Pre Menopause
Pre menopause is more correctly referred to by the medical term perimenopause, although pre menopause is a completely accurate description. Perimenopause is a transition that eventually all women will go through. Usually the pre menopause phase lasts about 2 – 8 years. There are no exacts when it comes to pre menopause or menopause, because each women is physically and emotionally unique with different life style habits. Typically symptoms will begin to exhibit when women reach their mid 40’s, but a smaller percentage of women may get symptoms as early as their mid 30s.
Pre menopause marks the start of a women’s declining fertility. Once menopause is reached, a woman is completely infertile, but during pre menopause it is still possible to get pregnant. Menopause is the day a woman has her final day of menstrual bleeding, however it takes one full year with absolutely no bleeding to fully confirm menopause. The year it takes to fully confirm menopause is still considered perimenopause so a woman is still considered possibly fertile until the full year has elapsed.
Pre Menopause Symptoms
- Fluctuating hormone levels. During pre menopause hormone production become erratic, estrogen levels may be higher than normal or lower than normal. It’s these fluctuating hormones that are thought to be responsible for most symptoms.
Irregular periods. During pre menopause, it’s possible to have more or less periods with heavier or lighter flow. - Ovulation becomes erratic. During some menstruation cycles, a woman will still drop mature eggs to be potentially fertilized, this is called ovulation, and if this occurs it is possible to get pregnant. During cycles where ovulation does not occur, pregnancy is not possible.
- Hot flashes. This is the mostly commonly reported symptom during pre menopause and menopause.
- Night sweats. These are similar to hot flashes but more irritating because they sometimes result in insomnia. A lack of sleep can also increase stress level potentially exacerbating other symptoms such as mood swings and anxiety.
- Mood swings. Just like during PMS, this is also common during pre menopause. It’s not fully known if this is due to hormone fluctuations or other symptoms such as insomnia.
- Vaginal dryness and painful intercourse. This is due to a loss of natural lubrication and elasticity in the vaginal tissue.
- Drop in sexual interest. Generally if women had healthy sex lives before pre menopause this will continue past menopause if physical problems like the loss of vaginal dryness are overcome with vaginal lubrication.
- Osteoporosis. This is one of the long term risks associated with menopause, but the loss of bone density can begin to happen during pre menopause.
- Potentially dangerous cholesterol levels. During this phase, bad cholesterol levels (LDL) may rise while good cholesterol levels (HDL) may decrease; this increases the risk of heart disease.
- Depression and anxiety. A small percentage of women experience clinical depression or anxiety during pre menopause.
- Heart palpitations
- Tinnitus (ear ringing)
- Memory loss
- Formication . This is the sensation that insects are crawling under or on the skin or the sensation of pins and needles.
- Urine leakage. This usually happens during laughing or coughing.
- Bladder infections
- Joint pain
Pre Menopause Treatment
Pre menopause isn’t considered a medical condition needing treatment, however if the symptoms are serious enough, they may require treatment. Symptoms such as insomnia, hot flashes, night sweats, vaginal dryness, mood swings, depression and anxiety are all symptoms that may require medical treatment.
Up until recently, hormone replacement therapy (HRT) was widely used for symptoms associated with pre menopause, but widespread use of this treatment fell off after a study reported that it increased the risks of heart disease, breast cancer and blood clots. Now, the seriousness of the symptoms has to be carefully weighed against the risks of the treatment. In addition, because of the health risks associated with HRT, it is usually only prescribed for short time frames.
There are a few treatments available for hot flashes besides HRT, but these treatments aren’t specifically approved for the treatment of hot flashes, but some women have reported success using them for menopause related symptoms. Low dose antidepressants, Gabapentin (a seizure medication) and Clonidine (a medication used to treat high blood pressure) have all shown results in treating hot flashes, but once again, the risk/reward ratio has to be carefully weighed.
Vaginal dryness can usually be treated quite easily with over the counter vaginal lubricants. Depression, anxiety, and insomnia symptoms should all be discussed with a doctor. There are many well know treatments for these symptoms such as anti depressants and sleeping pills.
Diagnosing Pre Menopause
There are a few blood and urine tests that can help your doctor determine if you are entering into pre menopause, these tests include Estradiol, FSH, and LH.
At this time, your doctor may also conduct a bone density test to see if you’re at risk for osteoporosis.
