Perimenopause is a transition between the reproductive years of a woman and menopause. Onset of menopause normally occurs in women of 40’s, but it can start as early as age 30. Onset of perimenopause is marked by irregular menstrual cycles. Irregular menstrual cycles are a result of reduced ovarian function.
Menopause ends perimenopause. Perimenopause ends when there is absence of menstruation for 12 consecutive months.
Duration of perimenopause varies in women. Average period is 4 years. It can however occur for a few months or as long as 10 years.
The physical signs and symptoms of perimenopause are due to hormonal changes as women age. Declining oestrogen levels contribute mainly to the myriad of signs and symptoms experienced in perimenopausal age.
Signs and Symptoms of Perimenopause
- Hot flashes and night sweats
- Vaginal dryness
- Urine urgency and incontinence
- Uterine bleeding problems
- Sleep disturbances
- Mood swings
- Memory loss and difficulty in concentrating.
Hot flashes and night sweats
Up to 50% of women of perimenopausal age experience sudden waves of body heat that could last up to 10 minutes. These hot flashes usually occur in the night. Hot flashes affect the scalp, face, neck and chest. There is a variation in how women of perimenopausal age experience hot flashes.
Reduced oestrogen levels in late perimenopause can cause changes in the tone of vaginal muscles and tissues, making the vagina thinner and drier. This could lead to itching, irritation and pain during sexual intercourse. Painful sexual intercourse will result in reduced or loss of sex drive.
Urine urgency and incontinence
Just like the vaginal muscles and tissues, reduced oestrogen levels affect the bladder muscles and tissues. This leads to urine leakage when the woman coughs, sneezes or laughs.
Uterine bleeding problems
It’s not just oestrogen production that diminishes during perimenopause, progesterone production declines too. The resultant effect is that the endometrium, the walls of the uterus, becomes more thick before menstruation takes place. Such women therefore experience heavy menstrual bleeding due to the greater lining of the endometrium removed. Also due to the thicker endometrium, benign tumours of the uterus such as fibroids, and endometriosis are common in perimenopausal women.
It is pertinent to note that sleep disturbances are common to both sexes as we age. In perimenopausal women, sleep disturbances have been attributed to oscillations in the levels of the female hormones and also to hot flashes and night sweats.
During the perimenopausal age, the best predictors of mood changes are stress, overall health and any history of depression before perimenopause. Hormonal changes have not been directly linked to mood swings in perimenopausal women.
Memory Loss and Difficulty in Concentration
Aging is associated with loss of memory and concentration. Although hormonal changes during perimenopause contribute immensely to the signs and symptoms experienced by women in that phase, no study has been done to establish a direct link between hormonal changes in perimenopause, memory loss and concentration problems.
By Chinenye H.G Ofokansi