Describe Your Last Period Before Menopause

Are There Any Health Risks Associated With Perimenopause

Women’s Wellness: Perimenopause – What the Heck is Happening to My Body?

There are health risks associated with menopause, which happens right after perimenopause.

Estrogen plays an important role in preserving your bones. Osteoporosis is a condition where the insides of your bones become less dense and more fragile. This increases your risk for bone fractures. Your healthcare provider may recommend a multivitamin, calcium supplement, extra vitamin D or more weight-bearing exercises.

People in menopause are also at an increased risk for heart disease and other cardiovascular health conditions.

How Will I Know If I Am Starting The Transition To Menopause

Sometimes it can be hard for you and your doctor to tell whether you are in perimenopause, the transition to menopause:

  • Symptoms: Tell your doctor or nurse about any menopause symptoms, such as hot flashes or trouble sleeping.
  • Irregular periods: Track your periods. Irregular periods may be your first sign of menopause.
  • Hormone levels: Your doctor may test the amount of hormones in your blood if your periods stopped at an early age . Doctors dont usually recommend this test unless there is a medical reason to do so. This is because, for most women, hormone levels go up and down in an unpredictable way during the transition to menopause. So it is difficult to tell for sure whether you have gone through menopause or are getting close to it based on this blood test.

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What Can I Do About Hot Flashes

Hot flashes occur from a decrease in estrogen levels. In response to this, your glands release higher amounts of other hormones that affect the brain’s thermostat, causing your body temperature to fluctuate. Hormone therapy has been shown to relieve some of the discomfort of hot flashes for many women. However, the decision to start using these hormones should be made only after you and your healthcare provider have evaluated your risk versus benefit ratio.

To learn more about women’s health, and specifically hormone therapy, the National Heart, Lung, and Blood Institute of the National Institutes of Health launched the Women’s Health Initiative in 1991. The hormone trial had 2 studies: the estrogen-plus-progestin study of women with a uterus and the estrogen-alone study of women without a uterus. Both studies ended early when the research showed that hormone therapy did not help prevent heart disease and it increased risk for some medical problems. Follow-up studies found an increased risk of heart disease in women who took estrogen-plus-progestin therapy, especially those who started hormone therapy more than 10 years after menopause.

The WHI recommends that women follow the FDA advice on hormone therapy. It states that hormone therapy should not be taken to prevent heart disease.

Practical suggestions for coping with hot flashes include:

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What Even Is Perimenopause

Perimenopause is the time leading up to menopause.

Menopause is defined as when your period has stopped for a full year.

And after that comes postmenopause.

Perimenopause can start as early as your mid-30s or as late as your mid-50s.

While the average length of perimenopause is four years, symptoms can last anywhere between several months to a decade.

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The bottom line? Theres no one way to do this.

For some, perimenopause symptoms get more obvious the closer you are to the end of it.

And for others about 15% of us there are no symptoms at all.

So if youre looking for signs that perimenopause is ending, well, its complicated. Because its just not the same for everyone.

That being said, there are some clues your body might give you.

Heres what you need to know.

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What Questions Should I Ask My Doctor


Discuss your perimenopause symptoms with your healthcare provider. It might help to keep a journal of your menstrual cycles including when they start and stop and the amount of bleeding.

Some questions you should ask are:

  • Are these symptoms of perimenopause?
  • What can I do to relieve my symptoms?
  • How long do you think I will have these symptoms?
  • Would hormone therapy be an option for me?
  • Do I need to start taking medication or vitamins?
  • Are there any tests that should be done?
  • Can I still become pregnant?

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Some Menstrual Symptoms Are Wrongly Attributed To Perimenopause

You also want to get checked by a physician if your periods become heavier during perimenopause rather than getting lighter periods as is most common, Santoro says. Medical conditions including endometriosis or cancer are sometimes confused with perimenopause in midlife women because they can alter your menstrual cycle.

Hot Flash Symptoms May Start In Perimenopause But Continue After Menopause

Women who have moderate to severe hot flashes may experience them beyond the perimenopause stage. In fact, research published in September 2014 in the journal Menopause found that many women continue having hot flashes for nearly a decade after menopause, although the severity of the symptoms begins declining after about two years.

Women who are younger when they start perimenopause typically experience symptoms longer than women who are older, Santoro says.

Hormone therapy is still the best treatment for most perimenopausal symptoms. Other women find relief from making lifestyle changes or trying natural remedies.

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General Recommendations For Ht

Current guidelines support the use of HT for the treatment of severe hot flashes that do not respond to non-hormonal therapies. General recommendations include:

  • HT may be started in women who have recently entered menopause.
  • HT should not be used in women who have started menopause many years ago.
  • Women should not take HT if they have risks for stroke, heart disease, blood clots, and breast cancer.
  • Currently, there is no consensus on how long HT should be used or at what age it should be discontinued. Treatment should be individualized for a woman’s specific health profile.
  • HT should be used only for menopause symptom management, not for chronic disease prevention.

Initiating Therapy

Before starting HT, your doctor should give you a comprehensive physical exam and take your medical history to evaluate your risks for:

While taking HT, you should have regular mammograms and pelvic exams and Pap smears. Current guidelines recommend that if HT is needed, it should be initiated around the time of menopause. Studies indicate that the risk of serious side effects is lower for women who use HT while in their 50s. Women who start HT past the age of 60 appear to have a higher risk for side effects such as heart attack, stroke, blood clots, or breast cancer. HT should be used with care in this age group.

Discontinuing Therapy

Safety Concerns

Women who should not take hormone therapy include those with the following conditions:

Can I Get Pregnant If I Am In Perimenopause

What happens to your periods & whats normal during menopause

Yes, you can still become pregnant. You may be less likely to get pregnant during perimenopause, but it’s still possible. As long as you have a period, you can still get pregnant. If you want to expand your family during this time, speak with your healthcare provider about your health, fertility and possible fertility treatment options.

When your periods are irregular, you may be more likely to get pregnant unexpectedly. If you dont want to expand your family at this age, continue using birth control until your healthcare provider tells you its safe to stop. Continue to practice safe sex to prevent sexually transmitted diseases throughout your life.

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Can Perimenopause Cause Heavy Bleeding

From your early 40s and into your 50s, during perimenopause, you may find that your periods change and become erratic as your ovaries slow down and oestrogen levels start to fluctuate. It can be very common for your cycle to become highly unpredictable and periods to be heavier and longer.

There are a whole range of menstrual issues in perimenopause that are normal but if it impacts your life, consult your doctor for treatment and to exclude iron deficiency, anemias and check there isnt an underlying cause other than menopause.

There are also a number of other conditions of the womb that can cause heavy bleeding including fibroids , a pelvic infection, polyps and, rarely, cancer, so its really important that you see a doctor.

I would advise keeping a diary of whats happening and when, how long the bleeding lasts and how it is affecting you on a daily basis, as that can be useful for your doctor to see, says Dr Armstrong.

What Are The Signs And Symptoms Of Menopause

Estrogen is used by many parts of a womanâs body. As levels of estrogen decrease, you could have various symptoms. Many women experience mild symptoms that can be treated by lifestyle changes such as avoiding caffeine or carrying a portable fan. Some women donât require any treatment at all, but for others, symptoms can be more severe. The severity of symptoms varies greatly around the world and by race and ethnicity.

Here are the most common changes you might notice at midlife. Some may be part of aging rather than directly related to menopause.

Change in your period. This might be what you notice first. Your periods may no longer be regular. They may be shorter or last longer. You might bleed more or less than usual. These are all normal changes, but to make sure there isnât a problem, see your doctor if:

  • Your periods happen very close together.
  • You have heavy bleeding.
  • Your periods last more than a week.
  • Your periods resume after no bleeding for more than a year.

Bladder control. A loss of bladder control is called incontinence. You may have a sudden urge to urinate, or urine may leak during exercise, sneezing, or laughing. The first step in treating incontinence is to see a doctor. Bladder infections also can occur in midlife.

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How Long Are Normal Perimenopause Periods

Ordinarily, your menstrual cycle occurs every 21 to 35 days and lasts from 2 to 7 days. However, perimenopause periods can last much longer. Some months, the ovaries might not produce sufficient levels of estrogen and progesterone, preventing menstruation altogether. Other months, the imbalance might cause the uterine lining to become overly thick, which means it will take longer to be shed by your body to shed.

Excessive bleeding and long periods are fairly common during perimenopause. Many women experience an increased flow and extended perimenopause periods before entering menopause.

If youve had periods that are several days longer or more frequent or heavier than usual, its a good idea to see your doctor.

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Menstrual cycle

As aforementioned, symptoms of a period can begin up to two weeks before menses and last until a day or two into menstruation. On the other hand, perimenopause symptoms start to occur in a woman’s mid-40s or – in some cases – even late 30s and can last up to a decade before the menopause date. On average, a woman reaches menopause at age 51. Menopause occurs due to a decrease in the function of the ovaries and usually signifies the end of a womans reproductive years. The occurrence of menopause is defined by menstrual periods having stopped for at least one year, which reflects the ovaries no longer releasing an egg each month ( ovulation. It is a normal process that leads to a.

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Hi, I’m 48, had a 35 day regular period and gradually over the last 8 years they have come closer to 21 days regular, for the last 2 years, with the odd one at 14 days. They also went from a 5 to 7 day flow to 1 heavier day and 3 light. I have been lucky with not having many period symptoms during my life, a little breast tenderness, mild. Jun 01, 2011 · The transition period leading up to menopause is called perimenopause . Changes in hormone patterns during this stage can trigger a variety of symptoms. Some women are bothered by only a few….

When Perimenopause Starts

Every womans body operates under different hormonal, chemical, and biological pressures. Because of these variables, its hard to say exactly when perimenopause begins. Some women start to notice signs as early as their 30s, while others wont notice well into their 40s.

Certain risk behaviors, like smoking, can trigger the process earlier. Other factors, such as your family history and medical history, can affect exactly when perimenopause begins.

There isnt a set length of time perimenopause lasts, either. The average amount of time women spend in perimenopause is four years, but some women report being in perimenopause for as long as ten years. The drop in estrogen levels accelerates during the last couple of years of your perimenopausal cycle. Eventually, after 12 months with no period, perimenopause ends, and menopause officially begins.

The only guarantee with perimenopause is that it will happen , so it’s essential to be aware of the symptoms associated with it.

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Calcium And Vitamin D

A combination of calcium and vitamin D can reduce the risk of osteoporosis, the bone loss associated with menopause. The best sources are from calcium-rich and vitamin D-fortified foods.

Doctors are currently reconsidering the use of calcium and vitamin D supplements. The U.S. Preventive Services Task Force advises that healthy postmenopausal women don’t need to take these supplements. According to the USPSTF, taking daily low-dose amounts of vitamin D supplements , with or without calcium supplements , does not prevent fractures. For higher doses, the USPSTF says there is not enough evidence to make a recommendation. In addition to possible lack of benefit, these supplements are associated with certain risks, like kidney stones.

However, calcium and vitamin D are important nutrients. Supplements may be appropriate for certain people including those who do not get enough vitamin D through sunlight exposure and those who do not consume enough calcium in their diet. They are also helpful for people who have been diagnosed with osteoporosis. Talk with your doctor about whether or not you should take supplements.

The National Osteoporosis Foundation recommends:


Vitamin D

Vitamin D is necessary for the absorption of calcium in the stomach and gastrointestinal tract and is the essential companion to calcium in maintaining strong bones.

Can Perimenopause Be Treated

What is the menopause?

There isnt any treatment to stop perimenopause. Perimenopause is a natural part of life. The cure for perimenopause occurs when your periods stop and you enter menopause.

But your healthcare provider may recommend over-the-counter or prescription perimenopause treatment to help ease symptoms. Your provider may recommend:

  • Antidepressants: These medications help with mood swings or depression.
  • Birth control pills. These medications stabilize your hormone levels and typically relieve symptoms.
  • Estrogen therapy: This treatment stabilizes estrogen levels. You may take estrogen therapy as a cream, gel, patch or swallowable pill.
  • Gabapentin : This medicine is a seizure medication that also relieves hot flashes for some women.
  • Vaginal creams: Your provider can tell you about prescription and over-the-counter options. Treatment can decrease pain related to sex and relieve vaginal dryness.

Your healthcare provider will discuss the risks and benefits of perimenopause treatment with you and recommend the best option based on your needs. Certain lifestyle changes like eating a healthy diet, light exercise and avoiding foods or activities that trigger hot flashes can also help.

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What Are The Signs Perimenopause Is Ending

Your body might also be signaling to you that perimenopause is drawing to a close. Certain symptoms will increase in severity and frequency during the last few years of your perimenopausal cycle while others might disappear or become less intrusive.

1. More Time Between Periods

As you near the end of perimenopause, the time between periods will increase until they stop altogether. If you are going 60 or more days between periods, this is a pretty reliable sign that you are in late perimenopause.

2. Less Frequent Headaches

Finally, heres some good news. Because the wildly fluctuating hormones youve been experiencing in early and mid-perimenopause are starting to settle down to their new, albeit much lower levels, headaches actually start to improve. Women with menstrual migraines will notice that those debilitating headaches start to get fewer and farther between as the periods start to space out.

3. More Stable Mood

The ups and downs that affect 75%of women experiencing perimenopause are likely to taper off as we begin to enter menopause. Mood fluctuations and hormonal fluctuations go hand in hand. So it stands to reason that once you reach menopause, although your hormones will hit a new low, at least its a consistent low.

4. More Hot Flashes

5. Less Sleep

Should I Be On Birth Control During Perimenopause

Yes. If you do not want to become pregnant, you should use birth control during perimenopause. Even if you are getting your period every few months, you are still ovulating those months. Since its not possible to predict when you are ovulating, you should use birth control until you havent gotten a period for at least 12 months.

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What Will My Last Period Be Like Before Menopause

Theres no set answer to this one.

Like the other periods youve had during this transition time, your final period could be long or short, light or heavy, painful or painless.

One of the more reliable indicators that its your final period is the length of your cycle.

A big gap between bleeds is probably the best indicator that theyre soon going to be gone for good.

When Does Menopause Occur

Understanding the Menstrual Cycle

Although the average age of menopause is 51, menopause can actually happen any time from the 30s to the mid-50s or later. Women who smoke and are underweight tend to have an earlier menopause, while women who are overweight often have a later menopause. Generally, a woman tends to have menopause at about the same age as her mother did.

Menopause can also happen for reasons other than natural reasons. These include:

  • Premature menopause. Premature menopause may happen when there is ovarian failure before the age of 40. It may be associated with smoking, radiation exposure, chemotherapeutic drugs, or surgery that impairs the ovarian blood supply. Premature ovarian failure is also called primary ovarian insufficiency.

  • Surgical menopause. Surgical menopause may follow the removal of one or both ovaries, or radiation of the pelvis, including the ovaries, in premenopausal women. This results in an abrupt menopause. These women often have more severe menopausal symptoms than if they were to have menopause naturally.

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