A Gradual Change
For most women‚ menopause— literally‚ the cessation of menstruation—isn’t a single event that occurs all of a sudden. Rather‚ it’s a gradual transition that takes place over several years’ time in three distinctive phases. Perimenopause‚ the first phase‚
generally occurs from two to four years before menopause. During this time‚ your menstrual periods will become more irregular as the number of eggs in your ovaries— and the amount of estrogen they produce—declines. Along with these physical changes come some of the tell-tale signs: hot flashes (yes‚ you can get them even though you’re still menstruating)‚ night sweats (the nighttime version of hot flashes)‚ PMS-like mood swings‚ insomnia‚ and maybe even an “achy-all-over” feeling. Many women simply have a sense that something’s “not quite right.” The actual onset of menopause—when your ovaries produce so little estrogen that your menstrual periods cease altogether—occurs next. On average‚ this happens around age 51‚ but it’s perfectly normal for menopause to occur anywhere from the early 40s to mid- 50s. If you smoke or have your uterus surgically removed‚ you may experience menopausal symptoms earlier than average. For many women‚ hot flashes kick in around this time and may last for a year or two—sometimes more—after your periods end. And when your periods have
stopped for a year or longer? After that‚ you’ve entered the postmenopausal years—and there are plenty of them to be had.
75 45
percent of women have hot flashes
percent of menopausal women have mood swings
Irregular Periods, Declining Fertility
Even if you’ve been as regular as clockwork in the past‚ your menstrual cycles can be wildly unpredictable throughout perimenopause: light one month‚ heavy the next. You may even skip periods altogether‚ sometimes for months at a time. But as long as you’re still menstruating‚ you can still get pregnant. Whatever you do‚ unless you’re trying to get pregnant‚ be sure to use some form of contraception until your doctor tells you it’s OK to stop.
Hot Flashes, Night Sweats
If you’re over age 45‚ you may be asking‚ “Is it hot in here‚ or is it me?” Chances are good it probably is you. Some 75 percent of women have hot flashes and night sweats at some point during this time. Hot flashes and night sweats can be uncomfortable and
inconvenient‚ but they are temporary and can be managed. In fact‚ many women find that they can cope just fine by making some fairly simple changes in their lifestyle. (See Hot Flashes—Why Me???, page 16.) If you need more help dousing the fire‚ hormone therapy and other medications are available from your doctor.
Mood Swings
While rates of depression in postmenopausal women are generally lower than they are in younger women in their childbearing years‚ depressive symptoms‚ including irritability‚ crying jags‚ and the like (aka PMS-like mood swings)‚ are not unheard of in perimenopausal women. “In fact‚ women are more prone to depression during perimenopause‚” says Schiff. Up to 45 percent of women who see their doctors for menopausal
symptoms complain of having irritating mood swings. It’s no wonder: Hot flashes and night sweats can disrupt sleep‚ leading to irritability. Heart palpitations that sometimes accompany hot flashes can mimic anxiety. If you’ve suffered an earlier bout of depression‚ you may be more
vulnerable to slipping into depression again now. But for the vast majority of women‚ these emotional ups and downs are temporary and manageable.
SPRING / SUMMER 2012 pause 13
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