Perimenopause is defined as the time period of 5-6 years before menopause actually occurs. A woman’s body undergoes multiple changes during this period, including fluctuating levels of Estrogen and Progesterone hormones. These changes require necessary adaptations in diet and lifestyle to alleviate any symptoms and hence complications.
During perimenopause, ovaries produce a lesser amount of oocytes because of aging. Menopause is a natural biological stage in every woman’s life! It marks the end of the fertile window and of the monthly menstrual cycle.
Technically, Menopause is defined as absence of menses for 12 or more months in a row. The average age of menopause is 51 years, hence perimenopause window usually starts from late 40s leading up to Menopause.
How your body is changing during Perimenopause?
Menopause is a part of life and not a disease! One should be aware of the changes their body is going through and adapt their diet and lifestyle accordingly. In majority of the societies in Asia and in native cultures, elderly women have been known to fare through perimenopause without any symptoms. Here is a list of the changes that occur before Menopause
Decreasing levels of hormones that have played a major role in functioning of the reproductive system till now. These hormones also play an important role elsewhere in body as the endocrine system, neural system, and in metabolic pathways.
- Follicle-stimulating hormone (FSH)
- Luteinizing hormone (LH)
During perimenopause, the ovaries reduce in size, and egg production slows down. Fluctuating hormone levels and irregular production of eggs results in irregular menses during perimenopause. This is also the reason for decreased fertility. While a woman may still get pregnant during this window (hence requiring contraception), the chances go down exponentially!
How does your Menstrual Cycle change during Perimenopause?
Fluctuating levels of the hormones and irregular production of egg affects the menstrual cycle during perimenopause. In fact, changes in menstrual cycle is one of the symptom of approaching menopause.
- Frequency of menstrual cycle lowers down
- Length of the cycle increases beyond 35 days or decreases from 21 days.
- Spotting or bleeding between periods.
- Heavier flow is observed
- Menstruation may extend beyond usual window of 2-5 days
Why does Menopause occur?
The loss of active ovarian follicles due to ageing is the primary reason for natural menopause! Ovarian follicles both produce and release eggs from the ovary wall, causing menstruation and fertility.
In some cases, menopause occurs due to injury or surgical elimination of the ovaries and associated pelvic structures. Some women also undergo induced menopause. Here are some causes of induced menopause:
- Ovarian ablation, or the ending of ovary function, which may be the result of hormone therapy, radiotherapy techniques, or surgery in women with Estrogen receptor-positive Tumors
- Bilateral oophorectomy, or surgical removal of the ovaries
- Pelvic radiation
- Pelvic injuries which seriously damage the ovaries
Complications associated with Perimenopause
Menopausal symptoms are an indication of imbalances in the body. A healthy menopause does accompany the changes in the body but the symptoms can very well be managed if one keeps their diet and lifestyle in place. Following complications may occur during perimenopause if the symptoms are not alleviated:
- Vulvo-vaginal Atrophy – Thinning, Drying, and Inflammation of vaginal walls.
- Slower metabolic function leading to obesity and water retention
- Dyspareunia or painful intercourse
- Osteoporosis, or weaker bones with reduced weight and strength
- Mood swings and sudden emotional changes
- Overactive bladder
- Periodontal disease
- Cardiovascular Disorders leading to heart failure
- Vaginal bleeding may cause the precancerous or cancerous condition of the uterus or endometrial lining.
Symptoms of Perimenopause
Women should consult a doctor for the confirmation of menopause when a woman has not had a menstrual period for consecutive 12 months. Usually, following symptoms are observed during perimenopause.
The first symptom of the onset of menopause is changes in the menstrual patterns. Some women have menstrual periods in every 2 to 3 weeks, whereas others will not have for months at a time.
Perimenopause is the stage which occurs 5-to-6-years before menopause. At this time, a woman’s estrogen levels fall drastically and ovaries are irregular in production of eggs. So, during this period, there are lower chances of becoming pregnant.
Due to aggravated Pitta Dosha, some women may experience hot flashes. It is an unexpected sensation of heat in the upper body around the face, neck, or chest. Feeling of sensation may move upward or downward.
The skin may look red and patchy, and a woman will have sweat. The heart rate of the woman may rise rapidly, or happen to be irregular. Women may experience hot flashes usually in the first year of their final period.
At the perimenopause stage dryness, itching, and discomfort of the vagina are felt. Thus, some women feel dyspareunia, or pain during sex. Low levels of estrogen are the main reason behind these symptoms. Lower estrogen also causes vaginal atrophy, thinning and shrinking of the vaginal lining tissues.
Hot flashes which occur during the sleeping time are known as night sweats. Most women say that the night sweats are for a few minutes.
An imbalanced Vata Dosha leads to disturbed sleeping patterns. Some women may observe anxiety, insomnia, reduced sleeping hours, or inability to fall asleep. Night sweats also disturb the sleeping cycle.
Excessive urge to urination or urinary incontinence may also be observed in some.
Management of the Symptoms
It is necessary to consult a doctor when one observes chronic symptoms that affect the normal functioning of their life. Often the symptoms observed during perimenopause trigger serious complications that needs medical intervention. The doctor will suggest appropriate treatment according to the severity of symptoms, medical history, and personal choices.
In menopause, Physical activity can help to prevent weight gain, decreases the risk of cancer, reduces osteoporosis, and improves the mood. There are certain exercises which can help to prevent urinary incontinence, strengthening the pelvic floor etc. Women can practice 3-4 times to make the symptoms under control.
- Researches show that omega-3 rich foods can reduce psychological distress including the mood swings.
- Due to reduced Estrogen levels, bone density starts to go down leading to joint pains, and often complications as Osteoporosis. Calcium rich foods and Estrogen rich foods should be consumed to prevent the same.
According to research, hypnosis is helpful in reducing the symptoms of menopausal hot flashes up to 74 percent. Additionally, deep breathing techniques, guided meditation, and progressive relaxation can improve the sleeping cycle. Meditation can reduce stress, hot flashes, and night sweats symptoms.
- Reduce the consumption of spicy food, processed food, sugary foods, and fried foods.
- Reduce or stop caffeine. Replace by herbal teas to calm down aggravated Doshas.
- Stop Alcohol and Smoking.
- Do not wear tight clothes.
- Stay sexually energetic to decrease vaginal dryness.
- Reduce stress and take enough rest.
- Sleep in a cool and comfortable temperature at night to reduce night sweats.
- Always go to sleep and wake up at the same time regularly or have enough sleep and to keep Vata in balance.
- Consume food at around same time, eat nutritious meals, and avoid overeating.