Perimenopause begins several years before menopause, when a woman is still having periods. This stage can last up to four to five years or longer, until period stops and menopause begins. Periods will become irregular and may be shorter, longer, lighter, or heavier.
Menopause , when it is atleast 12 months since her last period. At this point, her ovaries have stopped releasing eggs. Production of the hormones estrogen and progesterone significantly decreases. This stage indicates an end to fertility.
Postmenopause is the years following menopausal changes in a woman’s body are called postmenopause. During this time, symptoms like night sweats and hot flashes ease for most women.
In the months or years leading up to menopause , you might experience these signs and symptoms:
- Irregular periods
- Vaginal dryness
- Hot flashes
- Night sweats
- Sleep problems
- Mood changes
- Weight gain and slowed metabolism
- Thinning hair and dry skin
It’s possible, but very unusual, to menstruate every month right up to your last period. More likely, you’ll experience some irregularity in your periods.
Skipping periods during peri menopause is common and expected. Often, menstrual periods will occur every two to four months during peri menopause, especially one to two years before menopause. Despite irregular periods, pregnancy is possible. If you’ve skipped a period but aren’t sure you’ve started the menopausal transition, you may want to determine whether you’re pregnant.
Natural decline of reproductive hormones – As you approach your late 30s, your ovaries start making less estrogen and progesterone – the hormones that regulate menstruation – and your fertility declines. In your 40s, your menstrual periods may become longer or shorter, heavier or lighter, and more or less frequent, until eventually – on average, by age 51- you have no more periods.
Hysterectomy – A hysterectomy that removes your uterus but not your ovaries (partial hysterectomy) usually doesn’t cause immediate menopause. Although you no longer have periods, your ovaries still release eggs and produce estrogen and progesterone. But surgery that removes both your uterus and your ovaries (total hysterectomy and bilateral oophorectomy) does cause menopause, without any transitional phase. Your periods stop immediately, and you’re likely to have hot flashes and other menopausal signs and symptoms, which can be severe, as these hormonal changes occur abruptly rather than over several years.
Chemotherapy and radiation therapy – These cancer therapies can induce menopause, causing symptoms such as hot flashes during or shortly after the course of treatment. The halt to menstruation (and fertility) is not always permanent following chemotherapy, so birth control measures may still be desired.
Primary ovarian insufficiency – About 1 percent of women experience menopause before age 40 (premature menopause). Menopause may result from primary ovarian insufficiency — when your ovaries fail to produce normal levels of reproductive hormones — stemming from genetic factors or autoimmune disease. But often no cause can be found. For these women, hormone therapy is typically recommended at least until the natural age of menopause in order to protect the brain, heart and bones.
Heart and blood vessel (cardiovascular) disease – When your estrogen levels decline, your risk of cardiovascular disease increases. Heart disease is the leading cause of death in women as well as in men. So it’s important to get regular exercise, eat a healthy diet and maintain a normal weight. Ask your doctor for advice on how to protect your heart, such as how to reduce your cholesterol or blood pressure if it’s too high.
Osteoporosis – This condition causes bones to become brittle and weak, leading to an increased risk of fractures. During the first few years after menopause, you may lose bone density at a rapid rate, increasing your risk of osteoporosis. Postmenopausal women with osteoporosis are especially susceptible to fractures of their hips, wrists and spine.
Urinary incontinence – As the tissues of your vagina and urethra lose elasticity, you may experience frequent, sudden, strong urges to urinate, followed by an involuntary loss of urine (urge incontinence), or the loss of urine with coughing, laughing or lifting (stress incontinence). You may have urinary tract infections more often. Strengthening pelvic floor muscles may help relieve symptoms of incontinence.
Fortunately, many of the signs and symptoms associated with menopause are temporary. Take these steps to help reduce or prevent their effects:
Cool those hot flashes – Have a cold glass of water or go somewhere cooler. Try to pinpoint what triggers your hot flashes. For many women, triggers may include hot beverages, caffeine, spicy foods, alcohol, stress, hot weather and even a warm room.
Get enough sleep – Avoid caffeine, which can make it hard to get to sleep, and avoid drinking too much alcohol, which can interrupt sleep. Exercise during the day, although not right before bedtime. If hot flashes disturb your sleep, you may need to find a way to manage them before you can get adequate rest.
Practice relaxation techniques – Techniques such as deep breathing, paced breathing, guided imagery, massage and progressive muscle relaxation can help relieve menopausal symptoms. You can find a number of books, CDs and online offerings on different relaxation exercises.
Strengthen your pelvic floor – Pelvic floor muscle exercises, can improve some forms of urinary incontinence.
Eat a balanced diet – Include a variety of fruits, vegetables and whole grains. Limit saturated fats, oils and sugars. Ask your provider if you need calcium or vitamin D supplements to help meet daily requirements.
Exercise regularly – Get regular physical activity or exercise on most days to help protect against heart disease, diabetes, osteoporosis and other conditions associated with aging.
Yoga – Some studies show that yoga may be effective in decreasing the number of hot flashes in peri menopausal women. It’s best to take a class to learn how to perform postures and proper breathing techniques.
Acupuncture – Acupuncture may have some temporary benefit in helping to reduce hot flashes. Controlling your health is the key to preparing yourself for menopause. Put to use the information found above to make your transition a successful one. Always remember to consult with your doctor before starting any special routine, since your medical condition may not warrant generalized guidance. It takes hard work, diligence, knowledge and fortitude, but you can do it.
