Oh no, could this really be perimenopause?

What’s going on? Your period has become whacky, and so have your moods. Your stomach feels fat, and your memory seems flat. Could it possibly be perimenopause?

Perimenopause is the transition time between your normal menstrual cycles and the final, permanent ending of your periods, called menopause. (You have reached menopause after an entire year without a period.)

In perimenopause, there are several symptoms that result from big changes going on with your hormones:

  • Decreasing estrogen, which can cause hot flashes, night sweats, vaginal dryness, poor sleep and even migraines in some women
  • Decreasing progesterone, which can cause heavier and longer periods
  • Changes in mood, memory, concentration and libido, which are less well understood, but thought to be caused by a combination of factors, such as poor sleep and discomfort from hot flashes in addition to changing hormones

Your periods definitely may seem irregular. Initially, in perimenopause, they start arriving closer together. Then, as you spend more time in perimenopause, the cycles grow further apart. You may even go several months without a period — only to have a heavy one that lasts for weeks.

Don’t be alarmed; most likely this irregularity is the result of not ovulating. Your body has had a drop in progesterone, which is the hormone your ovaries make after ovulation and that regulates your menstrual cycle.

It’s a good idea to talk to your doctor if your period is irregular, very heavy or lasts more than a week. Heavy or long periods could lead to anemia, and might also indicate more serious problems like fibroids, polyps or cancer.

Have a conversation with your doctor about how to cope with hot flashes if they are causing discomfort. A hot flash is a feeling of warmth, usually in the upper body, that begins when you least expect it and lasts less than five minutes. You might break out in a sweat, have a racing heartbeat or even feel anxious. It may be scary, making you wonder what’s going on. Blood vessels in the skin are dilating, causing warm blood to rush to the skin surface. Antidepressants can reduce the vessel dilation that causes hot flashes. As an extra benefit, your mood and sleep could improve.

Another alternative is hormone therapy, which can be highly effective for hot flashes, but not a treatment recommended for all women. Weigh the risks and benefits with your doctor. If you have a family history of breast cancer, for instance, this might not be a good option for you.

The Good News

Treatment for perimenopausal symptoms can be tailored to your individual needs. With your doctor’s help, your symptoms can be reduced, no matter how serious or mild they are. Find a doctor with whom you feel comfortable discussing any and all concerns.

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