Perimenopause is the time during which a woman’s body transitions to menopause. Women experiencing perimenopause, or “around menopause,” often show one or more related menopause symptoms. Symptoms and signs of menopause often start in the 40s but can begin earlier.
It is sometimes difficult to tell whether a symptom is related to menopause or to something else, so be sure to report any concerning changes to your health care provider. Women may also benefit from consulting with a menopause certified practitioner (NCMP).
Perimenopause Signs and Symptoms
As a woman reaches perimenopause, changes may occur in her menstrual flow and regularity. Some women simply stop menstruating one day and never have another period. However, about 90% of women experience 4-8 years of menstrual cycle changes before the periods are gone for good. These irregular periods are caused by the erratic production of hormones. Although there are several different ways menstrual cycles change, each woman will know that, for her, a change has occurred.
Hot flashes are the most common menopause-related symptom. As many as 75% of North American women will have hot flashes during perimenopause according to Johns Hopkins Medicine. Blood vessels near the surface of the skin dilate to allow more blood flow which gives off body heat. This can produce a red, flushed look to the face and neck and may cause sweating to help cool down the body. A cold chill usually follows a hot flash. A rapid heartbeat and feeling of anxiety are often common with hot flashes. Hot flashes and sweating may occur at night, night sweats, and can disturb a woman’s sleep cycle leading to fatigue and irritability.
At least 1 in 3 women will have some troubling symptoms in the vulva and vaginal area or in the urinary tract. These symptoms can include vaginal discharge, irritation, burning, dryness, itchiness, pain with and without sexual activity, and urinary incontinence. This is caused by a decrease in estrogen which causes the surface of the vulva and vagina to become thin, dry, and less elastic. There are treatments to keep the vagina healthy including nonprescription options and vaginal estrogens.
Menopausal women sometimes report tearfulness, mood swings, lack of energy, anxiety, panic attacks, and feeling blue or discouraged. They may also notice memory and other cognitive changes (“brain fog”) which can seem like they are developing dementia. Sometimes coping skills and lifestyle changes are not enough to relieve the symptoms. Once again, there are treatment options that may include hormone therapy or other prescriptions to help with these symptoms.
Women frequently experience a decline in their libido or other sexual dysfunction. This can be due to multiple factors but there are options out there to help women. Ask your physician about treatment options.
During perimenopause, hormone tests are usually not helpful to determine menopause status. Hormone levels change daily and can swing high and low throughout perimenopause. There are some situations that a provider may want to check your hormone levels, but it is most important to address your symptoms and monitor your menstrual cycle.
In addition to bothersome symptoms, this is also a time that the risk of cardiovascular disease increases, which is the number one cause of death in women. It is a time in life to reexamine lifestyles and overall health choices. This includes getting an annual physical exam with your physician.
You’re not alone with your symptoms! MercyOne health care providers have experts ready to help you in any way. MercyOne Comfort Health Center for Women offers perimenopause/menopause consultations, convenient and customized women’s health screenings, and assessments with treatments of numerous medical problems of special concern to women. The center is the first-of-its-kind facility dedicated to providing specialty health care for women in mid-life.
About the author: Valerie Stratton, DO, NCMP, is a board-certified internist and North American Menopause Society (NAMS) certified physician at the MercyOne Comfort Health Center for Women in Clive, Iowa.
To schedule an appointment, please call 515-222-7474.
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Clive, Iowa 50325