopause or menopause. Hot flashes happen when your brain has trouble regulating your internal temperature, which is a common response to having less estrogen. The shift in temperature may not be noticeable. Or, it may feel like someone cranked up the thermostat on your core body temperature. You suddenly feel uncomfortably hot and sweaty, or you may wake up drenched in sweat (called night sweats).

When to call a doctor

You don’t necessarily have to call your doctor to obtain a perimenopause or menopause diagnosis, but there are instances when you should definitely see your OB-GYN.

Call right away if you experience:

  • spotting after your period
  • blood clots during your period
  • bleeding after sex
  • periods that are much longer or much shorter than normal

Some possible explanations are hormonal imbalances or fibroids, both of which are treatable. However, you also want to rule out the possibility of cancer.

You should also call your doctor if the symptoms of either perimenopause or menopause become severe enough to interfere with your daily life.

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