Menopause can be challenging for any woman. Just like the start of a woman’s menstrual cycle brings major changes in her body, the same is true for menopause. Technically, a woman reaches menopause when she doesn’t menstruate for 12 months straight. Just like menopause, the period preceding that can be challenging as well. You experience several symptoms whose intensity differs from woman to woman. Irregular periods, hot flashes, sleep disturbances are some such premenopausal symptoms women experience. Many try home remedies to get some respite, others seek medical help. Since perimenopause can be challenging, information regarding it is important. Hence, to understand perimenopausal symptoms, complications, and the ways to manage them, Onlymyhealth spoke to Dr. Rashmi Varshney Gupta, Principal Consultant, Obstetrics & Gynaecology, Max Super Specialty Hospital, Dehradun.
What Is Perimenopause?
Perimenopause means ‘around menopause’, said Dr. Gupta. It is the period when your body transitions to menopause, after which your reproductive years are over. Hence, perimenopause can also be called the menopausal transition.
Perimenopause differs from woman to woman. Most women start experiencing perimenopausal symptoms, like irregular periods, sometime in their 40s. However, in some women, it can appear as early as their 30s. During perimenopause, a woman experiences the following:
- The level of estrogen, which is the female sex hormone, rises and drops unevenly.
- The menstrual cycle may lengthen or shorten.
- You may start having a menstrual cycle during which ovaries do not release eggs.
- Not just that, you may also experience menopause-like symptoms like irregular periods, hot flashes, vaginal dryness, sleep problems, etc.
Treatments are available to manage these symptoms.
On average, the perimenopause period generally lasts for four years. However, it differs from woman to woman. Some might experience it for two months, others for up to 10 years. But, once she doesn’t menstruate for 12 months, she is said to have reached menopause and her perimenopause period gets over.
Symptoms Of Perimenopause
During perimenopause, your body undergoes several changes, some of which are mild, others not. Because of them, you might experience some of these perimenopausal symptoms:
During this time, there is a major change in the ovulation cycle. Hence:
- There is be smaller or longer gap between your periods.
- You might also bleed more or less than normal.
- There can be times when you skip your periods.
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A hot flash is a sudden rise in the temperature of the upper body. You might feel intense warmth, especially on your face, neck, and chest. Many women experience hot flashes during perimenopause. The intensity, duration, and frequency vary from woman to woman.
As perimenopausal women experience hot flashes and night sweats, it can cause sleep disturbances. However, they can also experience these without the two underlying issues.
Several hormonal changes happen during perimenopause. It can lead to mood swings. Sleep disruption can be another reason for that. Several non-hormonal factors can also cause mood swings. Not just that, irritability and depression-like symptoms can also be seen in perimenopausal women.
Vaginal & Bladder Problems
During perimenopause, your estrogen level dips. It can cause the vaginal tissues to lose lubrication and elasticity. It, in turn, makes sexual intercourse painful. The low estrogen level can also make you more prone to vaginal and urinary infections. The loss of tissue tone can lead to urinary incontinence.
As ovulation gets disrupted during this period, it can impact your fertility. You have fewer chances of conceiving. However, as long as you have periods, you can get pregnant. Hence, unless you don’t have periods for 12 months straight (which means you have reached menopause), it is better to use protection if you aren’t planning a child.
Changes in sexual functions also occur during perimenopause. There may be decreased sexual drive or arousal.
Loss Of Bone
One of the primary risks that perimenopausal and menopausal women face is osteoporosis. It is a condition in which bones become weak and brittle. The dip in estrogen level can be one of the reasons for it. It is because this hormone plays a prominent role in women’s bone health. Hence, if you are a woman in her 40s or 50s, take good care of your bone health. Consuming enough calcium and vitamin D is one of the ways to do it.
Change In Cholesterol Level
The dip in estrogen can also have an impact on a woman’s blood cholesterol. Her LDL cholesterol (bad cholesterol) levels may increase, while that of good cholesterol (HDL) may decrease. Both these cases increase the risk for heart diseases.
Perimenopause-Related Complications You Must Take Note Of
Experiencing irregular periods is normal while undergoing perimenopause. It is nothing to be alarmed about. However, if you experience the following, you should consider seeing your gynecologist:
- If your bleeding is extremely heavy and you are changing pads every hour or two.
- If bleeding continues for over seven days.
- Periods occur regularly within the gap of 21 days.
- Bleeding happens between periods.
Such signs indicate there is something wrong with your reproductive system, and you need to be diagnosed and treated accordingly.
How To Manage Perimenopausal Symptoms?
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There are several ways to manage symptoms associated with perimenopause. In some specific cases, doctors recommend hormone replacement therapy for managing symptoms. However, if your symptoms are mild and you wish to treat them with some home-based remedies, here are some of the remedies you can try:
- Balanced Diet: Eat well-planned, nutritious, and balanced meals that consist of plenty of seasonal fruits and vegetables, whole grains, lean protein, and healthy fats.
- Exercise: Exercising is crucial to stay fit. Dr. Gupta recommends weight-bearing exercises for women underdoing perimenopause. Some options include walking, hiking, and strength training.
- Sleep Hygiene: Sleep disturbance is a common problem during perimenopause. Hence, you must take steps to manage that. Taking care of your sleep hygiene is one way you can do it. Hence, sleep and wake up at the same time every day, avoid screen in bed and engage in relaxing activities before bedtime.
- Avoid Stimulants: Many people prefer alcohol before bedtime. It, they say, helps them fall asleep. Although that might be true, it can have an impact on their sleep quality, and they might wake up mid-sleep. It is advisable to avoid all stimulants before bedtime. Other than alcohol, you must avoid drinking caffeine in the evening and around your bedtime.
- Stress Management: Mood swings, irritability, and depression-like symptoms are common during perimenopause. They can impact your day-to-day life massively. Hence, you must take steps to relieve them. Stress management through yoga and meditation are some of the ways you can do that.
- Quit smoking
- Weight Management: If you weigh more than normal, you are advised to lose the extra weight. Not only it will ensure good health, but it can also help relieve some of the perimenopausal symptoms like hot flashes, and night sweats. It will also increase your energy levels.
Perimenopause, just like menopause, can be a challenging period. You will experience several changes and symptoms. Gladly, there are both medical and non-medical ways to manage them. However, if you experience any complications, don’t lose time and see a doctor as soon as possible.
(With inputs from Dr. Rashmi Varshney Gupta, Principal Consultant, Obstetrics & Gynaecology, Max Super Specialty Hospital, Dehradun)
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