Riverview Physicians for Women

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Perimenopause

The perimenopause is a highly variable time in a woman's life. It occurs in the 10 years before menopause. Some women don't experience any symptoms during this time while others have a very difficult time.

Those who do experience perimenopause often say that menopause was a welcome relief. Perimenopausal symptoms are often inconsistent and vague: ranging from irregular menstrual periods to severe emotional distress and everything in between. The most common symptoms are: irregular bleeding, hot flushes, vaginal dryness, painful intercourse, decrease in desire to have sex (which may be because it hurts to have sex), urinary incontinence (both unable to "hold" urine once the urge to void occurs as well as loss of urine in spurts with coughing-straining-laughing, etc.), depression and trouble sleeping. Other changes include a decrease in bone density and an increase in the "bad" cholesterol. These changes are due to the slow decline in hormone production by the ovaries. It usually occurs in spurts and culminates in the total failure of ovarian function. The result is menopause. In other words, while tests may show a woman with perimenopausal symptoms has normal hormone levels, the levels are not normal for her. If you experience abnormal bleeding for 2 consecutive months, have heavy bleeding (changing pads or tampons every hour) or are not having a period at least every 35 days (not on hormonal contraception), you should see your gynecologist.

Fortunately, we have a better understanding of, and treatment for, symptoms of the perimenopause. If you are experiencing any symptoms to an uncomfortable degree, you should see your gynecologist. Treatment is aimed at the underlying cause and is individualized.

Because the perimenopausal decrease in estrogen production results in loss of calcium from bones, it is very important for women to get at least 1200mg of calcium and 800-1000units of vitamin d a day from all sources to help maintain bone health. Calcium with vitamin d supplements should be taken twice a day (after breakfast and dinner).

More good information about the perimenopause can be found here.