Surprising signs of perimenopause

A racing heart, forgetfulness and rage are not exactly what a woman in her 40s hopes to experience as she strives to manage her home life, work life and social life while also (for some) caring for children and aging parents. Unfortunately, this is what perimenopause feels like for many women, and some may not even know what’s hit them.

Perimenopause is the time before menopause — the permanent end of menstrual periods caused by a natural decline in estrogen — that usually lasts three to four years. While we hear a lot about the hot flashes, mood changes and weight gain related to menopause, women are not given much warning about what may come prior to this transition.

“Traditionally, there has been a stigma around menopause and perimenopause,” says Dr. Ray Kamali, a board-certified OBGYN affiliated with Sharp Chula Vista Medical Center. “Women often feel uncomfortable talking about the signs and symptoms associated with this transition, possibly due to feeling ashamed of some of the symptoms they are experiencing. Additionally, there are many myths and misinformation that is passed along through family members, friends and the internet that further contribute to the confusion.”

Signs and symptoms of the perimenopause stage
According to Dr. Kamali, women will usually begin to notice changes in their menstrual cycles and bleeding patterns. The usual interval between menses is 25 to 35 days and this may change to 40 to 50 days in early perimenopause; however, not all women experience this. Women might also experience heavier than usual bleeding.

The change in menses is often accompanied by additional signs and symptoms of perimenopause, including:

• Hot flashes

• Night sweats

• Weight gain

• Vaginal dryness

• Breast sensitivity

• Decreased sex drive

• Insomnia or sleep disturbances

• Mood swings

• Difficulty concentrating

• Forgetfulness

• Fatigue

• Nausea

• Anxiety

• Depression

While these symptoms may seem ominous, not all women experience every one of them, and some find they notice few changes during this phase. It’s also important to remember that perimenopause is a normal physiological change in your body and does not need to be treated medically.

Tips to get you through this time
Dr. Kamali offers the following suggestions to help manage your perimenopause:

• Make the transition more comfortable by making some lifestyle changes — maintain a healthy diet and weight, exercise regularly and practice relaxation.

• Educate yourself on perimenopause and menopause and their related signs and symptoms.

• Talk about the symptoms you are experiencing with friends, family and your doctor, despite how uncomfortable or embarrassed you may feel.

• Question and research various over-the-counter remedies advertised to resolve symptoms. Just because a product is labeled as herbal or natural, does not mean it is effective or safe.

Talk with your doctor if you are experiencing symptoms of perimenopause. Together, you can address your symptoms and possible treatments if needed — including vaginal estrogen, birth control pills and some antidepressants — to help lessen the more serious effects perimenopause may be having on your life.