You're in your 40s, you wake up in a sweat at night, and your periods are erratic and often accompanied by heavy bleeding. Chances are, you're going through perimenopause.
According to WebMD, perimenopause, otherwise known as menopause transition, begins several years before the menopause. It’s the time when the ovaries gradually begin to make less estrogen.
Perimenopause is a process — a gradual transition. It can last for years. No one test or sign is enough to determine if you've entered perimenopause. Throughout this transition, some subtle — and some not-so-subtle — changes in your body may take place.
In case it's not glaringly obvious, these changes wreak havoc on you mentally and physically. You're exhausted. You worry you're becoming invisible. You're anxious that you're drying up.
Because no one really talks about perimenopause, those going through it don't really know what to expect. It can be a lonely and scary time. Read on to find out the 5 most common things you might experience during this important period of life.
#1 The age is not definite
It usually starts in a woman’s 40s, but can start in a woman’s 30s or even earlier. There’s more; the average length of a woman’s perimenopause is a staggering four years.
Perimenopause varies greatly from one woman to the next. The average duration is three to four years, although it can last just a few months or extend as long as a decade.
Perimenopause ends when a woman has gone 12 months without having her period. That, of course, is when the menopause we are significantly more familiar with kicks in.
Most women experience menopause between ages 40 and 58. The average age is 51.
#2 Your periods may be confusing
As ovulation becomes more unpredictable, the length of time between periods may be longer or shorter, your flow may be light to heavy, and you may skip some periods.
If you have a persistent change of 7 days or more in the length of your menstrual cycle, you may be in early perimenopause. If you have a space of 60 days or more between periods, you're likely in late perimenopause.
At one point, you may be confused by your body’s behavior that you think you might be pregnant. It turns out the symptoms of pregnancy are almost identical to the symptoms of perimenopause. Weight gain, breast tenderness, spotting – you might have them all.
As ovulation becomes irregular, your ability to conceive decreases. However, as long as you're having periods, pregnancy is still possible. If you wish to avoid pregnancy, use birth control until you've had no periods for 12 months.
#3 You may have hot flashes
These are the most common menopause-related discomfort. Most women don't expect to have hot flashes until menopause, so it can be a big surprise when they show up earlier, during perimenopause. They involve a sudden wave of heat or warmth often accompanied by sweating, reddening of the skin, and rapid heartbeat. They usually last 1 to 5 minutes. Hot flashes frequently are followed by a cold chill.
An estimated 35%–50% of perimenopausal women suffer sudden waves of body heat with sweating and flushing that last 5–10 minutes. They typically begin in the scalp, face, neck, or chest and can differ dramatically among women who have them; some women feel only slightly warm, while others end up wringing wet.
Hot flashes often continue for a year or two after menopause. In up to 10% of women, they persist for years beyond that.
#4 You may have vaginal dryness
During the late perimenopause, falling estrogen levels can cause vaginal tissue to become thinner and drier.
Vaginal dryness (which usually becomes even worse after menopause) can cause itching and irritation, and a feeling of vaginal tightness during sex. It may also be a source of pain, burning, or soreness during intercourse, contributing to a decline in sexual desire at midlife.
Low estrogen may also leave you more vulnerable to urinary or vaginal infections. Loss of tissue tone may contribute to urinary incontinence.
#5 Sleep disturbances may become frequent
About 40% of perimenopausal women have sleep problems. Some studies have shown a relationship between night sweats and disrupted sleep; others have not.
The problem is too complex to blame on hormone oscillations alone. Sleep cycles change as we age, and insomnia is a common age-related complaint in both sexes.
Night sweats are hot flashes at night that interfere with sleep. While it’s a myth that perimenopause itself makes women irritable, the sleep disturbances that stem from hot flashes and night sweats can certainly make a woman irritable.
As every woman and each body is different, the very best thing to do is to start a conversation with your physician about your symptoms.
Also, women need to be able to talk with other women, because that's how you get support. It may just save you the horror of feeling like you are alone. Talk to each other; let’s reclaim the driving seats of our own lives.