What are Perimenopause and Menopause?

Perimenopause and Menopause

As women age, they may experience inconvenient changes to their body, such as sweating during the day or night, fatigue, mood swings and more. Or they may notice they no longer have monthly menstrual periods.

Perimenopause is a transition where women may experience changes in their menstrual cycles, as well as sweating (hot flashes) or other symptoms. In perimenopause, the ovaries produce varying levels of estrogen and progesterone. Perimenopause can last several years before women go into menopause, which starts 12 months after their last period.

Menopause usually starts when women are between 45 and 55 years old, but some women may start it earlier due to autoimmune disorders or another cause. Menopause can last up to 14 years, depending on race and ethnicity, the age it starts and lifestyle factors.

In addition to age, menopause can start if women get a hysterectomy (removal of the uterus) or have their ovaries removed and do not take replacement hormones. Menopause is caused by a decline in estrogen levels in the blood, as well as removal of the ovaries or loss of function in ovarian follicles.

Symptoms of Perimenopause and Menopause

Some women may not experience symptoms when they are in perimenopause or menopause. Other women may experience any of the following symptoms:

  • Menstrual cycle changes: You may have periods more or less often, have a heavier or lighter flow, or have a shorter or greater duration. If you have extreme changes in your menstrual cycle, see your primary care provider or gynecologist to rule out any other concerns.
  • Hot flashes: You may sweat, feel very warm, or experience cold chills during the day or night. A red heat rash could also appear on your body. When hot flashes occur at night, they are called night sweats. Hot flashes and night sweats can last up to 10 minutes and the frequency of them can vary.
  • Incontinence: You may have less control of your bladder. This may involve leaking urine or feeling the need to urinate more often. If you experience this symptom, see your primary care provider or a urogynecologist.
  • Fatigue: You may experience changes in your sleeping patterns, which can lead to feeling tired and fatigued.
  • Pain during sex: Your vagina may get drier, which can cause pain during intercourse. Your sex drive could also increase or decrease.
  • Mood swings: Your moods may change often or you may be irritated or annoyed more often. Many women in perimenopause or menopause also experience symptoms of depression. If you feel you could be depressed, see your primary care provider or a mental health provider.
  • Other body changes: You could gain weight, notice your skin gets thinner, get aches and pains, and more.

What Should I Do if I’m in Perimenopause or Menopause?

It’s important to realize that perimenopause and menopause are normal parts of the female lifespan. These life transitions are nothing to be ashamed of, and you can still be happy and healthy.

Your primary care provider or gynecologist can be a great resource if you are having any symptoms. Your provider may conduct an examination and ask you about your family history, symptoms and age. To rule out any other concerns, your provider may order blood work to check your estradiol (E2) and follicle-stimulating hormone (FSH) levels.

Your provider may prescribe medications or recommend lifestyle changes if you are in perimenopause or menopause. It is recommended that you see your provider annually to discuss if treatment or lifestyle changes are working for you and see if any other changes are needed.

Make sure you consume enough calcium to keep your bones healthy. It’s also important to exercise regularly and eat an overall healthy diet. These lifestyle factors will lower your risk of osteoporosis and heart disease as you age.

If it has been less than 12 months since your last menstrual period, you should still use some form of birth control if you do not want to get pregnant. If you are in perimenopause or menopause, still take precautions if you remain sexually active because you can still be at risk of getting a sexually transmitted infection.

UofL Health has the following locations that can help if you think you may be in perimenopause or menopause:

If you experience depression symptoms because of perimenopause or menopause, UofL Health – Peace Hospital offers no-charge level of care assessments and assistance with treatment options. For more information, call 502-451-3333.

Also, the University of Louisville Trager Institute/Republic Bank Foundation Optimal Aging Clinic provides wellness and lifestyle services, mental health support, resources and more. To request an appointment or learn more about services offered, call 502-588-4340.

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Article by: Katana Ratliff, APRN, CNM

My registered nursing career blessed me with 7 years of caring for women and their families as a labor and delivery nurse. I discovered my love and passion in this field and heeded the calling to become a Certified Nurse Midwife. I have been providing care to women in the Frankfort, Ky area since 2021 and now the greater Louisville area.

All posts by Katana Ratliff, APRN, CNM
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