Understanding Perimenopause

In my early forties, things started to change. I was unable to read a restaurant menu in dim lighting, and I started to have aches in places I didn't know existed. These were typical, age-related nuisances I had always heard my parents grouse about.

A few years later, though, something else started happening. I was feeling "weird-different." My equilibrium seemed off, I had somehow lost my Energizer Bunny battery, and I was having an awful time sleeping through the night...not to mention waking up to a neck full of sweat.

What was happening to me? It couldn't be menopause. After all, I was still getting my "friend" extremely regularly. When I spoke to my gynecologist, I learned that I was experiencing the transitional stage of menopause - a.k.a. perimenopause. I was a newbie with little to no idea about what to expect.

Since I've been dealing with this "stage" for several years now, I suppose one might consider me a veteran. I've learned to live with my mild symptoms like a champion. Unfortunately, some tell quite a different story. A close friend or two have found their "transitions" to be much more challenging.

About the Transition

Think of perimenopause as the "transitional phase" before menopause. Menopause is defined as the stage when ovaries stop releasing eggs and when a woman has gone without a period for twelve consecutive months. If you are a woman in your forties, it is highly likely you will begin to feel changes due to hormonal fluctuations. This is a sign that your "transition" has started.

"The average woman starts experiencing the symptoms of perimenopause around forty-seven years of age. These include hot flashes, irregular bleeding and night sweats. There may also be mood swings, vaginal dryness, and breast tenderness," says Michelle P. Warren, M.D., professor of obstetrics and gynecology and medical director of the Center for Menopause, Hormonal Disorders and Women's Health at Columbia University Medical Center.

The symptoms of perimenopause vary from patient to patient and so does the severity of those symptoms. Some women may only experience perimenopause for a few months and others for up to ten years.

Women should discuss changes they are experiencing with their doctors. Don't wait for an annual visit if symptoms are severe. For example, very heavy bleeding might be a sign of a precancerous condition, and severe mood swings can spiral out of control. "Severe mood problems should be addressed as they can become very serious," cautions Warren. In general, if any of the symptoms are severe enough that they interfere with daily activities, you should speak to your doctor.

Lifestyle adjustments can reduce symptoms. Warren advises, "Exercise and stress reducing options may help." Women should also be sure to eat a well-balanced diet and maintain a healthy weight.

A good night's sleep is also important, but for some perimenopausal women, a good night's sleep seems unattainable. If possible, avoid napping and be sure your bedroom is cool and comfortable. Do not drink alcohol close to bedtime or caffeinated drinks after 2 pm. Some women who experience night sweats find that a portable fan on the nightstand works wonders.

Medication might be necessary to ease severe symptoms when a healthy lifestyle doesn't seem to be doing the trick. Warren states, "Antidepressants are used to reduce hot flashes and mood problems. Local estrogen therapy will help vaginal dryness, and sometimes oral contraceptives will control irregular bleeding and heavy periods. Small amounts of hormone therapy are used to prevent the wild fluctuations of estrogen that occur at this time." Speak with your healthcare provider about possible options.

There is definitely a light at the end of the tunnel. After menopause, many women say they experience an increase in creativity and a rekindled desire to reach lifelong goals or create new ones. So don't fret. Instead, reach for your running shoes and head to the farmer's market for some fresh veggies and a salmon steak.