Not Just Menopause – There’s Perimenopause, too

By Dr. Denise Morin

If you’re a woman, you’re probably familiar with menopause – but did you know there is also a period of time called “perimenopause?” If you’re in your 40s, you may have begun experiencing the symptoms of perimenopause without even knowing the term exists.  What exactly is the difference between perimenopause and menopause?

Perimenopause is the transitional phase that includes physical changes in the years before your final menstrual period. It can start as early as your late 30s or as late as your early 50s and may last for four to eight years. It begins with changes in the length of time between periods and ends one year after your final menstrual period.

Menopause is defined as the final menstrual period and is usually confirmed when a woman has missed her period for 12 consecutive months. Menopause marks the permanent end of fertility and occurs, on average, at age 51.

Common Symptoms of Perimenopause
Of course, not every woman is the same, but many report similar symptoms.

• Hot flashes - Hot flashes are the most common discomfort.  They involve a sudden wave of heat or warmth often accompanied by sweating, reddening of the skin, and rapid heartbeat. Hot flashes usually last 1 to 5 minutes and are frequently followed by a cold chill. Relieve the symptoms of hot flashes by removing the outer layer of your clothing when you feel warm, sitting by an open window or fan, sipping a cold drink, avoiding spicy food and caffeinated beverages, quitting smoking  or even meditating.

• Mood Changes - Hormone fluctuations in perimenopause create a feeling of being out of control. Relaxation and stress-reduction techniques, including deep-breathing exercises and massage, maintaining a healthy lifestyle, and self-nurturing activities may all be helpful. Discussing mood issues with your healthcare provider can help you identify the cause, assess you for depression, and decide on the most appropriate treatment plan.

• Urinary Incontinence - Urinary incontinence is an unintentional urine leakage caused by some kind of physical activity or movement, such as laughing, coughing, sneezing, exercising, or heavy lifting. You can treat incontinence with pelvic floor exercises (also known as Kegel exercises), by managing your fluid intake, losing weight or with prescription medication that will relax the bladder.

• Night Sweats - To get relief from night sweats (hot flashes that occur during sleep),dress in light nightclothes, use layered bedding that can easily be removed during the night, cool down with an electric fan, keep a glass of cool water by your bedside that you can sip throughout the night, or keep a frozen cold pack under your pillow.

• Sexual Discomfort - Menopause contributes to sexual function changes through decreases in ovarian hormone production and may lead to vaginal dryness and a decline in sexual function. To counteract these changes, try vaginal lubricants or moisturizers, available without a prescription. These products decrease friction and ease intercourse. Another option is regular sexual stimulation, which promotes blood flow to the genital area.

• Trouble Falling Asleep - Insomnia can cause daytime fatigue, irritability, poor memory and other health issues. It’s important to establish a regular sleep schedule and sleep routine by waking up and going to bed at consistent times, even on weekends; sticking to a relaxing routine before going to sleep; drinking a cup of chamomile tea or a glass of milk; and avoiding caffeine and alcohol late in the day.

Remember that menopause is a natural part of growing older and not a disease that requires treatment. In general it does not require medical intervention; however, treatment of severe symptoms is possible. Learning about the changes in your body leading up to menopause can help you stay as healthy as possible during this phase of your life. Talk to your doctor if you have any questions about whether any of the symptoms discussed above is related to menopause or some other medical condition.

About Dr. Denise Morin

Dr. Denise Morin is a board-certified obstetrician and gynecologist and is a fellow of The American College of Obstetrics and Gynecology. She practices at Harvard Vanguard Medical Associates in Quincy, MA and is affiliated with Beth Israel Deaconess Medical Center, Brigham and Women's Hospital, and Faulkner Hospital. She received her medical degree from Boston University School of Medicine and completed her Obstetrics and Gynecology residency at Beth Israel Deaconess Medical Center in Boston, MA. Dr. Morin enjoys caring for women of all ages. Her professional interests include prenatal care and preconception counseling, abnormal pap smear management, abnormal uterine bleeding, and contraception. When she is not at work, she enjoys spending time with her husband and two children, cheering on Boston sports teams, and traveling.