What’s this perimenopause about anyway?

You’re feeling extra premenstrual, your cycle is all over the place and you’re starting to get those hot flushes your girlfriends have been talking about. Is it the perimenopause and what does this mean?

The term perimenopause is often used to describe the years leading up to the last menstrual period during which menstrual cycles change and hormone levels fluctuate and, later, drop. Researchers have now changed the terminology to the “menopausal transition”.

The menopausal transition lasts 1-3 years on average, with age of menopause (the last menstrual period) happening at 51 years of age in most European women. This age may vary due to weight, smoking status, physical activity, or genetics.

What happens during the menopausal transition? Cycles start to change – they may initially be shorter, and then (yay!) get longer. Skipping a period is seen as a hallmark sign of the menopausal transition.

The number of “eggs” in the ovaries has declined to a critical level (usually less than 100 an ovary) and as a result hormone levels fluctuate a great deal, and eventually fall.

A number of symptoms are blamed on the menopausal transition, including hot flushes, joint pains, sleep disturbances and depression. It is unclear if any of these symptoms, apart from hot flushes, are due to the menopause itself or due to other factors such as stress or physical ageing.

It’s not all bad news. Many women feel liberated when they stop having periods – FINALLY! – and are no longer “trapped” by their cycles or reproductive capacity. In India, women speak of this liberation as “attaining heaven” and “finally becoming like a man”. (This is especially important when you consider the low status of women in India).

If you’re less than 45 years of age and are experiencing changes in your menstrual cycle, see your GP to assess if any other reasons apart from the menopausal transition are causing this. If you’re over 45, it’s still a great idea to see your GP to discuss lifestyle and preventive issues. Kind of like a mid-life overhaul. You’re likely to live another few decades so this investment is worth it!

Photo credit: By Jmettlen (Own work) [CC-BY-SA-3.0 (http://creativecommons.org/licenses/by-sa/3.0)], via Wikimedia Commons