When women reach their early 40s to mid-50s, the transition into menopause begins. During this time, the body gradually produces less estrogen, and your menstrual cycle may become irregular. This transitional period is known as perimenopause.
Perimenopause can last anywhere from 2 to 10 years, after which menopause begins. Menopause is when a woman has not had her period for 12 consecutive months or a full year.
During perimenopause, fertility and chances to become pregnant decline due to decreased estrogen levels. Once menopause starts, it is considered the end of a woman’s ability to naturally become pregnant. The years after menopause are called post menopause.
Postmenopause lasts for the rest of a woman’s life. During this time, symptoms of menopause tend to decrease or go away completely. Hormone levels will continue to remain low, and the ovaries stop releasing eggs, thus ending a woman’s chances to get pregnant.
“Many women think that the arrival of menopause and completion of childbearing means they no longer need to see a gynecologist. Not only is it still important to have routine exams and screening, your gynecologist can help you navigate this new phase of life and all of the changes that come with it. I try to help my patients understand what changes are normal (or abnormal) during this transition. I want to find out what symptoms are most bothersome to them so that we can work together to come up with a plan for how to best manage them, whether through lifestyle changes or medications when needed.”
Mary Peace, DO
OB/GYN, Piver Center For Womens Health and Wellness
Symptoms and length of perimenopause vary depending on what age it starts. Many women experience hot flashes, vaginal dryness, and mood swings due to the hormonal changes. The drop in estrogen levels can also affect a woman’s cholesterol levels and bone density, putting them at an increased risk of developing cardiovascular disease or osteoporosis.
Menopause symptoms are very similar to perimenopause. Many women experience night sweats, hot flashes, and flushing (vasomotor symptoms), increased urination, vaginal atrophy, and weakening of the pelvic muscles which can cause urinary incontinence or prolapse of the reproductive organs. The hormonal changes can cause weight gain due to slowed metabolism, an increase in facial hair or loss of hair on the scalp, low energy levels, depression, and insomnia.
Menopause can even affect your heart. Dizziness, heart palpitations, fast heart rate, and a tingling or numbing sensation have been reported by women in menopause.
Postmenopause symptoms are similar to perimenopause and menopause, but are not as frequent or intense. Due to hormone levels remaining low, an occasional hot flash may occur in your postmenopausal years, as will some of the other aforementioned symptoms.
Dressing in light layers, keeping your environment cool, and practicing meditation or breathing exercises can help with hot flashes. In the afternoon, avoid drinking coffee, caffeine, energy drinks and alcohol, as they can disrupt sleep. Practicing Kegel exercises can strengthen pelvic floor muscles and control incontinence, while exercising and eating a healthy diet high in vitamin D and calcium can help control weight gain, and prevent bone loss and heart disease.
Because menopause is a natural part of aging, there is nothing we can do to prevent or delay it, but there are factors that can cause premature menopause. Genetics, autoimmune diseases, or undergoing chemotherapy are uncontrollable factors that can accelerate menopause. Quitting smoking is considered the biggest modifiable factor in early menopause.
Women who have had surgery to remove their ovaries experience immediate menopause, as the ovaries produce the menstrual cycle regulating hormones estrogen and progesterone. Symptoms of surgical menopause tend to be more severe than if menopause were to happen naturally.
As previously mentioned, irregular periods are common during perimenopause. But if you begin noticing they are lasting longer than several days, are becoming heavy with blood clots, or that they are occurring less than 21 days apart, there could be an issue with your reproductive system. Speak with doctor as these can be signs of fibroids, endometrial polyps, infection, pregnancy-related bleeding, or cancer.
Perimenopause and menopause can usually be diagnosed based on symptoms and do not require medical treatment. Instead, your OB/GYN will discuss lifestyle modifications and things you can do to relieve your symptoms. If your symptoms begin to interfere with daily life, your doctor may recommend hormone therapy, medications to treat vasomotor, insomnia, and osteoporosis symptoms, or refer you to a therapist for any mental health changes.
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