Perimenopause and Menopause

We are all aware of the typical phases of a woman’s life: childhood, puberty, childbearing, motherhood, menopause, old age, and death. These phases may be difficult or uncomfortable to endure but are regular steps in a woman’s life. The first several of these changes, from puberty to motherhood, are often regarded positively and with excitement. But once these phases have passed, many women become frightened and depressed over what comes next. Menopause, the cessation of a woman’s menstrual cycle, means that she no longer has the ability to have children. Although disappointing for many, menopause should not be regarded as an end but rather as a continuation of the natural cycle of life.  

Menopause itself involves phases. Perimenopause is the transition into menopause, and it occurs when the ovaries gradually begin to produce less estrogen. This phase begins anywhere from 10 years to several months before menopause is fully reached. Marked by irregular periods, perimenopause usually occurs between age 40 and 50. This phase ends when a woman has had no period for 12 months. At this time, she has reached menopause.

The side effects of perimenopause are similar to those associated with menopause: fatigue, hot flashes, breast tenderness, worsening of premenstrual syndrome, vaginal dryness, discomfort during sex, decreased libido, frequent urination, difficulty sleeping, and mood swings. To relieve some of these symptoms, a woman may take low-dose birth control pills as hormone therapy. The hormones in these pills help to stabilize the varying levels of hormones within the body. Taking steps to improve overall health and wellness by exercising, eating nutritious foods, avoiding smoking and alcohol, taking supplements, reducing stress, and resting may also alleviate these symptoms.

Although perimenopause means a decline in a woman’s fertility, this phase does not make pregnancy impossible. Infertility is only reached at menopause, when a woman’s ovaries stop producing eggs. To avoid pregnancy, a woman should continue using some form of birth control until her period has stopped for one year. Pregnancy during perimenopause is difficult, however. Perimenopausal women who wish to get pregnant may choose to look into fertility treatments and techniques to counteract the decline in estrogen.      

Changes in a woman’s reproductive system and hormone levels cause perimenopause and menopause. As a woman gets older, her egg supply decreases and the eggs that do remain grow older, and ovulation becomes less frequent. As she approaches her 40s (or earlier for some), she will begin to notice an irregularity in her period. During this time, a woman’s body produces less estrogen and progesterone until the levels of these hormones drop so low that the menstrual cycle stops altogether. It is important to remember that the term “menopause” applies to the point in a woman’s life at which she hasn’t had a period in a year. It marks the end of her childbearing years. By the time a woman has reached 50, she has most likely completed this transition.

Treatment for menopause is not necessary unless there are specific symptoms that are particularly bothersome. As with perimenopause, menopausal symptoms can be addressed by lifestyle modifications. Eating a nutritious diet, exercising, maintaining a healthy weight, and avoiding caffeine, nicotine, alcohol, and stress are all effective in easing symptoms. Other methods such as breathing exercises, herbal remedies, and yoga have helped many women deal with their discomfort.