One third of all American women are approaching or are already in menopause. If you are in your late 30's or early 40's and are experiencing menstrual irregularities, irritability and hot flashes, you may be in perimenopause. More than ever before, women are entering menopause, educating themselves, asking their doctors questions, and requesting information about options for treatment.

Overview

Menopause is the milestone in every woman's life that marks the end of the reproductive years. Perimenopause, which means "around menopause," refers to the 2 to 8 years of fluctuating hormones and related symptoms leading up to menopause. During perimenopause, the body starts making less of certain hormones (estrogen and progesterone), and the woman's body begins to lose the ability to become pregnant.

When perimenopause starts and how long it lasts varies. Women normally go through menopause between the ages of 45 and 55. Many women experience menopause around age 51. However, perimenopause can start as early as age 35. It can last a few months or a few years. Although the perimenopausal transition is a natural body change that doesn't require treatment, symptoms may disrupt life and the sense of well being. The first and best approach to reducing perimenopausal symptoms is to lead a healthy lifestyle-eat well, exercise regularly, and avoid excess caffeine, alcohol, and stress.

Signs and Symptoms

Some women have symptoms during this time that can be difficult. Symptoms can include:

• Changes in the menstrual cycle


• Hot flashes


• Night sweats


• Vaginal dryness


• Sleep problems


• Mood changes


• Urinary infections


• Urinary incontinence


• Less interest in sex


• Body and skin changes


• Loss of bone


• Changing cholesterol levels

Risk Factors

There are factors that may predispose a woman to experience earlier perimenopause. They can include:

• Family history - If a woman's mother experienced perimenopause at age 45 or younger, there is a good chance the daughter will also.


• Cigarette smoking - Perimenopause occurs one to two years earlier in women who smoke, compared with women who don't.


• Hysterectomy status - Surgery that removes the uterus may impact how well the ovaries function and how much estrogen is produced.


• Poor nutrition - Excessively thin or undernourished women may experience menopause at an earlier age.

Perimenopause is a process-a gradual transition. No one test or sign is enough to determine if a woman is in the perimenopause phase. If there are increasingly severe symptoms such as hot flashes, radical mood swings, or loss of sex drive, see your doctor.

Dr. Akwa is board-certified in family practice and specializes in women's health. She believes it is important for a woman to partner with her physician who listens to her concerns and meets her specific healthcare needs. Dr. Akwa is accepting new patients at Methodist at Mt. Hawley - Women's Health.