Menopause & Hormone Therapy - Stages of Menopause

Perimenopause

Perimenopause marks the time when your body begins its move into menopause. It includes the years leading up to menopause — anywhere from two to eight years — plus the first year after your final period. There is no way to tell in advance how long it will last OR how long it will take you to go through it. It's a natural part of aging that signals the ending of your reproductive years.

Signs and Symptoms

Perimenopause causes some changes in your body that may not be noticeable. For most women, the discomforts associated with perimenopause are minimal and manageable. Some things you might experience include:

Changes in your menstrual cycle (longer or shorter periods, heavier or lighter periods, or missed periods)

Hot flashes (sudden rush of heat from your chest to your head)

Night sweats (hot flashes that happen while you sleep)

Vaginal dryness

Sleep problems

Mood changes (mood swings, depression, or irritability)

Pain during sex

More urinary infections

Urinary incontinence

Less interest in sex

Increase in body fat around your waist

Problems with concentration and memory

By monitoring your menstrual cycle and recording your signs and symptoms for several months, you'll gain a better understanding of the changes occurring during this time. You will also have valuable information to discuss with your doctor.

Oral contraceptives (birth control pills) are often the treatment of choice to relieve perimenopausal symptoms — even if you don't need them for birth control. Today's low-dose pills regulate periods and eliminate or reduce hot flashes, vaginal dryness, and premenstrual syndrome.

Making lifestyle changes may help ease the discomfort of your symptoms and keep you healthy in the long run.

Good nutrition. Because your risk of osteoporosis and heart disease increases at this time, a healthy diet is more important than ever. Adopt a low-fat, high-fiber diet that is rich in fruits, vegetables, and whole grains. Add calcium-rich foods or take a calcium supplement. Avoid alcohol or caffeine, which can trigger hot flashes. If you smoke, try to quit.

Regular exercise. Regular physical activity helps keep your weight down, improves your sleep, strengthens your bones, and elevates your mood. Try to exercise for 30 minutes or more on most days of the week.

Stress reduction. Practiced regularly, stress reduction techniques such as meditation or yoga can help you relax and tolerate your symptoms more easily. The "Stress and Your Health" FAQ can be a good resource as well.

Pregnancy and Perimenopause

If you're still having periods, even if they are not regular, you can get pregnant. Talk to your doctor about your options for birth control. Keep in mind that methods of birth control, like birth control pills, shots, implants, or diaphragms will not protect you from STDs or HIV. If you use one of these methods, be sure to also use a latex condom or dental dam (used for oral sex) correctly every time you have sexual contact. Be aware that condoms don't provide complete protection against STDs and HIV — the only sure protection is abstinence (not having sex of any kind). But appropriate and consistent use of latex condoms and other barrier methods can help protect you from STDs.

Additional Information on Perimenopause:

Publications

Frequently Asked Questions - Perimenopause - This fact sheet discusses perimenopause, the time leading up to menopause when you start to notice menopause-related changes. It provides information on what to expect, how long it will last, what the symptoms and treatments are, and when to talk to your doctor.

http://www.womenshealth.gov/faq/perimenopause.htm

Menopause Guidebook (Copyright © NAMS) - This guidebook explains the emotional and physical changes that often accompany menopause. It also explains what to expect and how to take care of yourself after menopause.

http://www.menopause.org/edumaterials/guidebook/guidebook.aspx

Midlife Transitions: A Guide to Approaching Menopause (Copyright © ACOG) - This brochure explains the different physical and emotional changes you may experience as you approach menopause. It provides information on treatment and coping strategies that can help you relieve the different symptoms.

http://www.acog.org/publications/patient_education/ab013.cfm

Perimenopausal Women and the Use of Very-Low-Dose Birth Control Pills (Copyright © AAFP) - This publication provides information on very-low dose birth control pills, why someone would use these during perimenopause, who shouldn't take these pills, and how to know when menopause starts.

http://familydoctor.org/online/famdocen/home/women/reproductive/menopause/326.ht...

Perimenopause (Copyright © MFMER) - This publication explains what perimenopause is, what the signs are, and what factors may cause you to enter perimenopause early. It also discusses how you can care for yourself during this time of transition.

http://www.mayoclinic.com/health/perimenopause/DS00554

Perimenopause: Beginning of Menopause (Copyright © JAMA) - This publication explains the menopause transition known as perimenopause. It discusses the symptoms that often occur with perimenopause and the ways to ease them. It also raises awareness of health concerns that face women during menopause and beyond.

http://jama.ama-assn.org/cgi/reprint/289/7/940.pdf

Perimenopause: Pathways to Change (Copyright © ARHP) - This on-line publication is designed to help you understand what perimenopause is and what physical and emotional changes you may notice. It also highlights some important issues such as birth control, sexually transmitted diseases, nutrition, and exercise.

http://www.arhp.org/patienteducation/onlinebrochures/perimenopause/periapt.cfm?I...

Organizations

= Indicates Federal Resources

Current as of June 2007