The perimenopausal phase is the time of life when menstruation ends. This is the beginning of a journey, and there’s no consensus on when it begins. Figures as low as two years to up to 15 years prior to menopause are suggested. Generally, perimenopause is gradual, might evade detection at first, and represents a decline or instability in the production of estrogen. Perimenopause has recognizable common symptoms, and doctors may also perform some tests to diagnose it.
Since menopause age varies from about 45-55, most women may be able to guess they’re perimenopausal by the time they reach their early 40s. Age of menopause tends to be close to parental age of menopause, so an early or late menopause by a person’s mother can help refine the math slightly. It’s noted that many women start observing a few changes in monthly cycle as early as their 30s, and though their cycle may still be dependable, the occasional late or early period occurs.
As women become perimenopausal, they may begin to notice more changes in cycle or regularity. Very often the change noted is that cycles are shorter, though some women experience longer cycles. Actual flow of menstruation could be different too, and many women may have heavier flow.
Changes in the menstrual cycle aren’t the only indicators of the perimenopausal state. As this stage progresses, women frequently notice vaginal dryness, which can interfere with enjoyment of intercourse if a lubricant is not used. Some women also report skin dryness and increase in conditions like rosacea.
Another symptom is increase in tenderness of the breasts. This might or might not be a predictable part of the menstrual cycle. As this stage progresses, additional symptoms herald the beginning of menopause. These include skipped periods, more irregularity in cycles, hot flashes, and changes in mood. Insomnia, depression, or anxiety can occur, and women might find losing weight challenging.
Doctors may be able to help women ascertain if they are perimenopausal. Some of these symptoms can result from other causes like hypothyroidism or pregnancy, so any medical tests may rule these out. Generally, doctors listen to symptoms, perform an exam, and might order some medical tests.
A couple of blood tests evaluate hormone levels. One looks at estrogen, but needs to be repeated for several months in a row to a get sense of whether there is stability or decline. Another potential is evaluating follicle-stimulating hormone (FSH), since this increases in perimenopause. High FSH levels correlate to low fertility levels, and a hallmark of being perimenopausal is that fertility levels drop, though pregnancy is still very possible during this transition.
Testing for perimenopause isn’t always necessary, but as this stage moves to menopause, doctors usually begin other types of care suitable to the menopausal and post-menopausal woman. Such care includes assessing bone strength to determine risk for osteoporosis. Additional treatment could alleviate lingering symptoms of menopause or emphasize recommendations on how to live healthfully in the post-menopausal years.