Perimenopause (premenopause) is the approximately two- to eight-year period that the body spends preparing for the changeover into menopause. As a woman's ability to reproduce winds down, her estrogen and progesterone levels may fluctuate. The age that perimenopause begins varies, but it usually starts at some point in a woman's 40s.
Signs
Perimenopausal symptoms can be faint to quite obvious. Symptoms can include hot flashes, difficulty sleeping and irregular periods that may be longer or shorter in duration. Menstrual flow may be heavier than normal or scant and there may be fewer or more days between periods.
Emotional & Physical Symptoms
Mood swings are common during perimenopause, with some women having difficulty concentrating and feeling confused. As estrogen levels dwindle, vaginal dryness may occur and a woman may be more prone to vaginal and urinary infections. The risk of osteoporosis increases, making women more vulnerable to bone loss. A decline in estrogen can also increase LDL "bad" cholesterol, while HDL "good" cholesterol may go down. Thinning scalp hair and an increase in facial hair are also possible.
Diagnosing
Since perimenopause is a slow but steady transition, there is no definitive test or symptom that can make an absolute diagnosis. A doctor will consider age, symptoms and body changes as well as a woman's history of menstruation. In some cases doctors may test hormone levels. With the exception of examining thyroid function, hormone tests are not useful for diagnosing perimenopause.
Treatment
Oral contraceptives are frequently considered the most useful hormonal therapy for perimenopause regardless of whether they are used for birth control. Progestin therapy may help keep periods regular. An intrauterine device (IUD) that contains progestin may also offer relief from heavy menstrual bleeding.
Diet & Exercise
During perimenopause it's important to consume a diet rich in fruits, vegetables and whole grains. Because of the increased vulnerability to osteoporosis eat plenty of foods high in calcium (milk, cheese, yogurt) or consider taking a calcium supplement. Stay away from caffeine and alcohol since they can prompt the onset of hot flashes. A minimum of 30 minutes of exercise most days of the week can help a woman control weight, sleep better, elevate mood and keep bones strong.
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