Book an Appointment
+91-7899912611
What is Perimenopause?
Menstrual Cycle, Missed & Irregular Periods
29 January 2018 Visits: 185088
 4.82 Vote(s) Share Tweet

What is Perimenopause?

What is Perimenopause?
Dr. Sheetal Pandey
Written by

Dr. Sheetal Pandey

Perimenopause or menopause transition is a condition when a female body produces less amount of hormones namely estrogen and progesterone. During perimenopause, the function of ovaries slows down and finally diminishes to menopause.It usually starts in a woman in her 40s and can last for 4-10 years until menopause.

Perimenopause is a condition when a female body makes fewer hormones, which are responsible for controlling the menstrual cycle i.e. estrogen and progesterone. There are many reasons, which play a key role, and on the basis of it, your doctor will recommend hormone replacement therapy for estrogen or progesterone. And once you don't have periods for a year then it is possible that you have hit the menopause and so cannot get pregnant anymore.

What is a menopausal transition?

Perimenopauseliterally means around menopause. It implies the time during which female body starts making a natural transition to menopause and thus marking the end of female's reproductive years. It is also known as menopausal transition. The perimenopause period gets over when you don't have a menstrual cycle for a definite period of 12 months and post that you reach menopause.

When does perimenopause start?

It starts at different ages and one can notice the progression signs like irregular periods. Some notice it in their 40s while some women will notice the changes in early-mid 30s. Female hormone level i.e. estrogen in the body rises and falls unevenly during the period of perimenopause. The menstrual cycle can also lengthen or shorten and you also might start having periods where ovaries don't release the egg.

When does perimenopause start
You might also experience signs of menopause like hot flashes, vaginal dryness and sleeping troubles. There are treatments available for such symptoms. To check your symptoms in more detail please read our article on healthy periods.

What are the symptoms of Perimenopause?

During the menopausal transition, you will notice some subtle and unsubtle changes in the body like:

1- Irregular Cycles: As there is an unpredictable ovulation, the duration between periods might get longer and shorter, flow either gets heavy or light or there are chances of skipping some periods. You might be in your early perimenopause if you see a consistent change of 7 days or more in the average length of periods. The chances of late perimenopause are defined when you have a gap of 60 days or more between the cycles.

2- Hot flashes: This is a common sign of perimenopause. The frequency, intensity and length can vary. Some women may experience slightly warm while others can drench in sweat.

3- Sleeping problems: Sleeping issue arises due to changes in hormones including symptoms like hot flashes or night sweats.

4- Mood changes: Irritation, mood swings or increased risk of depression can happen during perimenopause. The reason behind this can be sleep disruption or hot flashes.

5- Vaginal dryness: Vaginal tissues might start losing the elasticity and lubrication when estrogen levels begin to diminish. It can further cause itching, pain and soreness while intercourse. Low estrogen levels can also leave you vulnerable to urinary or vaginal infections. Vaginal dryness
6- Decrease in fertility: The ability to conceive decreases, once ovulation becomes irregular.

7- Changes in sexual function: Sexual arousal as well as desire to have sex might change during the perimenopause.

8- Reduction in bone density: You may start losing bone density quickly due to declining estrogen levels. It increases the risk of osteoporosis, which is a disease leading to fragile bones.

Changing cholesterol levels: As estrogen levels start diminishing, it may cause unfavorable changes in blood cholesterol levels contributing to the risk of heart disease.

In case you are missing periods to frequently then does not always mean that you are are heading to menopause state. There may be other reasons to such irregularities. Please explore them with our article on causes of missed periods

What are the causes of Perimenopause?

Due to menopausal transition, the female body's estrogen and progesterone production rises and falls. Most of the changes are experienced during menopause because of diminishing estrogen.

How long does Perimenopause last?

The average duration of perimenopause is about 4 years but in some women, this might last only a few months or can continue for 10 years. It technically ends when the woman has gone without periods for 12 months.

Do Perimenopausal Symptoms Need Consideration?

One of the common and normal indications of perimenopause is irregular periods. But there are other reasons also which can cause changes in the menstrual bleeding. You must visit a doctor if you notice any of the following situations:

1- If your periods are very heavy or have blood clots.

2- Your period lasts longer than usual.

3- Spotting between menstrual cycles.

4- Spotting after intercourse.

5- Periods taking place close together.

Risk factors involved in Perimenopause

Though menopause is a normal phase but it might occur earlier in some females than others and there are certain factors which conclude that you may start perimenopause at an earlier age. Risks are:

1- Women who smoke may see the onset of menopause one or two years earlier than women who don't smoke.

2- Women who have a family history of early menopause may also experience early menopause.

3- One of the reasons that contribute to early menopause is cancer treatment with chemotherapy or pelvic radiation.

4- Uterus may be removed through hysterectomy but not the ovaries. This would not really mean menopause but ovaries would still continue producing estrogen.But the woman won't have their menstrual cycles. Such surgery can also cause menopause to occur early.

How to diagnose Perimenopause?

Perimenopause diagnosis is very much based on the woman’s age as well as symptoms. A blood test will help in determining the hormone levels. Doctor will advise to take several blood tests at different times for comparison due to hormone levels fluctuations caused due to perimenopause.Please note that other diseases can also mimic hormone levels changes as in case of perimenopause.

Chances of conception during perimenopausal

Yes, there are chances of conceiving. The woman can still get pregnant even though fertility declines during perimenopause stage. While for some women, it gets difficult to achieve pregnancy once they are in their late 30s to early 40s because of the drop in fertility. But if you don’t want to conceive then do use some form of birth control until the time you reach menopause.

What are the treatments available for Perimenopause?

For treating perimenopausal symptoms, drug therapy is used.

1- Hormone Therapy: The most effective treatment for relieving premenopausal and menopausal night sweats and hot flashes is systemic estrogen therapy. It comes in pill, skin patch, cream and gel form. It also prevents bone loss.

2- Antidepressants: For reducing menopausal hot flashes there are several antidepressants related to SSRIs class of drugs. These antidepressants are useful for women who cannot take estrogen for health reasons or women who require antidepressant for mood disorders.

3- Vaginal estrogen: Estrogen can be used directly to the vagina by using ring, cream or tablet for relieving from vaginal dryness. A small amount of estrogen is released in this treatment and is absorbed by the vaginal tissue.

4- Gabapentin: It helps in reducing the hot flashes and is used for treating the seizures. This is useful those women who cannot use estrogen therapy due to migraines and health troubles.

Stay positive mentally and physically once you enter this new phase of life. Perimenopause should not be taken as a negative phase of life. Take this stage as a time to consider what changes we can make to look ourselves better. So, the sooner you accept you are perimenopausal, the better it will be.

If you are experiencing the symptoms of perimenopause before your 40s than infertility drugs may be the reason. Understand how infertility drugs cause premature menopause. You should also know that if you have irregular cycles, then you may face trouble in conceiving.

Dr. Sheetal Pandey

About The Author

Gynecologic Surgeon, Laparoscopic Surgeon

Dr. Sheetal Pandey

Mumbai

Dr. Sheetal Pandey Tejwani is an Infertility Specialist, Gynecologic Surgeon and Obstetrician, located in Mumbai and having an experience of almost a decade. Her alma mater is B J MEDICAL COLLEGE in Pune from where she completed her MBBS and MS in Obstetrics and Gynaecology in 2007 and 2009, respectively. In the following year, she pursued her DNB in Obstetrics and Gynecology. She received her Post Doctoral Fellowship in Reproductive Medicine from Krishna IVF Vizag and Nadkarni IVF Centre, Surat in 2013. She is the member of 3 different associations i.e. Indian Society of Assisted Reproduction (ISAR), Indian Medical Association (IMA), and Association of Medical Consultants. Her area of expertise includes Tubectomy/Tubal Ligation, Hysterectomy (Abdominal/Vaginal), Intrauterine Insemination (IUI), Caesarean Section and In-Vitro Fertilization (IVF). She is a consultant in Veda Fertility And Urology Care, Mira Road and is a visiting consultant in Wockhardt Hospital, Mira Road, Mumbai. You can get the contact details of Dr. Sheetal Pandey Tejwani at elawoman.com

SOURCES AND REFERENCES:

  1. Branswell, Helen (15 December 2008) Success rate climbs for in vitro fertilization. The Canadian Press.
  2. Chatterjee, Paramita "IVF: Fertile Ground" BW Businessworld. Retrieved 8 July 2017.
  3. Goldstein, Jacob (19 August 2008) California Doctors Can’t Refuse Care to Gays on Religious Grounds. Wall Street Journal.
  4. IVF costs to NHS 'must be capped', says fertility expert.BBC News. 29 October 2015. Retrieved 30 October 2015.
  5. "IVF Treatment Step Four: Final Oocyte" Infertility.about.com. Retrieved 22 May 2012.
  6. Natural cycle IVF Archived 12 May 2012 at the Wayback Machine. at the Human Fertilisation and Embryology Authority homepage.
  7. "NHS access to IVF being cut in England"BBC News. 7 August 2017. Retrieved 5 September 2017.

2 Comments

user_img
Rashmi
June 30, 2018, 5:48 p.m.
 5.0
Helpful blog
user_img
April 12, 2018, 9:54 p.m.
 4.5
I used to have irregular periods with 45 - 50 days cycle but this time I had already crossed 2 months but still no signs of periods. What may be the reason? Shall I consult a physician.
Rating :

Disclaimer

The information displayed on this webpage covers general information on several medical conditions, fertility treatments, IVF ICSI, surrogacy procedure, home remedies, and their respective treatments. The exclusive purpose of the displayed information is for the sake of general understanding and it has been collected from open sources which heavily rely on research and laboratory tests. However, the information shared here should not be considered as a medical advice or an alternative to consultation with a registered medical practitioner or licensed healthcare professional.

It is not advised to self-diagnose or treat any medical condition or disease following the information given in this article. We insist you to consult a registered practitioner and never try to replace their advice or discontinue treatment in between by relying solely on the information obtained. External links to different websites as well as videos given on the website serve the purpose of sharing knowledge only. Ela being an Independent Medical Information platform is neither responsible nor guarantees the authenticity, reliability, and accuracy of these videos and websites in any way. We do not intend the information displayed here to be used for a medical emergency, if you seek medical attention for yourself (or any other person with whom you want to share the information with), we advise you to directly get in touch with the hospital or the doctor.

You May Also Like

Menstrual Cycle
Menstruation and Menstrual Cycle - All You Want to Know

Learn all the useful information on menstruation and menstrual cycle including signs of menstruation, problems associated with menstruation in this article.
Read More

Dr. Surveen Ghumman
 4.51 Vote(s)
Menstrual Cycle
Crocin Advance Tablet - Uses, Benefits, Composition and Side-Effects

Crocin advance tablet is a mild analgesic and antipyretic drug which is used to get relief from a number of health conditions like fever and mild to moderate aches and pains like headache, arthritis, joint pain, muscle pain, tooth pain as well as back pain. It is composed of Paracetamol as an active salt ingredient and can have side effects such as abdominal pain, nausea, vomiting, allergy, diarrhea etc.
Read More

Dr. R K Sharma
 4.54 Vote(s)
Menstrual Cycle
Dolo 650 MG Tablet - Uses, Side-effects, Composition and Dosage

Dolo tablets are mild painkillers used to treat fever, arthritis, stomach pain, tooth pain and any other muscle related pain. It is composed of Paracetamol. Adults can take dolo 650 mg thrice a day while the kids can have 0.25 to 0.50 tablets twice a day or as directed by the doctor. It can also cause certain side effects such as allergy, acne or bloating.
Read More

Dr. R K Sharma
 4.82 Vote(s)
Menstrual Cycle
Meftal Spas Tablet - Usage, Benefits, Side-Effects And Precautions

Meftal Spas is an antispasmodic NSAID drug, a drug that is beneficial in getting relief from stomach pain, menstrual pain, fever, heavy menstrual bleeding and headache. It may have certain side effects such as allergy, skin rash, acidity, diarrhea and vomiting. Pregnant women, breastfeeding mother and asthma patients should avoid taking Meftal Spas.
Read More

Dr. Sailaja Vuppu
 4.82 Vote(s)
Menstrual Cycle
Tips To Make Your Period Come Faster

Get handy tips on how to make your periods come early when you are planning for a big event in your life.
Read More

Dr. Sheetal Pandey
 4.85 Vote(s)
Menstrual Cycle
Signs Of A Healthy And Normal Menstrual Cycle

Help yourself finding out if you have any of these signs of a normal menstrual cycle such as a regular cycle, presence of cervical mucus, absence of PMS etc. through this article.
Read More

Dr. Chitwan Dubey
 4.52 Vote(s)
Menstrual Cycle
All about Menstrual Cycle, Menstruation Cycle, Period Cycle

A regular period cycle or menstrual cycle is a sign of good health. Keep a track of your menstruation cycle to know when you can get pregnant.
Read More

Dr. Neha Gupta
 4.82 Vote(s)
Menstrual Cycle
PCOD Problem and PCOD Remedies

Polycystic Ovary Disease PCOD or Polycystic Ovary Syndrome PCOS is a complex disease affecting hormones, reproductive system as well as metabolic level in women.
Read More

Dr. Srilatha Gorthi
 4.83 Vote(s)
Menstrual Cycle
Five signs of Healthy Periods!

Though menstrual cramps are common in periods, severe pain is not a sign of healthy periods. Here are a few more signs that your menstrual cycle is healthy.
Read More

Dr. Sailaja Vuppu
 4.84 Vote(s)
Menstrual Cycle
Natural Remedies for Polycystic Ovary Syndrome PCOS

PCOSis the most complex female health issue that may disturb menstrual cycle and might cause irregular periods or period problems and may also obstruct period cycle
Read More

Dr. Weena Krutsawad
 4.67 Vote(s)
Menstrual Cycle
Best Home Remedies for Irregular Periods

Simple home remedies for irregular periods, irregular menstrual cycle and period problems that many women face during their menstrual cycle or period cycle
Read More

Dr. Weena Krutsawad
 4.83 Vote(s)
Menstrual Cycle
Causes And Treatment of Irregular Periods

Menstrual cycle or period cycle may vary from woman to woman. Here are the cause of irregular periods or period problems and best treatment for irregular periods
Read More

Dr. Grace Jaafar
 4.75 Vote(s)

More From Author

Baby Bump
Zika Virus A Threat to Pregnant Women

Centre for Disease Control and Prevention(CDC) has been for so long...
Read More

Dr. Sheetal Pandey
 4.52 Vote(s)
Baby Bump
7 Weeks Pregnant, Time to Reveal the Secret

If you are 7 weeks pregnant and you have still kept it a secret, th...
Read More

Dr. Sheetal Pandey
 4.82 Vote(s)
Fertility Boosters
Physical Factors To Consider Before Donating Sperm

Donating sperm can enrich many lives and fulfill their dreams of ha...
Read More

Dr. Sheetal Pandey
 4.83 Vote(s)
CATEGORIES
Still Have Questions ? Call us at +91 7899912611