Prior to menopause is a period that is known as Perimenopause. This is a natural transition phase that could last anywhere from 4-8 years.
Perimenopause starts with changes in the amount of time between one period and the next. It ends one year after a woman has had her final period.
This time of transition could begin as early as your mid-30s, but most women begin to see menstrual irregularities in their 40s. Every woman is different, and perimenopause will begin at various ages.
Because your estrogen level will rise and fall in an uneven manner throughout perimenopause, you will notice that your menstrual cycle will become shorter or longer, and you might have cycles during which you don’t ovulate and skip your period.
You might even have symptoms that are typically associated with menopause, such as vaginal dryness, trouble sleeping, and hot flashes.
Ovulation will become unpredictable, and your menstrual flow might change as well, becoming lighter or heavier.
Other symptoms include changes in mood or sexual function, bone loss, an increase in LDL cholesterol, vulnerability to urinary and vaginal infections, urinary incontinence, and loss of vaginal lubrication and elasticity.
When 60 days or more pass between your periods, you have entered the latter stage of perimenopause.
Perimenopause is caused by changing hormone levels in the female body, something which naturally occurs as we age. Once we move past childbearing age, levels of estrogen and progesterone begin to decrease, but they can fluctuate along the way. The symptoms of perimenopause, in particular, are caused by a reduction of estrogen.
Although perimenopause is an unavoidable and perfectly normal aspect of aging, certain risk factors can cause it to occur earlier in some women than in others.
Women who have had a hysterectomy are likely to experience perimenopause much earlier than normal. Those who have had complete removal of the uterus and ovaries are at a particularly high risk of early perimenopause. If only the uterus has been removed but the ovaries remain, or the uterus and just one ovary have been removed, perimenopause may be slightly delayed but is still likely to occur earlier than usual.
Perimenopause is also linked with cancer treatment. Chemotherapy and pelvic radiation therapy can both lead to early menopause.
Smoking is known to cause perimenopause to occur earlier than usual. Research has found that women who smoke experience perimenopause symptoms, on average, two years earlier than those who don’t smoke.
Finally, some women are simply genetically predisposed to experience perimenopause earlier than others. Those who have a family history of early perimenopause are likely to experience it early too.
Perimenopause is completely normal and something that all women go through. However, if your symptoms become bothersome, your doctor can help by prescribing medications to ease those symptoms.
Treatment options include vaginal estrogen, hormone therapy, antidepressants, and Gabapentin. As you progress through perimenopause, your symptoms may change, so treatments may change as a result.
Unfortunately, there is no way to prevent perimenopause; it is a natural phase that every woman will go through. However, it may be possible to reduce your risk of early perimenopause by quitting smoking.
Women who have had pelvic radiation therapy, chemotherapy or hysterectomy may be able to reduce the symptoms of early menopause by having hormone replacement therapy (HRT). This is where synthetic estrogen and progesterone are delivered into the body to prevent symptoms. HRT can be delivered via: