Have you noticed that your periods are different? Are you having problems sleeping? Do you feel very warm at times in the head and neck areas? Have you noticed subtle changes in your mood and memory? These changes may even be affecting your overall quality of life since you feel tired and may be short of patience with loved ones.
No, you are not losing your mind and you are not alone. You may be undergoing perimenopausal changes.
Not too long ago, a woman in her 40s who experienced these symptoms might have been told by her healthcare provider that she was too young to be menopausal, her symptoms were all in her mind, and perhaps she might benefit from a tranquilizer. Today, we know that these symptoms may be attributed to normal changes in a maturing woman’s hormonal axis — perimenopause.
Perimenopause Explained
Perimenopause is that time period which occurs approximately four to eight years before menopause occurs. The average age of naturally occurring menopause is 51.7 years and is defined by not having a menses for one year. Therefore, perimenopause typically occurs when a woman is in her 40s and still menstruating.
Menses Differs During Perimenopause
Every menstrual cycle is made up of two parts: the follicular phase, when your ovaries produce an egg; and the luteal phase, when the egg ovulates.
One of the first signs of reproductive aging is shortening of the follicular phase. Therefore, one’s menses may come a few days earlier than before. Also, ovulation does not always occur monthly, therefore, a woman’s uterine lining may not shed appropriately with a normal menses. Instead, she may experience irregular bleeding. It is important to discuss any bleeding changes with your healthcare provider so that they are addressed appropriately. Since ovulation does not occur every month, there may not be sufficient progesterone in your body to prevent abnormal growth of the uterine lining, which, if unchecked, could potentially even lead to uterine cancer.
Sleeping Difficulty, Hot Flushes and Mood Swings?
If you’re experiencing these symptoms, you may be perimenopausal. As ovaries age, there are fewer functional eggs that produce estrogen. Your brain senses the decreased estrogen levels and sends increased levels of stimulatory factor (FSH). This causes eggs to develop and produce estrogen levels that are sometimes quite high, even higher than when a woman was in her 20s. The brain senses these increased estrogen levels and, as a result, sends lowered FSH levels the next month. This causes much lower estrogen levels. This resulting estrogen roller coaster is responsible for the hot flushes, however subtle or blatant they may be. Hot flushes may then interfere with normal sleep patterns and cause exhaustion. When exhausted, you usually are not at the peak of mental sharpness and you may even be quite cranky.
However, it is important to discuss your symptoms with your healthcare provider and not blame everything on changing hormones! It is crucial that other possible causes, such as thyroid disease, be ruled out.
