Known as the rocky road that leads to menopause, perimenopause is a transitional phase that occurs in a woman’s life immediately before menopause.
It can last from two to ten years before menstruation stops entirely. For some women, perimenopause is relatively uneventful, while for others, changes can be intense enough to cause significant distress. The good news is that this instability does diminish over time.
What is Perimenopause?
Perimenopause is the period right before menopause. Often, women experience emotional and physiological challenges during these volatile years before her period ends. During perimenopause, the body is making its natural transition towards the end of its reproductive years. It takes time to adjust.
During this window, estrogen levels – one of the main hormones in a woman’s body – start to rise and fall in an unpredictable way. There is a change in libido, a lessened ability to empathize with others, exhaustion, depression, and other changes.
One might experience longer or shorter menstrual cycles. There can also be a menstrual cycle where the ovary doesn’t release an egg.
Some women also experience symptoms of menopause like hot flashes, vaginal dryness, and insomnia during this transitional phase.
How Long Does it Last?
On an average, perimenopause lasts for about four years. For some it may end in a few months, but for others it can last as long as 10 years.
It usually begins in the 40s, but some women might experience it in their 30s. During the last 1 or 2 years, estrogen levels start dropping at a rapid speed and women start to experience menopause symptoms.
When a woman goes for 12 months without her period, her perimenopause comes to an end and menopause begins.
Common Symptoms of Perimenopause
During this transitional phase, you might notice some subtle and some striking changes in the body. The common symptoms of perimenopause include:
1. Irregular Periods
When your ovulation period starts to change, the time between your cycles can also change. A change of seven days or more in the length of your cycle indicates an early perimenopause phase. When you notice a space of 60 days or more between periods, it might be late perimenopause.
2. Hot Flashes
Women often dread the hot flashes that are a part of menopause. Unfortunately, the flashes start in perimenopause itself, though the length, intensity, and frequency might vary.
3. Mood Swings
This is the emotional roller coaster associated with menopause. You might feel anxiety, loss of motivation, and some level of depression. You might also experience mood fluctuations and a feeling of sadness. Irritability is another common symptom of perimenopause. You can manage this through exercise, relaxation techniques, and reduction in stress levels.
When a woman is under continued, abundant stress, her body begins to secrete cortisol, commonly referred to as the “stress hormone.”
5. Lower Fertility Rates
When your ovulation reduces, your ability to get pregnant also decreases. Yet, as long as you’re having your periods, there is a chance to conceive. To avoid pregnancy, it is best to use birth control until your periods haven’t come for 12 months.
6. Lower Libido
You might experience a decrease in sexual arousal and desire during this phase. Many women also notice vaginal dryness or discomfort when they’re having sex.
7. Increased Risk of Osteoporosis
As your estrogen levels are declining, you tend to lose bone faster than your body can replace it. It can increase your risk of osteoporosis – a disease that leads to fragile bones.
Sleep deprivation is another common symptom that continues until menopause. You might experience night sweats, which make it difficult to sleep through the night. Many times, sleep can be unpredictable even without hot flashes or sweats.
What are the Risk Factors?
Though menopause is a natural and normal phase, there are certain factors that can cause it to arrive early. For instance, the onset of menopause is 1-2 years earlier in smokers than non-smokers.
Women with a family history of early menopause will also experience early menopause. Treatments for cancer like chemotherapy and pelvic radiation contribute to early menopause. If you’ve had a hysterectomy, it may cause your menopause to arrive earlier than expected.
Perimenopause is like an alarm bell, indicating that something is not right in your body and that change is occurring. It is a signal that you need to take care of yourself, address your symptoms, and lead a healthy lifestyle.