Question:

Are premenopause and perimenopause the same thing? When do they typically start and what changes can I expect?

Answer:

Perimenopause is the interval leading up to menopause during which you start to notice certain changes in your body and menstrual cycle. (Perimenopause also includes the first year after your final period.) During this transition from premenopause ─ the years between the start of your menstrual cycle and the time perimenopause begins ─ your ovaries begin to make less estrogen and progesterone. Levels of these reproductive hormones can rise and fall erratically during this time, and you may notice certain signs and symptoms.

 

Perimenopause is what some people refer to as “being menopausal” or “going through menopause.” These changes are normal ­─ a natural consequence of aging that signals the end of a woman’s ability to get pregnant.

 

For more clarification, take a look at these definitions from the North American Menopause Society:

 

Ø Perimenopause: Transitional time (up to 6 years or more) of menopause-related changes immediately prior to natural menopause and 1 year after menopause.

Ø Menopause: The end of menstruation, confirmed after 12 consecutive months without a period or when ovaries are damaged or removed. Menopause actually lasts only 1 day ─ the day you haven’t had a period for 12 months in a row.

Ø Induced menopause: Immediate menopause caused by medical or surgical intervention that damages or removes both ovaries.

Ø Premature menopause: Menopause that occurs before age 40.

Ø Postmenopause: All the years after menopause.

 

The age perimenopause begins and the time the interval lasts varies from person to person. Most women go through perimenopause between ages 45 and 55 years, but it can begin in some women in their mid-30s. Some women notice no symptoms other than their period becoming irregular or stopping. Most, however, will observe other changes, though again, this is different for every woman. Menopause-related symptoms include:

 

Ø Changes in the pattern of your periods. They may be shorter or longer or lighter or heavier and the time between them also may become erratic.

Ø Hot flashes ─ a sudden rush of heat to the upper body.

Ø Night sweats ─ hot flashes that happen while you sleep, often followed by chills.

Ø Insomnia.

Ø Vaginal dryness and other changes in sexual function, including reduced desire.

Ø Mood changes, irritability.

Ø Trouble concentrating, anxiety.

Ø Bone loss. Drops in estrogen levels lead to accelerated bone loss and an increased risk of osteoporosis.

Ø Decreased fertility. Ovulation becomes irregular during perimenopause, but as long as you’re having periods, you can still become pregnant. If you want to avoid pregnancy, use birth control until you’ve gone 12 consecutive months without a period.

 

Perimenopausal symptoms may be quite mild and easily tolerated, and many women don’t need extra medical care during this time. If you’re experiencing symptoms that interfere with your life, such as severe hot flashes, mood swings, or troublesome changes in sexual function, consider discussing treatment options with your physician.

 

You also can make some lifestyle changes that might ease your symptoms and optimize your health. Consider these suggestions from the National Women’s Health Information Center:

 

Ø Eat Healthy. A healthy diet is more important now than before because your risks of osteoporosis and heart disease go up at this stage of life. Eat lots of whole-grain foods, vegetables, and fruits. Add calcium-rich foods (milk, cheese, yogurt) or take a calcium supplement to obtain your recommended daily intake (1000 mg before menopause and 1200 mg after menopause). Get adequate vitamin D from 15 minutes of exposure to sunshine a day or a 400 mg supplement. Avoid alcohol or caffeine, which can trigger hot flashes in some women.

 

Ø Get Moving. Regular exercise helps keep your weight down, helps you sleep better, makes your bones stronger, and boosts your mood. Try to get at least 30 minutes of exercise most days of the week, but ask your doctor to recommend what’s best for you.

 

Ø Find healthy ways to cope with stress. Try meditation or yoga ─ both can help you relax, as well as handle your symptoms more easily. (Click here to download the “Stress and Your Health” pamphlet for more information.)