Most people know that menopause brings changes that can significantly affect a person’s health and quality of life. What’s less widely understood is that many of these changes begin before menopause itself — during the transition known as perimenopause.
As an obstetrician-gynecologist, I want my patients to understand perimenopause and the support available to them. That’s why I always encourage my patients to ask questions about perimenopause. Here are nine of the common ones I hear.
1. What is perimenopause, and how is it different from menopause?
The word perimenopause means “around menopause.” It describes the years leading up to menopause. It begins when your ovaries start making less of the hormones estrogen and progesterone.
Menopause describes a very specific point in time: when you haven’t had a period in 12 months. The time in your life after menopause is called postmenopause, and it’s the last stage of the menopause transition.
2. When does perimenopause start?
It usually starts when you’re in your mid to late 40s, but it can happen in your 30s. Some people may start perimenopause later, such as in their 50s.
3. How long does it last?
Once perimenopause starts, the transition to menopause typically takes about two to eight years, with four years being the average. But this varies from person to person. Some people are in perimenopause for only one year; others are in it for several years.
4. What are the early signs of perimenopause?
I tell my patients to watch for irregular periods. Compared to before, your periods may be longer or shorter, heavier, or lighter, or they may stop for a few months and then start again.
In addition, some people have:
- Hot flashes. They can make your skin flush (turn red) and your face and upper body feel suddenly warm. If they occur at night, they’re called night flashes, and they can make it hard to sleep.
- Mood changes, like irritability or depression.
- Vaginal dryness, which can make sex painful.
- A lower sex drive.
- Insomnia
- Brain fog
However, some people don’t notice any changes aside from irregular periods.
5. Can I still get pregnant?
Yes. Even though your period might not happen some months, you can still have them and ovulate during perimenopause. It is only after you have reached menopause — a full year after your last period — that you cannot get pregnant. Until then, if you don’t want to get pregnant, you should use a birth control method.
6. How does perimenopause affect my health?
During perimenopause, declining estrogen levels can elevate the risk of certain health conditions. For instance, some people lose bone density, which increases the likelihood of osteoporosis, a disease in which bones become brittle and prone to breaking. I often recommend supplements and lifestyle changes to help my patients reduce their risk of osteoporosis. For instance, getting enough calcium and vitamin D can help keep bones strong. So can regular weight-bearing exercise.
The risk of heart disease and stroke also goes up. Adopting a heart-healthy diet — one that includes fruits, vegetables, whole grains, and less saturated fat — is an important thing you can do to protect your heart during this transition in your life.
7. Will perimenopause cause me to gain weight?
Metabolism tends to slow during perimenopause due to hormonal changes. So, yes, it can lead to weight gain. But unwanted pounds aren’t inevitable. Making healthy food choices and exercising regularly can help you maintain a healthy weight.
8. Can perimenopause affect my mood or thinking?
Many people experience mood changes during perimenopause. They might become irritable or sad more often. They may also have cognitive difficulties, such as memory problems or trouble concentrating, sometimes called brain fog.
Talk to your doctor if you experience significant mood swings or emotional changes.
9. How can I relieve hot flashes and other perimenopause symptoms?
Different approaches may offer relief, including:
Lifestyle changes. For example, you can try wearing lightweight layers you can remove if you get hot flashes. Use a portable fan to stay cool. Exercise regularly to boost your energy, sleep, and mood.
Medications. Options for hot flashes might include birth control pills, which stabilize hormone levels, and hormone therapy pills, creams, or skin patches. Vaginal creams can relieve dryness, and antidepressants may help with hot flashes, anxiety, or depression.
You should discuss the risks and benefits of treatments with your provider and decide together what’s best for your symptoms.
Help is available
If you’re experiencing bothersome perimenopause symptoms, you should talk with your doctor about treatment options and potential health risks during this phase of your life.
Temple’s highly trained and compassionate OB-GYNs can help you manage your symptoms during the perimenopause years, which may be some of the best of your life. Schedule an appointment online or call 800-TEMPLE-MED (800-836-7536).
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