What is Pre-menopause?

A woman’s body is always undergoing transitions in terms of fertility and hormone levels, from the time of puberty until after menopause, and on a smaller cyclical scale of menstrual periods.

Fertility usually peaks during a woman’s mid twenties, and in her late thirties this fertility begins to diminish. Fertility begins to diminish around this time because the body begins to produce less progesterone.

Menopause, however, does not technically occur until a woman has gone twelve full months without getting a period. So what do we call the time between when fertility begins to diminish and when it is extinguished? Broadly speaking, this period of time is called perimenopause or pre-menopause.

This should be considered a broad term because it covers a broad period of time. While the conclusion of this phase is clearly defined as twelve months after a woman’s last period, its inception is inherently vague and subjective. Perimenopause, as pre-menopause is usually called, begins when a woman starts to experience certain symptoms which are associated with a diminishing production of the hormones estrogen, progesterone and testosterone.

Perimenopause is defined as the transitional phase in which a woman goes from her normal menstrual cycle to having no periods at all. This transition often takes over five years, and it can sometimes take over ten.

The first signs of perimenopause can be hard to spot in isolation, but are made easier to identify by the fact that the symptoms usually occur after a woman has turned forty. It is not necessarily true that a woman who has perimenopausal symptoms before the age of forty is experiencing premature menopause.

Premature menopause occurs when true menopause, marked by twelve months without a

period, sets in before a woman turns forty. The transition into perimenopause often begins in a womans' late thirties or forties.

The signs of perimenopause can be divided into two sorts: one is a symptom of the body adjusting to a changing level of fertility, and the other is a symptom of diminishing fertility. In other words, some things that you experience during perimenopause are characteristic of a person who is post-menopausal. Other things, however, you will only experience during this transition period known as perimenopause.

Some women’s bodies have very strong symptoms during this period, while other women barely seem to notice the transition. This difference is comparable to the morning sickness that keeps some women in the bathroom for three months, while other women bear children without experiencing any nausea at all. Every woman will experience perimenopause differently, just as she has experienced reproductive cycles that are also different from those of other women.

The most infamous symptom of perimenopause is the hot flash. Hot flashes can range from the feeling of a blush to a full body sweat; they can be uncomfortable or unbearable. Hot flashes know no hours, and night sweats can wake some women out of a dead sleep because of their intensity. Hot flashes, thankfully, are only a symptom of the changes that your body is going through during menopause and will diminish as you actually approach menopause.

Most commonly, the earliest symptom of perimenopause is an irregular period. This, unfortunately, is a hard change to articulate because it, like other symptoms, is different for different women. However, there are a few characteristics that are notably different about a woman's menstruation cycle during perimenopause. Periods often become erratic during this time, coming either closely together or with more time than usual spaced between periods. Some, not all, women get spotting between periods during perimenopause.

Some women also begin to miss periods because of perimenopause, although a missed period can be caused by other reasons as well, such as stress for some women

Periods during perimenopause can also be either unusually heavy or unusually light, and likewise can last for a longer or shorter number of days than is usual. This, of course, is not particularly helpful advice for someone who does not have a very regular menstrual cycle against which to compare any changes. During perimenopause, and even when periods are spaced far apart, it is still possible for women to get pregnant.

Another hard-to-pin-down symptom of perimenopause is a fluctuation in mood, similar to PMS. Perimenopausal mood changes, however, do not come in relation to the onset of a period, however. Like PMS, these mood changes are caused by varying levels of hormones produced by your body. As your body begins to transition into menopause, hormone levels are prone to rise and fall, making this period potentially unstable emotionally. This symptom may be particularly aggravated when conjoined with other perimenopause symptoms, such as hot-flashes.

Women begin to produce less estrogen during perimenopause, and estrogen production continues to diminish into post-menopause. This leads to thinner skin and thickening of the waist. A lessening of estrogen also results in vaginal tissues becoming less lubricated and also less elastic. This can make sexual intercourse uncomfortable without artificial lubricants.

Pre-menopause, marked by a wide and varying array of symptoms, marks a woman’s transition out of her fertile reproductive years and into menopause. Symptoms of pre-menopause may be uncomfortable, but they usually disappear in post-menopause. Having overcome the hot flashes, mood swings and poor sleep of perimenopause, many women take joy in their postmenopausal years.

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