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There are a lot of misconceptions and misinformation about perimenopause and menopause. Let’s get to the facts!
What is Perimenopause?
It’s also known an menopause transition or climacteric, and is the gradual change from getting periods, to not getting them.
Contrary to popular belief, this doesn’t happen immediately, but there’s a normal transition period where you have symptoms of menopause, but also still have periods.
As far as hormones go, the ovaries gradually rebalance their estrogen and progesterone production in preparation menopause. Basically, it’s a serious drop in estrogen.
What are the Symptoms of Perimenopause?
- Changing periods (period length, time between cycles, intensity, etc)
- Skipped periods, with a longer duration of time between them until they eventually stop (Menopause)
- Spotting, including brown blood
- Changes in discharge, including intensity, duration and time of cycle
- Hot flashes and night sweats
- Fatigue or anxiety
- Decreased sex drive, vaginal dryness, and breast tenderness
- Increased symptoms of Pre Menstrual Syndrome
- Mood swings including depression and anxiety
- Hormone related headaches
- Urine leakage
- Aches and pains
- Weight gain
- Changes in menstrual cramps (including all month)
Find out more here: What are Perimenopausal Signs and Symptoms?
Learn More about Perimenopause
How is Perimenopause Diagnosed?
Your doctor is likely to make a diagnosis based on your age and symptoms.
Or, a blood test can be done to check your hormone levels. However, hormone levels vary considerably from day to day so this isn’t really the most accurate measure.
Perimenopause: When to See a Doctor?
When you start to notice symptoms of perimenopause, it’s a good idea to check in with your family doctor. You can discuss the severity of things like hot flashes, and changing periods and find out if things like Hormone Replacement Therapy are right for you.
In addition, just because you’re approaching menopause, doesn’t mean that every single change that happens with your period is related to that. It is still entirely possible to have a wide range of other medical conditions, some serious, some not.
If you notice your period getting longer or shorter, heavier or lighter, or your cycle length changing, check in with your doctor. Or, if something just seems not quite right.
What Age Does Perimenopause Occur?
According to research, it can take place several years before menopause. Because the average age of menopause is around 50, it often takes place in the mid 40’s.
For early menopause, perimenopause can happen in the late 30’s or early 40’s.
Learn more here: Menopause Age Range.
How Long Does Perimenopause Last?
Most people find that they have symptoms for 4-8 years before menopause, although it can stretch as long as 10 years.
It officially ends when you’re gone 12 months without having a period. Congratulations! You’ve now reached menopause.
Learn more here: Perimenopausal Stages.
When do periods stop? The average age is 51.5, but it largely depends on when your mother went through menopause.
When does perimenopause end, and menopause start? It’s a great question, but there’s no easy answer because everyone is different! Some people experience only a couple years of perimenopause, while others have 10 years worth of it.
However, one of the surest signs that menopause is approaching is when you start to have periods that are further and further apart. Menopause officially begins when you don’t have a period for a year.
Is there a Way to Prevent Periomenopause?
Is there anything I can do to prevent menopause? The easy answer is no! There really isn’t much you can do because it’s a natural thing. It’s the same as how you have no control over when you get your period.
What you can do is manage your symptoms when they do happen.
For most people, it’s just a natural process and not something that needs to be medically treated.
However, around 10% of people experience some terrible symptoms such as extreme hot flashes and require HRT (hormone replacement therapy). But, this is only for the exceptional cases and shouldn’t be the norm. Most people are able to make this transition without medical intervention.
Medical Treatment Options
Some of the treatment options include:
- Low-dose birth control pills (for a short time)
- Birth control skin patch
- Vaginal ring
- Progesterone injection
Natural Treatment Options
There are some things you can do to help yourself feel better, without HRT:
- Not smoking
- Sleeping more, and more regularly
- Less alcohol
- Maintaining a healthy weight
- Enough calcium in your diet
Natural Remedies for Perimenopause
There are a number of natural treatment options you could consider to deal with perimenopausal symptoms. They include:
- Ginseng, which has been shown to improve sleep
- Black Cohosh is a popular natural remedy that people have been using for years to deal with menopausal symptoms
- Soy, which contains estrogen can help you deal with the decreasing amounts your body is now making
- Vitamin D. When your body stops producing as much estrogen, you’re at a higher risk of Osteoporosis. Vitamin D helps to make your bones stronger
- Wild yam, which helps to mimic the effects of estrogen in your body
- Dong Qua, a Chinese medicine which is reputed to help with hot flashes
You can learn more here: Supplements to Consider for Perimenopause.
Learn more about natural treatment options here:
Periods During Perimenopause
Can I still get my period during perimenopause? Yes! You will get them, but they will probably be more irregular than you’re used to. You’ve officially begun menopause when you haven’t had a period for 12 months.
Although irregular periods are normal during this phase of life, there are some things that can indicate a more serious problem. They include:
- Periods are very heavy, or include blood clots
- They last several days longer than normal
- Spotting between periods
- Spotting after sex
- The length between cycles gets shorter
- The actual period length gets shorter (3 days instead of 5 for example)
More information about this here: Everything you Need to Know about Perimenopausal Periods.
What Period Protection Should I Use?
If your periods start to become very light, or irregular, tampons may not make the best choice. You might consider switching to a menstrual cup, cloth pad or pantyliners. Here are a few reasons why:
- You can use a menstrual cup before your period
- Menstrual cups can be left in for up to 12 hours
- They come with a lower risk of toxic shock syndrome than tampons
- They contain no toxic chemicals, unlike some popular brands of tampons
More information about menstrual cups here:
Or, just check out our top-rated cup, the Lena Cup over on Amazon:
What about Perimenopause and Weight Gain?
Many people gain some weight during the period before menopause. Part of it is the natural aging process, but part of it is related to changing hormonal levels.
Find out more here: Weight Gain and Perimenopause.
Can I Get Pregant During Perimenopause?
The ovaries are still producing eggs during this life phase, so you can get pregnant. It’s recommended that you use birth control, or other form of protection for at least a year after getting your last period.
The general rule? You still have a period? You can still get pregnant! Learn more here:
Are Perimenopause and Premenopause the Same?
A common question that people have is whether perimenopause and premonpause are the same things. We mean, aren’t they just two words that describe basically the same thing? Let’s find out!
What is Premenopause?
This stage of life is when you may have some hormonal changes going on in your body, but you’ll have no noticeable changes or symptoms.
You’ll still have periods that are similar to what they have been in the past, and are still able to get pregnant
What is Perimenopause?
Perimenopause is when changing hormones cause you to have symptoms such as hot flashes, mood swings, insomnia, etc.
You will still have periods, and are able to get pregnant, but it will be quite difficult.
Are Perimenopause and Menopause the Same?
A common question that people have is whether or not the terms, Perimenopause and Menopause can be used interchangeably.
Technically, they are different things. Perimenopause is the periods of time before menopause. It’s characterized by fluctuating hormones and symptoms resulting from this. It generally lasts for 4-10 years.
Menopause is when menstruation ceases. Periods will get further and further apart during perimenopause. Once they stop for 12 months, you’ve officially entered into menopause.
Is it Possible to Delay Perimenopause?
Okay, so you’re trying to get pregnant, and want to delay menopause as long as possible. Is there any way to delay perimenopause, and eventually menopause?
In general, no. Although some things like smoking have been shown to cause a slightly early menopause. However, genetics plays a far bigger factor in this than anything you can do, or not do. Learn more about that here: Menopause Age Range.
There are even some people who go through menopause far earlier than normal. Find out more here: Early Menopause FAQs.
Do Men Go Through Perimenopause and Menopause?
It all seems so unfair! Women have to go through perimenopause with hot flashes, weight gain and moodiness, but men don’t have to.
But, there is a well documented phenomenon known as Andropause, or more commonly known as Male Menopause.
You can learn more about it here:
Perimenopause and Depression
What is Perimenopausal Depression?
There have been numerous studies that associate perimenopause with depression, in addition to the depreciation of existing depressive symptoms.
According to the studies from the early 2000s, that were published in the Archives of General Psychiatry, it was documented that women undergoing the transition to menopause were twice as likely to be diagnosed with major depressive disorder (MDD) than the ones who did not enter this phase yet.
In the same batch of studies, it was found that perimenopausal women were four times more likely to develop depressive symptoms than those not going through perimenopause.
Hot Flashes? You’re More Likely to Experience Depression
Those women who have had constant hot flashes were reported to have an increased likelihood of depressive symptoms. Other women who are at a higher risk for depression include those who:
- Have been having antidepressants
- Haven’t given birth
There are even more studies that have determined the link between perimenopause and depression.
Perimenopausal Depression Signs And Symptoms
Even though MDD is a grave condition, it is possible to manage it with the right treatment. Whether you’re going through perimenopause or something else, the symptoms of the disorder may include:
- Reduced cognitive function
- Lack of energy or fatigue
- Decreased interest in hobbies or other activities
- Feelings of helplessness, hopelessness or worthlessness.
Other symptoms associated with perimenopausal depression may include:
- Tearfulness or crying without reason
- Mood swings
- Intense despair
- Elevated anxiety
- Night sweat or hot flash-related insomnia
Learn more about Anxiety and Depression During Perimenopause
Risk Factors for Depression Before Menopause
There are some studies that one of the risk factors of depression include the fluctuation of the female hormone estradiol. But, there are various other factors that result in perimenopausal depression.
In 2010, several studies concluded that perimenopausal women with no previous history of depression were two or four times more likely to develop depression than women in the premenopause phase.
Other symptoms in the review included impact on sleep patterns and hot flashes.
During the perimenopause phase, women go through a number of common stressful life events such as job loss, divorce or the death of a loved one. As such, these events serve as triggers to depression.
Numerous other factors that are associated with perimenopausal depression may include:
- A previous history of violence or sex abuse.
- A family history of depression
- Severe menopausal symptoms
- Negative feelings regarding menopause and aging
- Social isolation
- A sedentary lifestyle
- Sadness in not being able to have more children
- Low self-esteem
Mood And Hormones During Perimenopause
Lots of perimenopausal women experience a slew of mood swings during their phase and can be linked to fluctuating hormone levels.
For instance, when the estrogen fluctuate, the brain’s norepinephrine and serotonin levels are affected. Dopamine, serotonin and norepinephrine are essential brain chemicals that have a direct affect on your mood. They can reduce anxiety, make you happy, improve your sleep and more.
When the chemicals are balanced, you experience a general state of calm and well-being.
Hormone imbalances, like when your progesterone levels are falling whereas estrogen is rising can limit the ability of norepinephrine and serotonin to function as effective neurotransmitters.
Eventually, this leads to mood swings that result in depression.
The Effect Of Depression On Perimenopause
The relationship between depression and perimenopause is complex at best.
Apart from the effects of perimenopause causing depression, a 2003 study revealed that depression itself can lead to an early start to perimenopause.
The study showed that women with certain symptoms of depression in their late 30s and early 40s have an increased chance of entering perimenopause before their 45th birthday than women without any prior depressive symptoms.
However, the research could not conclude whether early perimenopause led to early menopause, or if it simply extended the duration of perimenopause.
In both perimenopause and menopause, lower estrogen levels are linked to other health risks such as:
- Heart attack
- Impaired cognitive functioning
According to the study, women who took antidepressants were three times more likely to enter early perimenopause than those who did not.
Other Side To Antidepressants and Perimenopause
Even though antidepressants are associated with an early start to perimenopausal depression, they can also help relieve one of its most uncomfortable symptoms.
According to a 2011 study, escitalopram (Lexapro) lowered the severity of hot flashes as well as their occurence by half compared to a placebo.
Escitalopram belongs to selective serotonin reuptake inhibitors (SSRIs), which is a group of drugs.
Lexapro, according to the study, is three times effective for relieving depressive symptoms as compared to hormone replacement therapy (HRT). Also, only 31% of women who received HRT, were said to have been relieved of their hot flashes while there was a 56% relief for those who took lexapro alone.
This finding brings a positive light for those who were worried about the 2004 study that found HRT increases the risk of stroke and heart attack.
Even though it is not known why escitalopram works, the findings reported no “serious adverse effects” on the woman who participated for the study.
Side-Effects of Antidepressants
Still, antidepressants have their own side-effects, like:
- Stomach problems
Home Remedies for Perimenopausal Depression
Other than antidepressants, various home remedies and lifestyle changes may help deal with perimenopausal depression.
It is crucial to get an appropriate amount of sleep between 7-9 hours. So be sure to adopt good sleeping habits such as going to bed at the same time in a cool, dark and quiet room. Also, avoid using electronics or they will keep you from sleeping.
Regular physical activities or exercise can release endorphins and serotonin into the body.
When these chemicals increase, they can help those who currently have depression or prevent it before it takes a hold of you.
The valerian plant has also been very useful in dealing with perimenopausal depression. It may reduce hot flashes and also help you sleep better.
Mindful breathing exercises like meditation or yoga can help reduce anxiety. One of the most useful techniques involve being attentive about your body’s response to natural relaxation as you breathe in slowly from the abdomen and then exhale.
Doing this routine for 15 minutes a day can reduce your stress levels.
B vitamins are essential for the emotional and mental well-being of perimenopausal women:
- B-1 (thiamine)
- B-3 (niacin)
- B-5 (pantothenic acid)
- B-6 (pyridoxine)
- B-9 (folic acid)
- B-12 (cobalamin)
There are some studies which show some promising results for supplements to help deal with symptoms related to fluctuating hormones during perimenopause.
Perimenopause and Anxiety
Perimenopause refers to the transitional phase in which the body undergoes several physical changes before the final menstrual period. These changes lead to factors such as hormone changes, sleep problems, life stresses, irregular periods, and infertility that contribute to a number of issues including anxiety.
Menopause usually occurs when a woman hasn’t had a period in the last 12 months. Some symptoms of perimenopause carry over to menopause but occur less frequently.
How Common is Anxiety During Perimenopause?
Some studies indicate that 23% of women experience anxiety during perimenopause and that anxiety symptoms are not the same as depression.
While it is normal to feel depressed or anxious when perimenopause starts, frequent and severe feelings of panic attacks or anxiety are not usual symptoms of menopause.
Menopause And Anxiety
Because of experiencing the loss of fertility during menopause, some women feel troubled or sad. On the other hand, some women feel relieved that they are no longer have to bear the burden of pregnancy.
Apart from that, women may undergo several other life changes during their perimenopausal years, such as their children leaving home, their parents or husbands becoming unwell due to aging. These are potential factors that eventually lead to accelerated feelings of anxiety.
During perimenopause, hormonal changes can also contribute to feelings of anxiety. This includes changes in the levels of estrogen and progesterone which can have an impact on a woman’s mood swings.
However, these symptoms may leave at the end of perimenopause and when women enter postmenopause, the hormones become more balanced.
Anxiety and Depression Before Menopause
Treatment for Anxiety During Perimenopause
There are a number of treatment options you might consider. Consult with your doctor for the best option for your specific situation.
Hormone Replacement Therapy
It is quite common for women who are going through menopause to receive hormone replacement therapy (HRT) as well as other treatments for menopause symptoms. However, it is important to consult a doctor first before opting for this treatment as it may not be suitable for some women.
If a perimenopausal woman is experiencing high levels of anxiety, her doctor may prescribe her medication to treat it. However, this is not always necessary. Sometimes, a doctor may also recommend counselling.
A popular type of antidepressant known as selective serotonin reuptake inhibitors (SSRIs) may be prescribed for women who have moderate-to-severe levels of anxiety.
Even though SSRIs are quite effective in treating symptoms of anxiety, North American Menopause Society states that half of those who use these antidepressants experience side effects that may affect their sex life. These side effects include trouble maintaining arousal or achieving orgasm and reduced libido.
That’s why there are antidepressants for women who experience sexual SSRI side effects, like newer ones such as duloxetine and bupropion.
Older antidepressants such as monoamine oxidase (MAO) inhibitors and tricyclic antidepressants have no link to sexual dysfunction. But they can still cause other side effects.
To reduce the side effects of the antidepressants for those who experience sexual dysfunction, it is recommended they take lower doses. But before doing this, women must consult their doctors first as stopping medication can have severe consequences.
Lifestyle Changes to Treat Perimenopausal Anxiety
Doctors have recommended women with perimenopausal anxiety to follow a healthy lifestyle in order to reduce the symptoms of anxiety and panic attacks.
One of most suitable ways of reducing anxiety significantly is regular and gentle exercise. Those with perimenopausal anxiety should pick out their favorite type of exercise and make a daily routine out of it. It doesn’t matter whether it’s walking, running, yoga or swimming, exercising on a regular basis can burn away nervous energy and improve symptoms of anxiety.
Drinking too much caffeine or alcohol is not advised as the former can trigger nervousness and anxiety, while the latter is a depressant that can aggravate the underlying causes of anxiety.
Acupuncture can also be effective in reducing as well as treating other symptoms of menopause. Check with your extended health plan. You’ll often find that this kind of treatment is covered.
Get Enough Sleep
A good long uninterrupted sleep is also useful in reducing anxiety. But women going through menopause may have troubles because of night sweats caused by surges in hormones.
During these times, women may find keeping a ‘pre-sleep journal’ can help improve their sleep. With these journals, the women can write down any of their nervous thoughts so that their minds can rest easier.
Support groups for women going through perimenopause and menopause can also be helpful. Women with similar problems can get together to discuss and share the problems that they’re going through to better cope with their anxiety.
Even if a woman who is going through menopause does not want to join a support group, then talking about it with her closest friends can also be very helpful.
Take Time for Yourself
It is important for perimenopausal women to take time out for themselves. To be frank, we mean engage in what they usually do in their leisure time like reading, gardening, meditating and yoga are all great examples to attain relaxation and self-awareness.
Supplements During Perimenopause
There are some supplements that you might consider taking to help you deal with mood swings due to hormonal changes during perimenopause.
However, studies are a bit inconclusive, so also be sure to check in with your doctor instead of relying solely on them.
How to Deal With a Panic Attack
Women who have had prior panic attacks are more likely to experience panic attacks during perimenopause. Doctors assume that panic attacks are a reaction to instead of being a symptom of menopause.
When a person experiences a panic attack, they harbor intense feelings of anxiety or “doom.” These feelings are usually followed by physical symptoms such as:
- Shortness of breath
- Heart palpitations
- Tingling sensations
Panic attacks usually last for about 10 to 30 minutes but they can also last for hours if they recur in a series of episodes.
Many who experience their first ever panic attack worry that they might be having a nervous breakdown or even a heart attack. It goes without saying that panic attacks are one of the worst experiences of a person’s life.
What to do if you have a Panic Attack
If you have a panic attack, go see your doctor right away. They may be able to prescribe some appropriate medication for you or refer you for mental therapy, which may also help.
Practising mindfulness techniques can also help prevent panic attacks for some people. With these techniques, practitioners are able to focus on the symptoms and thoughts that bring about a panic attack so they can be properly managed.
Irregular breathing can trigger panic attacks, which is when you breathe more than your body lets you or breathing too quickly. That is why you should learn breathing exercises as they can help lower your chances of a panic attack.
Have your Say about Perimenopause!
And questions or thoughts? Leave a comment below and let us know. We’d love to hear from you.