A Guide to Navigate Perimenopause

Perimenopause is the transitional time around menopause. Menopause is when a woman's periods stop, the cutoff being no periods for a whole one year. It's marked by changes in the menstrual cycle, along with other physical and emotional symptoms. This time can last 2 to 10 years. During this time:

• Releases eggs less regularly
• Produces less estrogen and other female hormones
• Becomes less fertile
• Has shorter and more irregular menstrual cycles

What causes perimenopause?

Perimenopause is a natural process caused when your ovaries gradually stop working. Ovulation may become erratic and eventually stops. The menstrual cycle lengthens and flow may become irregular before your final period.

Symptoms are caused by the fluctuating levels of hormones in the body. When estrogen is higher, you may have symptoms like you might have with PMS. When estrogen is low, you may experience hot flashes or night sweats. These changes may be punctuated with normal cycles.

What are the symptoms of perimenopause?

Each woman experiences perimenopause in a different way. The most common symptoms are:

• Mood swings
• Changes in sexual desire
• Trouble concentrating
• Headache
• Night sweats
• Hot flashes
• Vaginal dryness
• Sleep issues
• Joint and muscle aches
• Frequent urination
• PMS-like symptoms

How is perimenopause diagnosed?

Symptoms of perimenopause overlap with those of several other medical conditions. Your symptoms, medical history, age, and a physical exam is helpful in the diagnosis. You may also be advised blood tests to measure your hormone levels, mainly FSH.

How is perimenopause treated?

Perimenopause need to be treated unless symptoms are disrupting patient's day-to-day life. Treatments may include:

• Hormone therapy using estrogen or estrogen and progestins to level out hormone levels
• Antidepressants to stabilize moods

However, your doctor will always advise lifestyle changes as a first measure:

• Eat a healthy diet with fruits and vegetables and whole grains.
• Get at least 1,000-1,200 mg of calcium each day through your diet or supplements.
• Exercise for a minimum of 30 minutes for 5 days a week. Focus on strength training
• Find what triggers your hot flashes (for example, alcohol, coffee or tea) by keeping a record.

Remember, perimenopause is a natural process but may need medical assistance to make your transition smooth. Talk to your Gynaecologist about different available treatments, their side effects and actual need before starting any medication.