Perimenopause

PERIMENOPAUSE hot flashes

Last Updated February 21st, 2019

Overview

Unlike men, women are fertile and capable of reproducing only during a certain period in their lives. This is the period between menarche and menopause. Most women attain menopause sometime around their 40s or 50s. However, some may begin to notice the signs as early as the third decade of life.

Menopause does not involve an immediate and sudden cessation of the menstrual cycle. Instead, there is a progression of changes that gradually lead up to it. This set of changes in the period leading up to menopause is known as perimenopause. It can be highly distressing and discomfiting. There can be severe complications as well, not the least of which is depression. Perimenopause can last from anywhere between one year to a decade.

 

Definition

PerimenopauseThe term ‘perimenopause’ refers to the period of transition towards menopause in women. Although the symptoms may be painful and disturbing, this is not a disease but a completely normal aspect of aging. Perimenopause is characterized by fluctuations in the levels of hormones such as estrogen, progesterone, follicle stimulating hormone (FSH) and luteinizing hormone (LH).

This causes changes in the length of the menstrual cycle. Other typical symptoms include hot flashes, mood swings, anxiety and vaginal dryness. Naturally, perimenopause is associated with a diminished ability to conceive. However, conception during this time is entirely possible. Officially, a woman is considered to have attained menopause when she has gone twelve consecutive months without a menstrual period. This signals the end of perimenopause.

 

Causes

Human ovaries contain a limited number of ova and a human female is born with all the ova her body will ever produce. During the fertile reproductive years of a woman’s life, a mature ovum is released every month so that it may unite with a sperm and become fertilized. When this does not occur, the uterine lining that was prepared for pregnancy is shed through the vagina. This is the mechanism underlying menstruation in a healthy human female.

This process is governed by rhythmic and finely tuned hormonal changes. As a woman nears menopause, this balance of hormones begins to change. Further, the numbers of ova in the ovaries are depleted and their quality is diminished, leading to an irregularity of menstrual periods. This is a typical feature of perimenopause. The age of onset varies from one individual to another. However, earlier onset is associated with the following risk factors:

  • Smoking.
  • Having a family history of early onset of menopause.
  • Surgical removal of the uterus or ovaries. When the uterus alone is removed and the ovaries remain intact, the latter continues to produce estrogen and the woman will experience natural perimenopause although onset may be sooner than otherwise. This is so even if one ovary is removed. Women who have had both ovaries removed will go into menopause all of a sudden and without experiencing normal perimenopause. They will suffer symptoms associated with perimenopause although onset will be sudden and severe.
  • Undergoing chemotherapy or receiving radiation therapy to the pelvic region can hasten perimenopause.

 

Symptoms

The experience of perimenopause varies widely from one woman to the next. Some suffer severe symptoms while others have a fairly smooth transition into menopause. The length of time is variable as well. While some may continue to experience a few problems even after menopause, symptoms associated with perimenopause are temporary by nature and do not persist in the long term. They do not usually have any lasting adverse impact on one’s general health. The main factor responsible for these symptoms is fluctuation in the levels of the hormones estrogen and progesterone. Typical symptoms include:

  • PERIMENOPAUSE hot flashesIrregular periods. The length of menstrual cycles will typically fluctuate, becoming shorter and longer in an unpredictable fashion. The severity of bleeding may vary significantly. As one nears menopause, the temporal gap between consecutive periods may increase progressively until the woman has gone 12 months without a period, at which time she is deemed to have attained menopause.
  • Declining fertility and increasing difficulty in conception.
  • Hot flashes. This is a sudden feeling of warmth, typically in the face, neck, and chest along with perspiration and elevated heart rate. When it subsides, the patient may experience chills.
  • Heart palpitations.
  • Sore breasts.
  • Mood swings.
  • Nausea.
  • Migraine headaches.
  • Excessive sweating at night.
  • Loss of sleep.
  • Vaginal dryness.
  • Pain during intercourse.
  • Fluctuations in libido.
  • Weight gain.
  • Anxiety.
  • Mood swings.
  • Irritability.
  • Fatigue.
  • Difficulty in concentrating.

 

Clinical Complications

The following complications may arise during perimenopause:

  • Anxiety and depression.
  • Elevated risk of heart disease as a result of changes in cholesterol levels.
  • Increased susceptibility to urinary and reproductive tract infections.
  • Increased risk of developing urinary incontinence.
  • Heightened risk of osteoporosis.
  • Pregnancy during perimenopause is difficult to achieve because of declining fertility. However, it remains a possibility until the woman attains menopause. Pregnancy during the late 30s and 40s is already associated with risks because of declining quality of ova and advancing maternal age. Pregnancy complications such as gestational diabetes, hypertension, placenta previa and ectopic pregnancy are more likely. Further, in such instances, childbirth is more likely to require a Caesarean section.

 

Diagnosis

Most women are aware of the changes associated with menopause and may have sought advice from family or friends. If the symptoms are manageable, they may not seek medical help. However, when symptoms become intense or unbearable or women face difficulties in conceiving, they may approach medical practitioners for treatment and relief. There is no test that can confirm perimenopause. Instead, the physician may have to rule out other possibilities before arriving at a diagnosis.

Although blood tests can help assess hormone levels, these are rarely effective in diagnosing perimenopause unless a series of comparative tests are performed on a number of different occasions.

The irregularity of periods is the most common presenting symptom and, initially, it may be put down to other conditions such as polycystic ovary syndrome (PCOS). The physician will take into account the patient’s age, overall health, lifestyle, medical history and family history. If other conditions such as fibroids or PCOS are suspected, this can be ruled out by means of imaging tests.

 

Management

The following important points should be kept under check during the perimenopause period:

  • Healthy dietary practices should be followed. Include loads of fresh fruits and vegetables, antioxidants, high-fiber foods, and low-fat dairy products.
  • Exercising regularly is essential. Since there might be chances of weight gain; one should try to maintain a healthy BMI.
  • One should completely refrain from smoking as this causes a further dip in estrogen leading to more severe and frequent hot flashes.
  • Eat foods rich in vitamin D – beef liver, fatty fish, cheese, yogurt, and egg yolks.
  • Manage stress and adequate sleep every night.

Facts

  • The risk of osteoporosis increases as women enter the pre-menopausal phase, thus the daily calcium intake should be maintained at 1,200 mg.
  • The average age at which a woman attains menopause is 51; the menstrual cycles can end anytime between 45-55 years.

Facts

  • Stress, spicy foods, and caffeine can trigger episodes of hot flashes in perimenopausal women.
  • Since the menstrual cycles don’t stop completely during perimenopause, women can still get pregnant during this phase.

Facts

  • Due to a decline in estrogen levels, vaginal tissues tend to become drier and thinner which might be linked to decrease in sex drive during this phase.

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Dos and Don'ts

Dos
  • Include healthy doses of vitamin D and calcium in your diet in order to prevent bone degeneration.
  • Include at least weekly 150 minutes of brisk exercise in your routine.
  • Drink healthy amounts of water and fruit juices to ensure that you don’t get dehydrated.
Don'ts
  • Expose yourself to too high temperature or indulge in high caffeine consumption as these can cause hot flashes.
  • Delay in getting medical tests done, ranging from hormonal levels to bone density.
  • Indulge in crash diets (since this phase could cause weight gain too). Instead, have a low-sugar diet and exercise regularly.

 

 

 

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Eating Disorders: Lifestyle choice or a psychological condition? Is eating disorder just a harmless bad habit? Or does it represent grim psychological disorders? Do you want…
Beware of these common foods that cause high bodily inflammation! Maybe its the long list of inflammatory foods in your diet that is making you frequently sick. Find…
Find all the instant ways to get rid of blackheads Blackheads - Not only are they aesthetically unappealing but if left untreated these can cause bacterial overgrowth on…
How to correctly perform nasal irrigation using a Neti Pot? Neti pot has been a part of Ayurveda since centuries. This ancient tool is extremely effective in treating…
Oxalates: How healthy greens can sometimes be bad news for your kidneys Oxalates are compounds present in a majority of healthy foods. However, at times an overconsumption of these could…
SIBO Diet: The important dos and don’ts of this gut-healing diet A SIBO diet is a diet that works by eliminating certain sugars from your diet and adding fibers…
11 unbelievable health benefits of thyme you didn’t know! Thyme is a herb that has been used in alternative medicine.It is a well known seasoning in the…
Coffee Enema: Turn your favorite morning beverage into a powerful colon cleanser The wonders of coffee are not just limited to waking you up every morning. You can now use…
reflexology massage
Top reasons why you should go for a reflexology massage today Reflexology involves the application of pressure to your feet and hands to encourage self-healing. Could this be beneficial…
GGt test
GGT – Gamma-Glutamyl Transferase Test GGT or gammaglutamyl transferase test is a liver function test that is used to detect the extent of…
iron deficiency profile
Iron Deficiency Profile An iron deficiency profile is a battery of blood tests which are performed in order to determine the…
ureteroscopy
Ureteroscopy Ureteroscopy is the diagnostic procedure which is used for the detection of the kidney stones in addition to…
quinoa salad
Quinoa : A prodigious superfood you need to include in your diet today! Quinoa - what is so special about this native South American grain that has taken the world by…
L-theanine attention
L-Theanine: Better sleep, higher focus, and many other benefits Did you know that L-theanine found in green tea can make you sleep better and be focused at…
improve digestion weight loss
Power up your gut: 8 proven steps on how to improve your digestion Did you know you have a colony of bacteria in your gut that help you in digesting food?…
avocado benefits
Avocado: 15 reasons why this fruit should be a staple in your diet Did you know that the word avocado literally means "testicles". Don't get grossed out as this power-packed fruit…
bananas exercise
10 health reasons why you should go “bananas” over bananas! Bananas:The world's most popular fruit comes with a host of unbelievable health benefits. Find out how you can…
ashwagandha brain
Ashwagandha: The best-kept secret of Ayurveda now revealed! Ashwagandha literally means "smell of horse". Don't get bogged down by that one tiny detail because this ayurveduic…
Coconut sugar: What is it and is it healthier than table sugar? In the long list of things that the wonderful coconut gives us, coconut sugar is another remarkable addition.…
The right way to prepare Alfalfa sprouts at home Alfalfa or lusan ghas is not just a nutritious animal fodder. This flavonoid-rich herb has some amazing health…
Pescatarian Diet 101: What are the inherent health advantages of this diet? People opt to become a pescatarian in order to enrich their bodies with the essential health benefits that…
How to scrub away stress and fatigue with an Epsom salt bath? Epsom salt is a popular home remedy for many skin ailments. Though there is a lack of scientific…
thyroid_scan
Thyroid Scan Thyroid scan is a diagnostic procedure that aims to view the thyroid gland and detect any growths or…
vdrl test syphilis
VDRL Test The VDRL test is a blood test that is used to diagnose sexually transmitted or venereal diseases, primarily…
lp-pla2
LP-PLA2 Test The LP-PLA2 test is a test which is carried out to assess the levels of Lipoprotein-Associated Phospholipase A2…
complement c4 test
Anemia Profile Anemia Profile test (Basic) is a blood screening test that measures the levels of important components of the…
shoudler exercises
Keep your shoulders pain-free with these shoulder exercises Shoulder exercises are important in order to prevent chronic back and neck pain. Learn more about how you…
sugar toxic health
Sugar: 7 new shocking truths revealed about the sweet poison Can drinking soda bring you closer to death? Is sugar slowly poisoning you and your family? You would…