Perimenopause
article syndicated from NWHIC

• What is perimenopause?

• How long does perimenopause last?

• I've been depressed in the past. Will this affect when I start going through perimenopause?

• What should I expect as I go through perimenopause?

• I don't understand why I get hot flashes. Could you tell me what's going on with my body?

• I am feeling so emotional lately. Is this from the changes in my hormones?

• What can I do to prevent or relieve symptoms of perimenopause?

• I'm going through perimenopause right now. My period is very heavy, and I'm bleeding after sex. Is this normal?

• Can I get pregnant while in perimenopause?

What is perimenopause?

It is the time leading up to menopause (when you have not had your period for twelve months). During perimenopause, your body starts making less of certain hormones (estrogen and progesterone), and you begin to lose the ability to become pregnant.

How long does perimenopause last?

It varies. Women normally go through menopause between ages 45 and 55. Many women experience menopause around age 51. However, perimenopause can start as early as age 35. It can last just a few months or a few years. There is no way to tell in advance how long it will last OR how long it will take you to go through it.

I've been depressed in the past. Will this affect when I start going through perimenopause?

It could. Researchers are studying how depression in a woman's life affects the time she starts perimenopause. If you start perimenopause early, researchers don't know if you reach menopause faster than other women or if you're just in perimenopause longer.

What should I expect as I go through perimenopause?

Some women have symptoms during this time that can be difficult. These symptoms include:

• changes in your menstrual cycle (longer or shorter periods, heavier or lighter periods, or missed periods)

• hot flashes (sudden rush of heat from your chest to your head)

• night sweats (hot flashes that happen while you sleep)

• vaginal dryness

• sleep problems

• mood changes (mood swings, depression, irritability)

• pain during sex

• more urinary infections

• urinary incontinence

• less interest in sex

• increase in body fat around your waist

• problems with concentration and memory

I don't understand why I get hot flashes. Could you tell me what's going on with my body?

We don't know exactly what causes hot flashes. It could be a drop in estrogen or change in another hormone. This affects the part of your brain that regulates your body temperature. During a hot flash, you feel a sudden rush of heat move from your chest to your head. Your skin may turn red, and you may sweat. Hot flashes are sometimes brought on by things like hot weather, eating hot or spicy foods, or drinking alcohol or caffeine. Try to avoid these things if you find they trigger the hot flashes.

I am feeling so emotional lately. Is this from the changes in my hormones?

Your mood changes could be caused by a lot of factors. Some researchers believe that the decrease in estrogen triggers changes in your brain causing depression. Others think that if you're depressed, irritable, and anxious, it's influenced by other symptoms you're having, such as sleep problems, hot flashes, night sweats, and fatigue-not hormonal changes. Or, it could be a combination of hormone changes and symptoms. Other things that could cause depression and/or anxiety include:

• having depression during your lifetime

• feeling negative about menopause and getting older

• increased stress

• having severe menopause symptoms

• smoking

• not being physically active

• not being happy in your relationship or not being in a relationship

• not having a job

• not having enough money

• low self-esteem (how you feel about yourself)

• not having the social support you need

• regretful that you can't have children anymore

What can I do to prevent or relieve symptoms of perimenopause?

• Keep a journal for a few months and write down your symptoms, like hot flashes, night sweats, and mood changes. That can help you figure out the changes you're going through.

• Record your menstrual cycle, noting whether you have a heavy, normal, or light period.

• Find a physical activity that you'll enjoy doing.

• If you smoke, try to quit.

• Keep your body mass index (BMI) at a normal level. Figure out your BMI by going to www.nhlbisupport.com/bmi/bmicalc.htm.

• Talk to your friends who are in perimenopause or menopause. Most likely, they're going through the same things you are!

• Do something new - volunteer or take a class.

• Use a vaginal lubricant for dryness and pain during sex.

• Dress in layers.

• Try to figure out if certain triggers cause hot flashes, like spicy foods or being outside in the heat. Avoid these things.

• Talk with your health care provider (HCP) if you feel depressed or have any other questions about how to relieve your symptoms.

I'm going through perimenopause right now. My period is very heavy, and I'm bleeding after sex. Is this normal?

Irregular periods are common and normal during perimenopause, but not all changes in bleeding are from perimenopause or menopause. Other things can cause abnormal bleeding. Talk to your HCP if:

• the bleeding is very heavy or comes with clots

• the bleeding lasts longer than 7 days

• you have spotting or bleeding between periods

• you're bleeding from the vagina after sex

Can I get pregnant while in perimenopause?

Yes. If you're still having periods, you can get pregnant. Talk to your HCP about your options for birth control. Keep in mind that methods of birth control, like birth control pills, shots, implants, or diaphragms will not protect you from STDs or HIV. If you use one of these methods, be sure to also use a latex condom or dental dam (used for oral sex) correctly every time you have sexual contact. Be aware that condoms don't provide complete protection against STDs and HIV-the only sure protection is abstinence (not having sex of any kind). But appropriate and consistent use of latex condoms and other barrier methods can help protect you from STDs.