Premenopause, Perimenopause, and Menopause

There are actually different stages within menopause that are important to recognize and understand. Menopause itself officially occurs when you stop menstruating for one year. Where as perimenopause the menopause transitional phase, which

Updated: November 8, 2017

Menopause is the end of a woman's menstrual cycle and fertility. When two essential hormones(estrogen and progesterone) needed for a woman's fertility is not produced by the ovaries the periods will be stopped resulting in menopause. This is known as the end of female reproduction. There are actually different stages within menopause that are important to recognize and understand.
Menopause itself officially occurs when you stop menstruating for one year. Where as perimenopause the menopause transitional phase, which means that it happens before menopause. Both of these have differences in terms of symptoms and treatment options.

Premenopause and Perimenopause:

Premenopause is the stage of your life when you have no symptoms of going through perimenopause or menopause. You will still have your periods, whether they are regular or irregular. You are considered to be in your reproductive years. Some hormonal changes may occur but there will be no noticeable changes in your body.
On the other hand, during perimenopause you will start to show symptoms of menopause such as change in period cycle, hot flashes, sleep disturbances, or mood swings. This is the menopause transitional phase and is defined as around menopause.

Timelines for Perimenopause and Menopause:

Before you officially hit menopause, may be 8 to 10 years ahead of menopause, perimenopause occurs. The level of estrogen, which is the main female hormone produced by the ovaries will tend to decrease during this stage. The estrogen levels can also go up and down more sporadically than a normal 28-day cycle, which can cause irregular periods and other symptoms.
Despite the sharp drop in estrogen during the final stages of perimenopause, it is still possible to get pregnant. This phase of menopause can last from few months to four years.
When the ovaries produce no estrogen or so little estrogen that eggs are no longer released, Menopause occurs. This also causes your period to stop.
You may enter menopause earlier than normal if you:

  • have undergone cancer treatments
  • have had a hysterectomy
  • have a family history of early menopause
  • are a smoker

Symptoms of Perimenopause and Menopause:

Hot flashes are the most common symptoms in menopause. There are many other changes you might experience during this transition because of decreasing level of estrogen which includes:

  • mood swings
  • insomnia
  • vaginal dryness
  • frequent urination
  • night sweats
  • depression
  • fatigue
  • dry skin
  • anxiety or irritability

Some of these can occur while you are still at the perimenopause stage.
Symptoms of perimenopause may include:

  • breast tenderness
  • irregular periods
  • periods that are heavier or lighter than normal
  • increase in heartbeat
  • headaches
  • loss of sex drive
  • weight gain
  • hair changes
  • urinary tract infections
  • fertility issues
  • concentration difficulties
  • forgetfulness
  • muscle aches

Consult a doctor if you have noticed:

  • periods that are much longer, or much shorter than normal
  • blood clots during your period
  • spotting after your period
  • bleeding after sex

All of these could be due to hormonal imbalances or fibroids, both of which are treatable. The possibility of cancer should also be ruled out.

Treatments for Perimenopause and Menopause:

Hormone therapy can help treat both perimenopause and menopause. These medications work by normalizing estrogen levels so that sudden hormonal spikes and drops don’t cause uncomfortable symptoms. Some of them may even help reduce the risk of osteoporosis.

HT are available in many forms, including pills, creams, gels and skin patches.
Other menopause medications can be used to treat the root cause of the symptoms. These include:
prescription vaginal creams can alleviate dryness as well as pain from intercourse.
Antidepressants can help with mood swings.
Neurontin, a seizure medication can help treat migraines.
Other methods of symptom relief include:

  • avoid large meals
  • quit smoking
  • avoid alcohol
  • limit caffeine to small quantities
  • Regular exercise can help improve your mood, weight gain issues, and even your hot flashes. 
  • Relaxing activity right before bed, such as gentle yoga or a warm bath can help insomnia.


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