The medical term for the 2- to 10-year period leading up to menopause is premenopause, or perimenopause. During this time, symptoms arise as the ovaries gradually stop producing estrogen and progesterone. While perimenopause can begin in a womans 30s, it typically occurs between the ages of 45 and 55. According to the American Congress of Obstetricians and Gynecologists, (ACOG) the average age of menopause is 51.
Change in Periods
The first sign of premenopause is often a change in periods. Menstrual changes are different for each woman. Periods may become longer or shorter, heavier or lighter, more or less frequent. These are all normal changes, but if you experience heavy bleeding, spotting, or periods that last longer than a week be sure to consult your doctor.
Hot Flashes
Hot flashes, a sudden rush of heat in the upper body, can begin at any time and last until a few years after menopause. Night sweats (hot flashes occurring at night) can be severe enough to interfere with sleep. The face and body may flush and heavy sweating and cold shivering might be experienced. ACOG states that as many as 75 percent of women in the United States experience hot flashes.
Trouble Sleeping
Hot flashes can disturb sleep, but they are not the only sleep problem premenopausal women experience. Some women might have a hard time falling or staying asleep. Some women begin experiencing less time in the phase of sleep called REM (rapid eye movement). REM is a normal and necessary part of the sleep cycle, and is necessary to feel rested. Therefore, some women in perimenopause might experience fatigue.
Emotional Changes
Changes in hormone levels are associated with feeling nervous, irritable and depressed. Since midlife is already a time of increased stress due to life changes, it can be difficult to pinpoint the cause of these erratic feelings. Additionally, some women might struggle with sad emotions related to the loss of their child-bearing years. If emotional issues reach the point where they interfere with the ability to fulfill daily activities and enjoy life, consider talking to a friend, counselor or your doctor.
Cognitive Changes
Even though many women report problems with memory, attention and fuzzy-thinking, researchers have not conclusively shown a relationship between declining hormones and cognitive changes. In a study published in the September 2009 issue of Clinical Obstetrics and Gynecology, Victor Henderson, MD reported that, even though estrogen is known to affect functions in the brain, natural menopause is not associated with substantial cognitive changes.
Hair Changes
A cosmetically disturbing symptom during perimenopause is that hair on the head might start to thin, while facial hair increases. Again, this is a hormonally based change.
Urinary Tract and Vaginal Changes
The depletion of estrogen during premenopause causes the walls of the vagina to become thin and dry. This affects sexual intercourse and also increases the risk of bladder infection as the urinary tract can become dry and inflamed. Many women need to urinate more frequently or they might experience stress urinary incontinence, the leaking of urine during exercise, coughing, sneezing or laughing.
Body Changes
It is typical during perimenopause to lose muscle while gaining fat, especially around the waist. The chances of developing osteoporosis increase, as well. Perimenopause is a time to become more diligent about diet and exercise to help prevent these normal, but undesireable body changes. It's also important to be aware that loss of hormones during perimenopause and after menopause can increase your risk of heart disease and breast cancer.
