Menopause and Perimenopause
What is Menopause and Perimenopause?
Menopause is defined as the cessation of menstruation as a result of the normal decline in ovarian function. Technically, you enter menopause following 12 consecutive months without a period. Menopause has become increasingly medicalized, which means it is viewed as something that requires intervention and treatment rather than as a natural life transition that may benefit from support. Menopause signals the end of fertility and the beginning of a new and potentially rewarding time in a woman's life. Part of the stigma of menopause is its association with aging, but we age no more rapidly in our 50s than in any other decade of life.
When Does Menopause Happen?
For most women, natural menopause occurs between the ages of 45 and 55, with the average age of onset being 51.4 years of age. In rare instances, menopause can occur as early as the 30's or as late as the 60's. Menopause is considered premature if it occurs before the age of 40, or artificial if radiation exposure, chemotherapeutic drugs, or surgery induces it. Other factors that may contribute to the early onset of menopause include a history of smoking, poor nutrition, a co-existing medical condition, or even a traumatic experience.
Until a woman is technically considered menopausal (aka postmenopausal), she's considered to be premenopausal, also referred to as perimenopause. It's during the perimenopausal phase that most women experience the worst symptoms.
Menopause (or postmenopause) occurs when a woman hasn't had her period for 12 consecutive months. Once hormones have levelled off, most of the symptoms experienced during perimenopause will disappear -- although some women have occasional hot flashes, anxiety, bouts of depression, et al, for a few years after they become postmenopausal.
The Physiology of Menopause
To best understand what occurs at menopause, it is helpful to know about the physiology of menstruation and the hormones that are involved in our monthly cycle. Hormones are substances in our bodies that act like messengers. They travel throughout the body and can bind to specialized areas of cells known as receptor sites, where they then initiate a specific chain of events. The first half of the menstrual cycle is dominated by estrogen, whose role is to build the lining of the uterus in preparation for a potential pregnancy. At approximately day 14 of the cycle, or two weeks prior to menstruation, an egg is released from the ovaries. This is referred to as ovulation.
As a result of ovulation the ovary begins producing progesterone. It is during this second half of the cycle that progesterone is dominant. Progesterone's role is to change the character of the uterine lining to prepare for pregnancy, and to prevent further buildup of the lining by estrogen. At the end of the cycle, if the egg is not fertilized, estrogen and progesterone levels drop, causing a sloughing of the uterine lining, or menstruation. The body goes through this cycle every month to ensure a fresh uterine lining in preparation for a potential pregnancy.
If a woman fails to ovulate, however, she does not produce progesterone, and this may result in the experience of symptoms of hormonal imbalance. Women are born with a finite number of eggs that eventually runs out. At birth, a woman has close to a million eggs, by puberty a mere 300,000. In the 10 to 15 years prior to menopause, this loss begins to accelerate. Perimenopause is the term used to describe the time of transition between a woman's reproductive years and when menstruation ceases completely. Typically perimenopause occurs between the ages of 40 and 51 and may last anywhere from six months to ten years. During this time, hormone levels naturally fluctuate and decline, but they do not necessarily do so in an orderly manner. Shifts in hormones are a major contributor to that sense of physical, mental, and emotional imbalance that may characterize a woman's experience of menopause.
Eventually estrogen levels decrease to the point that the lining of the uterus no longer builds up and menstruation ceases. This is menopause. After menopause, estrogen levels off at approximately 40 to 60% of its premenopausal levels and progesterone falls close to zero. Although there are similarities in what happens hormonally, each woman's experience can be very different. Genetics may play a role in the timing, but lifestyle can certainly influence a woman's experience of menopause. Many women find that the right combination of herbs, exercise, nutritional support, and natural hormones helps them to manage most of their symptoms. Others find they may need some medical intervention and pharmaceutical agents. This site will help guide you in making the decisions that best support your individual needs.
How long does perimenopause last?
It varies. Women normally go through menopause between ages 45 and 55. Many women experience menopause around age 51. However, perimenopause can start as early as age 35. It can last a few months to quite a few years. There is no way to tell in advance how long it will last OR how long it will take you to go through it. Every woman is different.
34 Menopause Symptoms
Menopausal symptoms affect about 70% of women approaching menopause. Typical menopause symptoms, such as hot flashes or night sweats, are caused by changing hormonal levels in the female reproductive system. Almost all women notice early symptoms while still having periods. This stage of gradually falling and fluctuating hormone levels is called perimenopause, which often begins in the early 40s.
1.Hot Flashes, Flushes and/or Cold Flashes
About 75 to 85% of American women are estimated to get hot flashes when they're in menopause. Hot flashes, which can be felt like a sudden, transient sensation of warmth or heat that spreads over the body creating a flushing (redness) particularly noticeable on the face and upper body. Whether your own hot flashes are experienced as delicate flushes or the engulfing flames, rest assured they're normal.
Night sweats is the evening cousin of hot flashes, but typically more intense. Night sweats, which is also known as "nocturnal hyperhydrosis", isn't actually a sleep disorder, but it is a common perspiration disorder that occurs during sleep. Click here for more information about Night Sweats.
3.Irregular Periods, Menstrual Irregularities
Most women experience absent, short, irregular periods at some point in their lives. A wide range of conditions can cause these symptoms, while the most common cause is hormone imbalance. Your periods may come more frequently, every 24 days instead of every 28, or they may come later than they used to. You may have a light period that lasts only a few days, then the next month have very heavy bleeding. Your period may last a shorter amount of time, or go on and on for what feels like an eternity. You may skip a month, then go back to normal for several months, then skip two periods in a row
4.Loss of Libido
Sex therapists say tha low libido becomes a problem that should be addressed only when it is perceived as a problem. "It's usually only in the framework of a relationship that it becomes an issue" Dr. Zussman says. "It's when there is a discrepancy in desire between the person and partner, or when people feel there's something wrong with them because they have a low level of desire."
It's basically a loss of the usual moist and soft feel of the lining of vaginal area which may be associated with itching and irritation. When your estrogen levels drop, your vaginal tissues start drying and become less elastic. Sex becomes uncomfortable, you may be more prone to infections, your vagina is frequently itchy and easily irritated, and, on the emotional side, you may feel older.
6.Mood Swings, Sudden Tears
A person with a mood problem is like a human roller coaster. One minute he's up, the next minute he's down. He never seems to be able to get off the ride. His mood swings are intense, sudden and out of control. Chronic and severe mood swings are a psychological disorder, a health problem every bit as real as a physical ailment. In fact, sometimes they're the result of a physical problem, like a premenstrual syndrome. And just like a physical problem, they can be treated. You should contact your doctor to get more advice. Click here for more information about Mood Swings.
"Fatigue is second only to pain as the most common symptom doctors see in patients," says David S. Bell, M.D., a chronic fatigue researcher at Harvard Medical School and the Cambridge Hospital in Massachusetts. "One-fourth of all Americans will have long episodes of lethargy and tiredness." Particularly common in women undergoing the menopausal transition, chronic fatigue can have a drastic impact on daily life, putting a strain on relationships, work productivity, and quality of life.
8.Hair Loss or Thinning, Head, Pubic, or Whole Body;
Increase in Facial Hair
9.Menopause Sleep Disorders (With or Without Night
10.Difficulty Concentrating, Disorientation, Mental Confusion
During early menopause, many women are troubled to find they have difficulty remembering things, experience mental blocks or have trouble concentrating. Not getting enough sleep or having sleep disrupted can contribute to memory and concentration problems.
11.Disturbing Memory Lapses
Memory loss affects most people in one way or another. More often than not, it is a momentary memory lapse; nothing to worry about - it happens to the best of us. However, when memory lapses begin to become a regular occurrence, it is wise to dig a little deeper and seek medical advice.
12.Dizziness, Light Headedness, Episodes of Loss of Balance
Dizziness is a transient spinning sensation and/or a feeling of lightheadedness or unsteadiness; also, the inability to maintain balance upon standing or walking. Dizziness is a symptom of many medical conditions. There are things that people can do to cope with their dizziness. But if you experience an unexplained dizzy spell, see your doctor, because you can't be sure if it's a trivial problem or a symptom of a serious illness. Click here for more information about dizziness during menopause
13.Weight Gain during Menopause
Weight gain, specifically a thickening in your middle, is another sign of changing hormones. While a number of books and doctors claim that menopause has nothing to do with weight gain, that weight gain occurs in menopausal women because they're older and their metabolism is slowing down, other studies indicate that hormone levels are tied to weight gain and redistribution of fat.
14.Incontinence, especially upon Sneezing, Laughing, Urge
Incontinence falls into three main categories, although people can leak through because of a combination of causes. First, there's stress incontinence, in which you urinate accidentally when you laugh, cough, sneeze or exert yourself. This happens either when the bladder neck shifts position out of reach of the internal muscles that put pressure on it or when those muscles themselves fail to work effectively, because of age, surgery or childbirth. The second one is urge incontinence, in which the bladder develops a "mind of its own," contracting and emptying whenever full despite an individual's conscious efforts to resist. And last, overflow incontinence, in which you completely lose the sensation that you have to go. You should see your doctor if you urinate when you shouldn't, because you have no sensation that your bladder is full. Click here for more information about incontinence during menopause.
15.Sudden Bouts of Bloat
A puffy bloated feeling that seems to come out of nowhere; usually you'll notice bouts which are a periodic increases in fluid retention and abdominal distension.
16.Increase in Allergies
Many types of allergy have their basis in hormone reactions. This is particularly true of ladies who experience increasing symptoms as they undergo hormone changes, usually in their late twenties or after the babies are born. Hormone imbalance is a type of allergic reaction experienced by women from before puberty to old age. It is a heightened reaction to the normal function of hormones. Click here for more information about allergies during menopause.
17.Changes in Fingernails-Softer, Crack or Break Easier
A black or blue nail tells the world that you and your hammer had a problem. Reddish yellow nails demonstrate that you change your nail polish often. Nails that split and break can be a sign that you're spending too much time with your hands in the sink. Nails that take on a convex, spoon like appearance may mean respiratory deficiency or simply that you're not getting enough iron. Nibbled nails and hangnails can betray your anxiety level. Fingernail and toenail problems are usually caused by inflammation of the skin around the nail or by an infection. A persistently painful and inflammed fingernail or toenail requires your doctor's attention. Click here for more information about brittle nails during menopause.
18.Changes in Body Odor
Have you ever heard the saying: "body odor is the smell of sweat"? Well, it may be partly true. In fact, our bodies make two types of sweat: eccrine sweat, which is odorless, is present all over the body, and is used to control the temperature of the whole organism. The other type of sweat is aprocrine, a stronger substance produced by the glands under the arm. Apocrine sweat is odorless too, until bacteria on the skin surface acts upon it.
The smell of this sweat may be more intense in people with inadequate hygiene, or merely have bad genes. How to reduce the body odor? Use a deodorant soap whenever you take a shower. Antibacterial soaps will solve the problem because it's the bacteria that are producing the odor. The antibacterial soap will do all the work; making scrub unnecessary. Click here for more information about changes in body odor during menopause.
19.Bouts of Rapid Heart Beat
A pounding, racing heart is the second most common complaint associated with perimenopause. These bouts of rapid heart beat scare a lot of women because of their sudden onset, unexpected arrivals, and seemingly no way to stop them. This partially accounts for the sleeping troubles during perimenopause. This pounding can mean something other than perimenopause, so it's very important for a woman who is experiencing this symptom to report it to her doctor.
Feelings of sadness can be normal, appropriate and even necessary during life's setbacks or losses. Or you may feel blue or unhappy for short periods of time without reason or warning, which also is normal and ordinary. But if such feelings persist or impair your daily life, you may have a depressive disorder. Severity, duration and the presence of other symptoms are the factors that distinguish ordinary sadness from a depressive disorder. This is called: Depression, or irritability, which is a significant change in mood for an extended period of time associated with loss of interest in usual activities, sleep and eating disorders, and withdrawal from family and friends.
21.Anxiety, Feeling Ill at Ease
Anxiety can be a vague or intense feeling caused by physical or psychological conditions. A feeling of agitation and loss of emotional control that may be associated with panic attacks and physical symptoms such as rapid heart beat, shortness of breath and palpitations. The frequency of anxiety can range from a one-time event to recurring episodes. Early diagnosis may aid early recovery, prevent the disorder from becoming worse and possibly prevent the disorder from developing into depression. Click here for more information about Anxiety.
A significant change in mood for an extended period of time associated with loss of interest in usual activities, sleep and eating disorders, and withdrawal from family and friends. "Occasional irritability is a normal part of being human," says Paul Horton, M.D., a psychiatrist in Meriden, Connecticut. "But irritability also can go hand in hand with almost any illness. Very often, people who are falling ill will become irritable but don't know why."
If your irritability persists more than a week and is adversely affecting your job performance and relationships with your family, friends and co-workers, better see your doctor. Click here for more information about irritability during menopause.
23.Panic Disorder, Feelings of Dread, Apprehension, Doom
A significant and debilitating emotional state characterized by overwhelming fear and anxiety. These feelings can be vague or intense caused by physical or psychological conditions. The frequency can range from a one-time event to recurring episodes. If your life is totally disrupted by this symptom, better contact your doctor. Click here for more information about panic disorder during menopause
Pain, soreness, or tenderness in one or both breasts often precedes or accompanies menstrual periods but can also occur during pregnancy, breast-feeding, and menopause. It can be resumed in a generalized discomfort and pain associated with touching or application of pressure to breast. Consult your doctor if the pain is severe or persists for two months or more, also if the breast pain that is accompanied by a breast lump or nipple discharge. Click here for more information about Breast Pain. Also it is important to read about Breast Tenderness.
25.Headaches during Menopause
Though headaches can be caused by a variety of factors such as muscle tension, drinking too much alcohol or can occur with common illnesses such as the flu.
26.Aching, Sore Joints, Muscles and Tendons
Aching Joints and muscle problems is one of the most common symptoms of menopause. It is thought that more than half of all postmenopausal women experience varying degrees of joint pain. Joint pain is basically an unexplained soreness in muscles and joints, which are unrelated to trauma or exercise, but may be related to immune system effects mostly caused by fluctuating hormone levels. It is not wise to ignore these aches and pains. Early treatment can often bring about a cure and prevent further development of arthritis. Getting plenty of rest, using herbal aids, eating nutritious foods, preferably organic food, fruits and vegetables-and avoiding known toxins and stimulants, are healthy strategies for fighting joint pains. Click here for more information about joint pain during menopause
27.Burning Tongue, Burning Roof of Mouth, Bas Taste in
Mouth, Change in Breath Odor
Burning mouth syndrome is a complex, vexing condition in which a burning pain occurs on your tongue or lips, or over widespread areas involving your whole mouth without visible signs of irritation.
The disorder has long been associated with a variety of other conditions, including menopause. It affects up to 5 percent of U.S. adults, women seven times more often than men. It generally occurs after age 60. But it may occur in younger people as well. If you have persistent pain or soreness in your tongue, lips, gums or other areas of your mouth, see your doctor. Click here for more information about burning tongue during menopause
28.Electric Shock Sensation Under the Skin And In The Head
A peculiar "electric" sensation, or the feeling of a rubber band snapping in the layer of tissue between skin and muscle, that may be related to the effect of fluctuating estrogen levels on nerve tissue. It can also be the precursor to a hot flash. If the symptom gets intense, contact you doctor for further assistance. Click here for more information about electric shocks during menopause.
29.Digestive Problems, Gastrointestinal Distress,
Indigestion, Flatulence, Gas Pain, Nausea