Perimenopause, also called the menopausal transition, is the interval in which a woman's body makes a natural shift from more-or-less regular cycles of ovulation and menstruation toward permanent infertility, or menopause.
Women start perimenopause at different ages. In your 40s, or even as early as your 30s, your may start noticing the signs. Your periods may become irregular — longer, shorter, heavier or lighter, sometimes more and sometimes less than 28 days apart. You may also experience menopause-like symptoms, such as hot flashes, sleep problems and vaginal dryness. Treatments are available to help ease these symptoms.
Once you've gone through 12 consecutive months without a menstrual period, you've officially reached menopause, and the perimenopause period is over.
During the perimenopausal period some subtle — and some not-so-subtle — changes in your body may occur. Some things you might experience include:
When to see a doctor
If you do experience symptoms that interfere with your life or well-being, such as hot flashes, mood swings or changes in sexual function that concern you, see your doctor.
As you go through the menopausal transition, your body's production of estrogen and progesterone fluctuates. These hormonal fluctuations are at the root of the changes your body goes through during perimenopause.
Menopause is a normal phase in a woman's life. But in some women, it may occur earlier than in others. Although not always conclusive, some evidence suggests that certain factors may predispose you to entering perimenopause at an earlier age, including:
Irregular periods are a hallmark of perimenopause. Most of the time, this is normal and nothing to be concerned about. However, see your doctor if:
Signs such as these may indicate the presence of an underlying gynecologic problem that requires diagnosis and treatment.
Preparing for your appointment
You'll probably start by discussing your symptoms with your primary care provider. If you aren't already seeing a gynecologist, your doctor may refer you to one.
What you can do
Appointments can be brief. To make the best use of the limited time, plan ahead and make lists of important information, including:
Questions your doctor may ask
Tests and diagnosis
Perimenopause is a process — a gradual transition. No one test or sign is enough to determine if you've entered perimenopause. Your doctor takes many things into consideration, including your age, menstrual history, and what symptoms or body changes you're experiencing. Some doctors may order tests to check your hormone levels. But other than checking thyroid function, which can affect hormone levels, hormone testing is rarely necessary or useful to evaluate perimenopause.
Treatments and drugs
Possible therapies to treat perimenopausal symptoms include:
Lifestyle and home remedies
Making healthy lifestyle choices may help ease some of the symptoms of perimenopause as well as promote good health as you age. These choices include:
In addition to conventional therapies, many women transitioning toward menopause want to know more about complementary and alternative approaches to treating their symptoms. Researchers are looking into these therapies, hoping to determine their safety and effectiveness, but evidence is still often lacking. Be sure to tell your doctor about any complementary or alternative therapy you are using or considering. Here are a few options that show some potential for treating menopausal symptoms while still being fairly safe:
Although study results have been mixed, other complementary therapies with low-risk profiles such as acupuncture, yoga and paced breathing have shown some benefit in improving menopausal symptoms. These therapies may help reduce stress and improve psychological well-being, as well. Talk to your doctor about what complementary and alternative therapies may be helpful to you.
Last Updated: 2010-09-16
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