Do You Know About Peri-Menopause?

Most women are aware of menopause; however there is also a phase before menopause called peri-menopause which is a rather significant, but lesser known phase.  

This is not a disease and must not be considered one. Peri-menopause and menopause are few of the very few certain changes that every woman experiences, hence giving them a chance to prepare for it.  This transition phase lasts until a woman completely enters into menopause. 

So what is peri-menopause? Perimenopause is a transitional stage in a woman’s reproductive age that begins roughly around 4 to 5 years before menopause. Peri-menopause is a gradual and normal process, the number of years may vary in different women, in some women the stage may last only a few months and in others it could continue for more than 5 years. 

During this phase, a woman’s body undergoes hormonal changes causing the ovaries to reduce the production of estrogen. Estrogen is the primary sex hormone that is produced during pregnancy.  This reduces or fluctuation in the level of female hormones may be caused as a result of the body’s preparation towards cessation of menstruation.  

During this stage, women may experience a variety of symptoms caused due to the fluctuation in hormones. The main symptoms include; 

Irregular periods: Since ovulation becomes irregular during this phase, you may experience shorter or longer periods with heavy or lighter flow. In some cases, you may not even have regular periods. A gap of 60 days between each period indicates that a woman has entered late peri-menopause. If a woman has not had periods for 1 year, it means that they have entered the menopause phase. 

Hot Flashes: this may be caused because of the drop in estrogen levels in the body. The hot flashes can last for a few minutes or even longer. Having poor lifestyle conditions like overweight and smoking could increase your risk of having hot flashes. This when caused in the night can interrupt with your sleep patterns causing disturbed sleep. 

Vaginal issues: the vagina tends to lose its lubrication and elasticity with the low levels of estrogen production. This may cause sexual intercourse to be very painful. This may further cause urinary infections. 

Frequent mood swings: mood swings causing irritability, anxiety and depression are common during this time. It is important for a woman to express herself to people around her, failing which interpersonal relationships may get affected. 

Decreased fertility: this is an obvious symptom of peri-menopause. Reduction in ovulation also reduces your ability to conceive. However, since a woman does have periods during peri-menopause, conceiving is still possible until it stops completely. 

There are also other symptoms like fatigue, increase in body weight, high levels of cholesterol, and/or depression caused during this stage. However, there is no certainty that each woman will experience all of the major symptoms or only a few of them.  

Irregular periods are the most common symptom of peri-menopause and are absolutely normal. However, some woman may experience abnormalities like; 

  • Bleeding lasting more than 7 days.
  • Extremely heavy bleeding.
  • Bleeding occurring more than once a month.

These are complications requiring an expert’s opinion and must not be ignored. Medical assistance is available in order to ease the transition into menopause for women experiencing severe symptoms. Some women are medically aware and seek professional help in managing their pre-menopausal symptoms, others choose to bear the symptoms and a few other do not experience symptoms that are as serious and do not realize the association to peri-menopause. 

Symptoms of peri-menopause may not be severe in all women. Lifestyle changes including a healthy diet, physical activity, maintaining a healthy body weight etc. are extremely important in maintaining good overall health. Addressing severe symptoms and leading a healthy life will help keep health concerns at bay and will allow an easy transition into menopause. 

(Written by: Dr. Usha Sethi, specialist gynecologist at Aster Clinic, Tecom, Dubai)