What is Peri-menopause?

Preparing for “the change.”

As we said, menopause is a process. Perimenopause is part of the process. Perimenopause begins with your first menopausal symptoms (for example, hot flashes, night sweats, mood swings, insomnia) and ends when you reach full menopause, which is when your periods have completely stopped. As with other health issues affecting women, it’s better to be well-informed about health conditions that may affect you. Learn all you can about the process of menopause and perimenopause. Be aware of changes in your body so you can work with your health care team. Your health care professionals understand the process of menopause, it’s symptoms, and the risks and benefits of your treatment options.

When will menopause happen to me?

Average age is 51

We can’t predict when menopause will occur for any individual, but we can give you some facts about when it might happen. It might begin as early as age 35 and end as late as age 58 or later. Most of us will fall somewhere in between. The average age for menopause, that is, the completion of the perimenopause years, is 51. Perimenopause usually lasts about six years.

Also, there are some general factors that may affect you when menopause occurs. Some of these factors seem to make sense; some don’t.

Menopause may be earlier than average for women who:

  • are thinner and smaller-boned
  • are caucasian
  • have never had children
  • smoke
  • live at higher altitudes
  • have shorter than average menstrual cycles (that is, fewer than 25 days)
  • have suffered from poor nutrition most of their lives
  • have enjoyed a higher standard of living
  • have had a hysterectomy, tubal ligation, or several abortions

Menopause may be later than average for women who:

  • are heavy or big-boned
  • have had several children or have had a first child after age 40
  • are African American
  • are non-smokers
  • have been on birth control pills for many years
  • live at sea level
  • are ill, especially with cancer of the breast or uterus, fibroids in the uterus or diabetes

We also know there is no evidence linking how early or late you began having periods with how early or late you will begin menopause. However, there may be somewhat of a relationship between when your mother started menopause and when you will start menopause. In any case, it will happen when it happens. Don’t worry about it. The point is to learn all you can about it so you can make the right treatment choices for you.

What happens during peri-menopause and menopause?

Estrogen levels and egg production slows, then stops.

Before perimenopause, each month your ovaries release an egg and secrete estradiol, the body’s natural form of the hormone estrogen. The estrogen causes the lining of the uterus to thicken in anticipation of receiving a fertilized egg. If the egg is not fertilized, the lining of the uterus is “sloughed” off, resulting in your period. During perimenopause your ovaries start to run out of eggs and estrogen production decreases. During this time your periods may vary. You may have heavier periods, lighter periods, skipped periods, etc. Changes in your periods are one of the signs that the process of menopause has started. Although uncommon, some women’s periods can stop completely during perimenopause. When the production of estrogen stops completely, the uterine lining doesn’t thicken each month, and there is nothing to slough off as a period. When your periods have completely stopped for at least a year, you have reached menopause.

Estrogen also gives us our female traits such as a high voice and breast development. Estrogen helps maintain the tissues in our breasts, bones, skin, bladder, and vagina. When estrogen levels drop, you will begin to have changes in your breasts, bones, skin, bladder, and vagina. These changes can cause the symptoms listed next.