Perimenopause - Symptoms, Treatments & Premenopause vs Perimenopause

Perimenopause - Symptoms, Treatments & Premenopause vs Perimenopause

What is perimenopause?

Menopause is not a phenomenon that happens all of a sudden one fine day. The body has to go through a transition phase termed as ‘menopausal transition’, marked by a variety of symptoms, and this timeline is known as perimenopause. The word can literally mean ‘around menopause’.

When does it usually occur?

If we talk about hormonal changes in the body, like the drop in the level of estrogen, they can start around 8 to 10 years before the onset of menopause. This is around the 40s in most females, but some can show signs as early as in their mid-thirties. 

Perimenopause is marked by a steady drop in estrogen starting in their mid to late 40s for most people. It can be identified if a menstrual cycle varies by seven or more days or period occurs at least once in three months.

How long does it last?

On average, perimenopause lasts for around 4 years. However, in some females, it can last for as little as a few months or two years, or continue up to 10 years. A doctor will confirm the end of the perimenopausal period if a woman has gone 12 months without having a single period.

Perimenopause symptoms

Symptoms are varied and may include:

  • Irregular periods
  • Heavier or lighter than normal flow
  • Premenstrual Syndrome (PMS) symptoms are worsened
  • Tender breasts
  • Weight gain
  • Hot flashes and palpitations
  • Trouble sleeping
  • Headaches and muscle aches
  • Loss of libido or sex drive
  • Difficulty in concentrating or remembering things
  • Vaginal dryness and frequent UTIs
  • Lowered bladder capacity or urinary incontinence
  • Fertility issues
  • Changes in cholesterol levels

What are the treatment options for perimenopause?

There are several treatment options available to ease the symptoms of perimenopause. They include:

  • Hormone Therapy - Estrogen levels dropping at a sudden rate causes uncomfortable symptoms in the body, including the added benefit of the reduced risk of osteoporosis. This hormone can be introduced in the body in the form of oral pills, creams, gels and skin patches. Progesterone injections are sometimes used for treating hot flashes.
  • Medication - Several forms of medication are used to treat various symptoms. Birth control can be useful for treating hot flashes and mood swings, while antidepressants can be prescribed for managing difficult PMS symptoms regarding emotional imbalance. For vaginal dryness, prescription vaginal creams are available.
  • Home Remedies - While medicinal treatment is an option, several things can be done at home to reduce the effects of the symptoms. These include exercising, quitting smoking, limiting alcohol consumption, maintaining a healthy sleep cycle, intaking enough calcium, and maintaining a healthy diet to keep weight in check. Limiting caffeine consumption can also be beneficial for many women.

Premenopause vs perimenopause

People often use both the terms interchangeably, however, there is a difference between the two.

  • Premenopause: This is a phase in a female’s life which marks the beginning of transitioning into the menopausal stage of life. It is different from perimenopause in the sense that usually, there are no noticeable changes or symptoms of menopause. Although, her body may already start undergoing hormonal changes. The person may or may not have regular periods, but she is still considered to be in her fertile years, though on the path of decline.
  • Perimenopause: This marks the official onset of the transition into her menopausal years. The difference lies in the fact that hormonal changes are more rapid and there are various symptoms that can crop up while her fertility begins to decline.

Can you get pregnant during perimenopause?

Even with lowered fertility, a person can get pregnant in their perimenopausal years. Conceiving usually becomes difficult after she reaches her late thirties, but since the ovaries are still releasing eggs, there is a chance that a pregnancy might occur.

If you don’t want to become pregnant, using some form of birth control is advisable. And if becoming pregnant is the goal, then there are various fertility treatment options that one can explore.

How is perimenopause different from menopause?

Perimenopause is the transitioning phase before a woman hits menopause. Menstruation still occurs during the perimenopausal phase and a variety of symptoms start marking the rapid decrease in hormone levels. 

Some of the symptoms are the same as menopause. But, a woman is said to have hit menopause once she has not bled for 12 consecutive months.

What can cause perimenopause to start earlier than usual?

Even though menopause is a natural phase in a female’s life, there are some factors that can plunge her earlier into the perimenopausal state. These include:

  • Smoking
  • If there is a pattern of early menopause running in the family
  • Chemotherapy or radiation therapy
  • Hysterectomy or the removal of the uterus

When to see a doctor?

Most of the time, the symptoms can be managed at home, but a doctor should be consulted if any of the following cases occur:

  • Extremely heavy bleeding where you have to change tampons or pads or drain menstrual cups every hour or two
  • Your periods persist for longer than 7 days
  • Bleeding occurs between your menstrual cycles
  • Shorter cycle length of fewer than 21 days
  • Bleeding occurs after sex
  • Formation of larger than usual blood clots

Apart from these, a doctor should also be consulted if the symptoms become severe and start to interfere with regular life.

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