Menopause
The Menopause occurs when your periods have stopped for at least one year. It marks the permanent end of menstruation and fertility, and is a natural biological process, not a medical illness.
Even so, the physical and emotional symptoms of menopause can disrupt your sleep, sap your energy and can in some women trigger feelings of sadness and loss.
Perimenopause marks the interval in which your body begins its transition into menopause. Perimenopause encompasses the years leading up to menopause — anywhere from two to eight years — plus the first year after your final period. It’s a natural part of aging that signals the ending of your reproductive years.
Your estrogen level rises and falls unevenly during perimenopause. Your menstrual cycles may lengthen or shorten, and you begin having menstrual cycles in which you don’t ovulate. It’s only during cycles when you do ovulate that you can become pregnant.
When perimenopause starts and how long it lasts varies. You’ll probably notice signs of impending menopause, such as menstrual irregularity, sometime in your 40s. But some women notice changes as early as their mid-30s.
Perimenopause causes some subtle — and some not-so-subtle — changes in your body. Some things you might experience include:
Menstrual irregularity
As ovulation becomes more erratic, the intervals between periods may be longer or shorter, your flow may be scanty to profuse, and you may skip some periods.
Hot flashes and sleep problems
About 65 to 75 percent of women experience hot flashes during perimenopause. Their intensity, duration and frequency vary. Sleep problems are often due to hot flashes or night sweats, but sometimes sleep becomes erratic even without them.
Mood changes
Some women experience mood swings, irritability or depression during perimenopause, but the cause of these symptoms may be sleep disruption or other menopausal symptoms rather than the hormonal changes of menopause.
Vaginal and bladder problems
When estrogen levels diminish, your vaginal tissues may lose lubrication and elasticity, making intercourse painful. Low estrogen levels may also leave you more vulnerable to urinary or vaginal infections. Loss of tissue tone may contribute to urinary incontinence.
Decreasing fertility
As ovulation becomes irregular, your ability to conceive decreases. However, as long as you’re having periods, pregnancy remains a possibility. If that’s not what you want, use birth control until you’ve had no periods for 12 months.
Changes in sexual function
During perimenopause, sexual arousal and desire may change. But for most women who had satisfactory sexual intimacy before menopause, this will continue through perimenopause and beyond.
Loss of bone
With declining estrogen levels, you start to lose bone more quickly than you replace it, increasing your risk of osteoporosis.
Changing cholesterol levels
Declining estrogen levels may lead to unfavorable changes in your blood cholesterol levels, including an increase in low-density lipoprotein (LDL) cholesterol — the “bad” cholesterol — which contributes to an increased risk of heart disease. At the same time, high-density lipoprotein (HDL) cholesterol — the “good” cholesterol — decreases in many women as they age, which also increases the risk of heart disease.
