Apr 09, 2019 12:00 AM


Most women are familiar with menopause, a stage later in life when women no longer ovulate or have periods. What may not be as familiar is perimenopause, a transition period when women start to run out of eggs and experience a wide array of symptoms and changes to their bodies.

While some women face little to no symptoms when they undergo perimenopause, most women will encounter at least some changes to their body. The most common change is irregular periods. This may manifest as skipped periods, erratic periods, or periods that are heavier or more frequent. Along with irregular periods, women may also experience hot flashes, excessive sweating, mood swings, lower energy, anxiety, poor sleep, and changes in libido.

For most women, perimenopause begins in their early 40s, but it can occur as early as their late 30s or not until after the age of 50. Menopause is defined as one year without a period. While the idea of ten years of unpleasant symptoms can seem daunting, the symptoms often wax and wane over the years. Some women may go through a period of symptoms and then experience nothing for several years.

The onset of perimenopause does not mean that women can no longer have children. Even when periods are erratic and as infrequent as every 3–6 months, women can still get pregnant and should still use birth control if they wish to avoid pregnancy. As Dr. Sandra Van Leuven at University of Utah Health’s University Hospital says, “If you haven’t gone a full year without a period, you can still get pregnant.”

The number of children that a woman has had are no indication of when or how severe perimenopause will be. Each woman is born with a set amount of eggs. When that supply of eggs begins to die off, perimenopause sets in.

Doctors often ask women about their family history when discussing perimenopause, since the experiences of a woman’s mother or sisters can help determine both the severity of perimenopausal symptoms and when a woman will reach menopause. Of course, this is an estimate and not a guarantee.  

Many women seek treatment with perimenopause in order to help reduce the severity of the symptoms. Common treatments include birth control pills, anti-depressants, progesterone IUDs, and hormone therapy, along with over-the-counter options like herbal supplements and sleep aids. However, all of these treatment options come with possible complications. Antidepressants can affect libido and sexual function. Hormones can increase the risk of blood clots and breast cancer, along with elevating blood pressure and possibly causing liver or gallbladder disease.

This is not to say that women should avoid treatments if they need them. As Dr. Van Leuven puts it, “Not everyone suffers during perimenopause, and there is no required treatment. The goal is to tailor treatment to help women feel their best with minimal side effects.”

Perimenopause affects the lives of all women one way or another and can cause discomfort and anxiety. Understanding what is happening with your body and knowing that it is a normal transition is key to managing and coping with this significant life change. 

gynecology menopause perimenopause

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