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perimenopause Alternative Names
premenopause
Definition
Perimenopause refers to the time before menopause, that is, before a woman stops menstruating completely.
What is going on in the body?
Oestrogen levels decrease during perimenopause. The levels gradually decline until a woman stops menstruating. Until then, a woman is in perimenopause. Perimenopause is also called premenopause. Egg production by the ovaries is falling, and oestrogen is also diminishing. The production of progesterone also lessens, especially if a woman is no longer ovulating. These hormonal fluctuations vary from woman to woman. Both the amount of hormone produced and the timing of the decline can vary.
What are the signs and symptoms of the condition?
The symptoms vary from woman to woman. Only 30% of women see a doctor about symptoms of perimenopause. The other 70% either don't have severe symptoms, or get used to them.
Some women may have: About 90% of women have changes in menstruation. The amount of bleeding may increase or decrease. Periods may become longer or shorter, and happen more or less often. Some women have severe symptoms. Others have mild or no symptoms. Fertility decreases, but women can still get pregnant. A woman who does not wish to get pregnant needs to use birth control.
About 60% of women have hot flushes. A hot flash usually comes on suddenly. It feels like heat in the upper body or even the whole body. The woman's upper body or face often turns red, or get red blotches. She may sweat and then shiver as her body returns to a normal temperature. Hot flushes can appear at any time, day or night. The hot flash may last only seconds, or may last up to half an hour. Hot flushes are a result of decreasing oestrogen levels. As oestrogen levels decline, the body releases other hormones. These can cause the fluctuations in body temperature.
What are the causes and risks of the condition?
As women get closer to menopause, the risks of osteoporosis, or bone thinning, and heart disease increase. Lower oestrogen levels may be part of the reason that these risks increase.
What can be done to prevent the condition?
There is no prevention for perimenopause. All women will go through either a natural or surgical menopause. Women who, for one reason or another, have surgery that removes their reproductive organs earlier in life may not experience perimenopause.
How is the condition diagnosed?
Diagnosis of perimenopause is usually made by the woman's history and supporting symptoms. A blood test can confirm drops in oestrogen levels.
What are the long-term effects of the condition?
The long-term effects of perimenopause may depend on any treatments. All hormone replacement therapies have side effects and risks of their own.
What are the risks to others?
Perimenopause poses no risks to others.
What are the treatments for the condition?
The most common treatment for perimenopause involves the use of oral contraceptives or hormone replacement therapy. The low-dose pills that are available today regulate menstrual flow and frequency. They also can eliminate or reduce hot flushes, vaginal dryness, and emotional and physical symptoms of premenstrual syndrome.
Dietary changes may also help. Women in perimenopause will benefit from a diet high in calcium, low in fat, and rich in fruits, vegetables, and whole grains. This healthful diet helps prevent Osteoporosis, heart disease, and some cancers. It may also help reduce symptoms of perimenopause.
Exercise helps control weight, improve sleep, and keep bones strong. Exercise also helps with mood swings. Thirty minutes of exercise on most, if not all, days is recommended for everyone.
What are the side effects of the treatments?
Long-term use of hormone replacement therapy may increase the number of women who get breast cancer. If a woman has a family history of breast cancer, menstruated before age 12, or delayed pregnancy, hormone replacement therapy may not be advised. Women who are at higher risk of developing blood clots may also be unable to use hormone replacement therapy. A doctor can assist with decision making by pointing out the risks, risk factors, and benefits of any proposed therapy.
There are also side effects to using hormone replacement therapies. Side effects can include headaches, bloating, and irritability.
What happens after treatment for the condition?
Most symptoms of perimenopause go away after menstruation ceases. osteoporosis and cardiac risk factors continue unless oestrogen is replaced.
How is the condition monitored?
A woman's progression through menopause is monitored in regular gynaecological examinations, which include pelvic examinations and PAP smears. Any new or worsening symptoms should be reported to the doctor.
Author: Terry Mason, MPH
Reviewer: HealthAnswers Australia Medical Review Panel
Editor: Dr David Taylor, Chief Medical Officer HealthAnswers Australia
Last Updated: 1/10/2001
Contributors
Potential conflict of interest information for reviewers available on request |
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