What is Perimenopause?

Niki Foster

Perimenopause is time in a woman's life surrounding menopause, the end of her menstruation. While this time of life is sometimes referred to as menopause, technically menopause is a specific date, the day after a woman's last menstrual period. The years surrounding this date and the transitions a woman undergoes at this time are more accurately referred to as perimenopause, literally "around menopause."

Women entering perimenopause often experience hot flashes.
Women entering perimenopause often experience hot flashes.

In the Western world, most women experience menopause between the ages of 45 and 55, with an average age of 51. However, it can occur anywhere between the ages of 40 and 60. Some women experience "premature menopause" before the age of 40, but it is rare.

Menopause is a gradual process and for some women may take up to 10 years.
Menopause is a gradual process and for some women may take up to 10 years.

For most women, perimenopause is a similar change to menarche, the onset of the menstrual cycle, though in reverse. As menarche symbolizes the entry into womanhood, perimenopause marks the entry to a new stage of life. The psychological symptoms of each life event are similar.

Perimenopause causes a number of physical symptoms, as the woman's body produces hormones erratically before entirely ceasing production of progesterone, estradiol, and estriol. Estrone is the only female hormone that is still produced in post-menopausal women. There is a great deal of variation in the physical and psychological symptoms that women undergoing perimenopause experience, and the event can take anywhere from a couple years to over ten. During premenopause, the years leading up to menopause, most women have increasingly erratic menstrual periods and frequent missed periods.

Some symptoms associated with perimenopause include fatigue, hot or cold flashes, night sweats, and insomnia. Urogenital atrophy, inflammation due to changes in the female genitalia, is a common symptom of decreased estrogen. The skin all over a woman's body may change during perimenopause, losing elasticity and becoming thinner, and she may experience formication, a sensation of crawling on the skin. The breasts may also atrophy. Osteopenia, a decrease in bone density, and joint pain are other possible symptoms.

Women experiencing perimenopause may also experience psychological symptoms as a result of hormonal fluctuations and the life changes that accompany menopause. These may include irritability, mood swings, memory loss, depression, anxiety, and a decrease is sex drive.

If the symptoms of perimenopause are severely disruptive or uncomfortable, a woman may seek medical treatment. Hormone replacement therapy (HRT) can be effective in alleviating hot flashes and treating osteoporosis. There are many different kinds of HRT, each with its own possible side effects and risks. Antidepressants and blood pressure medicines are also sometimes prescribed to treat hot flashes.

Vaginal lubricants or low-dose estrogen creams can alleviate the symptoms of urogenital atrophy. Perimenopausal women suffering from depression often benefit from counseling. Alternative therapies, particularly acupuncture, are becoming more common to treat the symptoms of perimenopause.

In the Western world, women usually experience menopause between 45 and 55.
In the Western world, women usually experience menopause between 45 and 55.

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