What Is Perimenopause? Perimenopause, or menopause transition, is the stage of a woman’s reproductive life that begins several years before menopause, when the ovaries gradually begin to produce less estrogen.
Sometimes, menopause can happen earlier than usual. This can happen for a variety of reasons. Women who’ve received treatment for cancer may experience early menopause. That’s because chemotherapy, radiation, and hormone therapies can all interfere with hormone levels.
Another reason for early menopause is surgical removal of the ovaries. Surgical removal of the uterus does not cause menopause if your ovaries are still functioning. Another cause of early menopause is primary ovarian insufficiency. That’s when your ovaries simply don’t produce normal levels of female hormones. It can be an inherited condition or caused by autoimmune disease. According to the Mayo Clinic, about one percent of women reach menopause before their 40th birthday.
Smoking can also trigger early menopause. The cause of early menopause is not always clear. If you’re under age 45 and experience signs and symptoms of menopause, consult with your doctor so any problems can be detected and treated.
What Is Menopause?
Menopause is the permanent end of menstruation. It’s a turning point, not a disease, but it can have a big impact on a woman’s wellbeing. Although menopause can bring physical upheaval from hot flashes, night sweats, and other symptoms, it can also be the start of a new and rewarding phase of a woman’s life — and a golden opportunity to guard against major health risks like heart disease and osteoporosis.
Menopause isn’t exactly a time in life women look forward to: Hormone changes can bring on hot flashes, sleep problems, and more. But once you’re well-versed in menopause facts, you can put together a plan to sail through this transition in stride.
Every Woman Will Go Through The Menopause, But Each Experience Of It Is Different.
It doesn’t happen at a particular age or last for a fixed period of time, and it can cause a variety of different symptoms – both physical and emotional. The menopause can be an unsettling time in a woman’s life, while some women go through it with no problems.
The menopause is the time when a woman’s periods stop. It happens because as women age, they slowly run out of eggs. Some scientists believe this happens to protect women and their children from the dangers of late childbearing. The average age that women go through the menopause is 52, but a woman could start to experience menopausal symptoms between the ages of 45 and 55. The symptoms can last two to five years.
Medical conditions can cause the menopause to happen much earlier, sometimes in a woman’s 20s or, in extreme cases, in childhood. This is known as premature ovarian failure (POF).
Changes in hormone levels can produce different symptoms. It’s estimated that around two-thirds of women experience the most common symptoms of hot flushes and night sweats. However, some women also report psychological symptoms, including depression, tiredness, lack of energy and vaginal dryness, which can be associated with a reduced interest in sex.
Breast Changes In Menopause
As you get older, it’s natural for your breasts to lose their firmness, change shape, shrink in size and become more prone to certain abnormal lumps.
In most cases, breast lumps are harmless but, whatever your age, it’s important that you report any new lumps to your doctor.
From around the age of 40, you can expect your breasts to change in size and shape. It’s normal for breast tissue to become less glandular and more fatty as you get older, which makes them feel less firm and full.
With age, there’s also an increasing risk of abnormal growths in the breast. These are often harmless breast lumps, like cysts, but they can also be a sign of serious conditions like breast cancer.
As the years go by, you might also notice a wider space between your breasts and that your breasts shrink in size, sometimes by a cup size or more (unless you put on weight, in which case your breasts may get bigger). The area around the nipple (the areola) tends to become smaller and may nearly disappear, and the nipple may turn in slightly.
Many of the breast changes that happen as you get older are caused by hormonal changes.
Here Are 10 Basic Facts About Menopause Women Should Know:
- You’ve hit menopause after you go 12 months without a period. Because periods can be irregular in the years leading up to menopause, you won’t know you’ve reached it until you’ve gone a year without menstruating. Menopause means your ovaries have stopped producing estrogen, according to the American Congress of Obstetricians and Gynecologists (ACOG).
- On average, menopause occurs around age 51. Most women will have their last period sometime between ages 45 and 55, reports the North American Menopause Society (NAMS).
- Menopause before 40 is considered early menopause. This might run in your family or could be a result of a medical condition, such as an abnormal thyroid or a rheumatic disease such as lupus. Chemotherapy and radiation can also damage the ovaries and bring on early menopause, NAMS notes. If you have your ovaries removed as part of a medical treatment, you will begin early menopause right away, says Dr. Deighan
- The years leading up to your last period are called perimenopause. Fluctuating estrogen levels can begin in your thirties or forties, during the transition from menstruating regularly to not menstruating at all, according to ACOG. The most common sign is an irregular period, meaning your cycles may become longer or shorter or become heavier or lighter, says Deighan. You might also skip periods.
- Symptoms include hot flashes and weight gain. The most well-known symptom of menopause, the hot flash, is an intense feeling of warmth that can last a few seconds or several minutes, according to NAMS. When this happens while you’re sleeping, it’s called night sweats. Other possible symptoms of menopause include sleep problems, vaginal dryness, mood changes, headaches, and problems with memory.
Some women experience these symptoms during perimenopause, while others don’t experience them until after they’ve stopped menstruating, Papamihalakis says. Some symptoms, such as hot flashes and memory issues, may go away after you reach menopause, NAMS says
- Menopause leads to bone loss. This is due to the loss of estrogen. In fact, women may experience as much as a 20 percent drop in bone density in the five to seven years after menopause, according to the National Osteoporosis Foundation (NOF). “Osteoporosis is a silent and serious disease,” Papamihalakis says, but it is preventable. Get calcium in your diet, add weight-bearing exercise to your routine, check your vitamin D levels, and ask your doctor to check your bone density. Everyday Health columnist and associate clinical professor of obstetrics and gynecology at Northwestern University’s Feinberg School of Medicine.
- Risk for heart disease rises after menopause. Estrogen offers protection against heart attack and stroke. The drop in estrogen during menopause means your risk of heart disease may increase, especially if you have high cholesterol and high blood pressure and aren’t active. This is another reason to make healthy habits a top priority.
- Hormone therapy can help with menopause symptoms. Formerly called hormone replacement therapy, HRT, taking estrogen and progesterone, or just estrogen if your uterus has been removed, can help relieve symptoms, like hot flashes. But using hormone therapy long-term may raise the risk for heart attack, blood clots, and stroke. A large landmark study done in 2002 found that estrogen and progestin raised the risk for breast cancer. Review your individual risks and the pros and cons of hormone therapy with your doctor before embarking on this treatment.
the other hand, research also found that combination hormone therapy can lower risk for bone fractures and colorectal cancer, according to the U.S. Department of Health and Human Services. “I absolutely encourage [patients] to consider hormone therapy for a limited period of time,” Deighan says. Six months to two years of therapy can help women get through the worst of the symptoms, she adds.
- Lifestyle boosts can help you feel better. Exercise helps to slow the loss of bone after menopause and keep your weight in check, according to ACOG. It also increases natural endorphins, which could help with mood changes and irritability, Deighan says. Other healthy habits, such as eating well, are also crucial at this time of life.
- No more periods can be freeing. After decades of monthly periods, it can feel good to say goodbye, especially if they were heavy or painful. Sometimes problems like fibroids and endometriosis get resolved with menopause, Deighan says. Some women also enjoy their relationships more once they no longer have to worry about pregnancy.
Quality Of Life
Menopause is a natural life occurrence. For most women, there’s no cause for alarm or medical intervention. A study of menopausal women revealed that 80 percent experienced no change in quality of life. Sixty-two percent felt positively about menopause. Ten percent of women said they were irritable, fatigued, and had feelings of despair during the menopausal phase of their lives.
Menopause And Sexuality
One study showed that 75 percent of women don’t feel less attractive because of menopause. Relieved that pregnancy is no longer an issue, many women find sex more enjoyable.
Some physical changes may have an affect on your sexuality. Lower levels of hormones can interfere with your sex drive. It can also affect the skin in and around your vagina, making it thinner and drier. If these changes are a problem for you, there are a few things you can do:
- Tell your partner if intercourse is painful. Explain your likes and dislikes — what feels good and what doesn’t.
- Try over-the-counter vaginal lubricants and moisturizers.
- Consult with your doctor. A prescription strength medication may be able to treat vaginal dryness.
- Use it or lose it. When you have sex, it increases blood flow to the vagina.
Sex can be enjoyable and healthy at any age! But we hear from women that they’ve been instructed, even by their doctors, that a decrease in libido is a “normal” part of aging. In my practice it is a major concern for many women. As women in our 40’s, 50’s, and 60’s — that doesn’t sound normal to us! Decreased interest in sexual activity is often a sign of hormonal imbalance, which can cause both physical and emotional symptoms that have an effect on your sex life. This does not have to happen as it can greatly affects the intimacy of the relationship.
For example, approximately 50% of post-menopausal women will experience vaginal dryness which can make sex painful. Then of course many women are no longer interested in sex. And if intercourse hurts, you’ll likely see a drop in your sexual desire, too. But this doesn’t have to happen! Changes in your hormonal health can be difficult to discuss. The information in our articles about hormonal imbalance and low libido can help you get started.
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