Menopause, by definition says that when a woman does not get her periods for 12 months, her body becomes infertile. Menopause transition or perimenopause usually commences a few years before menopause (mostly when a woman is in her 40s but it can also start in her late 30s). During this duration the body prepares to close down the ovaries, resulting in no eggs, and hence the body produces less estrogen and progesterone than normal.
Perimenopause implies ‘around menopause’ and indicates the time period during which a female’s body produces its natural transition towards complete infertility-the menopause. In this transitional phase of perimenopause, you will still have periods, but they can be irregular which may affect your chances of becoming pregnant.. The menopause transition usually lasts for 4 years. However in some females it can last from few months to as long as 10 years.
Signs and Symptoms of Perimenopause
The common signs and symptoms of perimenopasue are enumerated as under:
- Breast tenderness
- Irregular periods – shorter, lighter periods; heavier periods, flooding; phantom periods, shorter cycles, longer cycles and hot flashes
- Lower sex drive
- Lassitude and fatigue
- Vaginal dryness; discomfort during intercourse
- Leakage of urine while coughing or sneezing; urinary urgency (desire and direness to urinate more frequently)
- Mood swings, anxiety, feeling ill at ease
- Feelings of doom, dread and apprehension; depression, irritability
- Difficulty in concentrating, disorientation, mental confusion; disturbing memory lapses
- Itchy, crawly skin
- Aching, sore joints, muscles and tendons; increased tension in muscles
- Gastrointestinal distress,bouts of bloating, indigestion, nausea flatulence, gas pain
- Exacerbation of existing conditions
- Increase in allergies
- Weight gain
- Thinning or hair loss, head, pubic, or whole body; increase in the facial hair
- Irregular heart beat
- Difficulty in sleeping
Besides these symptoms, if you experience any of the following conditions, do not hesitate in consulting your doctor.
The common causes of abnormal bleeding are birth control pills hormonal problem pregnancy, blood clotting problems fibroid, etc.
Diagnosis of Perimenopause
Based on the symptoms, your doctor will make the diagnosis of perimenopause. The hematological or blood tests are done to assess the levels of hormones.
Perimenopausal in Early Age
Here are a few risk factors that can increase your chances of experiences perimenopausal symptoms at an early age.
Pregnancy and Perimenopause
One might thinking that conceiving after late 30’s is not a big deal, when we So many celebrities continually get pregnant and deliver children in their 40’s. Women can become pregnant while nearing perimenopause. If you do not intend to conceive you can use contraceptive pills.
Can I Get Pregnant During Perimenopause?
You can become pregnant while nearing perimenopause – however the process of ovulation becomes pretty irregular and conception becomes difficult. With hormone levels fluctuating wildly, because the ovaries cease to produce eggs – the necessary hormonal balance to facilitate fertility is just not there. When there is no ovulation, there is no fertility and no pregnancy. Add to this the fact that women, unlike men, are born with all the eggs they can produce in their lifetime. Men on the other hand keep on producing sperms.
Age Factor, Perimenopause and Pregnancy
A woman in her 30s has 20 percent chance of becoming pregnant in a month while a woman in 40s has mere 5 percent chance of being pregnant. Add to that a 20% increased risk of a preterm labor. This is the reason why women are encouraged to conceive within the ages of 35 years.
Risks and Perimenopausal Pregnancy
There are certain risks associated with conceiving at old age for example, a 50% increased risk for gestational diabetes, pregnancy induced hypertension placental abnormalities, etc. Elderly gravid or elderly pregnant women are more prone to caesarean section as compared to other pregnant women. Babies born to elderly mothers have greater risk of Down’s Syndrome.
However, some people feel that there are advantages associated with having babies at late age. Some women have been preoccupied in stabilizing their career and at late stage feel the need to have a baby. They feel they are more comfortable and are mentally and psychologically ready to raise a little one. Yet, it is better and safe to conceive till you hot 35 – for a healthier you and a healthier baby. Nevertheless, there have been many cases where women in their 40’s, and even 50’s have given birth to healthy babies.
The symptoms of perimenopause can be effectively treated with following drug therapies.
- Hormone therapy
Estrogen therapy is done to treat the symptoms of perimenopause such as hot flashes night sweats.
After assessing your personal and family medical history your doctor can advise you estrogen in minimal dose. Progestin is also added if hysterectomy has not been done
- Vaginal estrogen
Estrogen is given directly in the vagina as vaginal tablet for reducing vaginal dryness. It also reduces vaginal discomfort noticed in intercourse
SSRIs or selective serotonin re-uptake inhibitors are used to relieve hot flashes