Greetings! It’s Dr. Dawne, Chicago’s own Board-certified Ob/Gyn. My mission is to empower women of all ages with pertinent medical knowledge and proactive reproductive health information that will optimize your physical AND mental health. Today, let’s chat about 5 things women should know about perimenopause/menopause. My goal is to demystify this transitional period for you!
Perimenopause is a period starting around age 45 to age 55, where your body transitions into menopause. Menopause is simply the absence of a menstrual cycle for 12 consecutive months. The average of onset is 51 years old. During perimenopause, there are changes in your hormone levels, specifically estrogen, which causes changes in your menstrual cycle, and changes in your body.
1 First, menstrual changes occur during perimenopause/menopause because your ovaries make less of the hormone estrogen during this time. As a result, during perimenopause, you may or may not ovulate every month, and your menstrual cycle changes. The number of days between periods may increase or decrease; your periods may become shorter or longer, and your menstrual bleeding may get heavier or lighter. You may even skip periods. Birth control pills are quite helpful in regulating your menstrual cycle during this time.
2 Typically, when ladies come in to see me, it’s because of hot flashes. Hot flashes are sudden feelings of heat that rush to your upper body and face; you may also break out in a sweat. A hot flash may last a few seconds to several minutes. They may occur a few times a month or several times a day, at any time, day or night. When they occur during sleep, they’re called night sweats. They may wake you up and leave you tired and sluggish the next day. The good news is, there are some definite steps you can take to improve hot flashes. You can avoid triggers, such as hot foods such as coffee, spicy foods and or alcoholic drinks. You can dress in layers (which you’re probably already doing if you live in Chicago, brrr!). You can set temps low on the thermostat, and exercise regularly. Black Cohosh is an OTC herb that can also improve mild hot flashes.
3 Sleep disturbances can be common during perimenopause/menopause. They may include trouble falling asleep, waking up before your usual time, or night sweats that disrupt your sleep. These abnormal sleep patterns can also lead to more mood changes (grouchiness), trouble concentrating and/or even depression. To help with sleep disturbances, you can try going to bed and waking up at the same time daily (weekends too!). Avoiding late night meals/snacks, late night alcohol (alcohol makes you drowsy, but can lead to abnormal sleep), and caffeine up to 6 hours before bedtime, also tends to help. Finally, try having regular exercise, not less than 3 hours before bedtime.
4 During perimenopause, you may notice vaginal or urinary changes, due to decreased levels of estrogen in your body. The vaginal lining gets thinner, and dryer. This can lead some women to have more vaginal burning and itching, or even pain during sex. It may take longer for your vagina to become moist during sex. During perimenopause or menopause, you may notice a decreased desire for sexual intercourse, or notice that sexual arousal takes longer. Some women may not feel a desire to have sex until they begin to engage in sexual activity; they then become aroused, and the enjoyment is the same. If any of these things occur, no worries! You can spend more time on foreplay and try new sexual positions. Water-based lubricants can also help.
5 Subtle skeletal changes are occurring during this time. After 30, bone is broken down faster than it is made. This process is heightened with menopause, where the decreased estrogen levels can possibly lead to osteoporosis: a condition in which bones become thin and weak and can result in a break and disability. To help prevent this, focus on getting plenty of calcium and calcium rich foods, vitamin D, and weight-bearing exercise.
Most importantly, remember to talk with your partner about these changes. People are often a bit more understanding once you tell them what you are going though. And if you want, can show them this blog to get the conversation started!! Perimenopause and menopause are a normal part of life; knowing what to expect will help you have a less traumatic experience. Communication with your partner, and if needed your physician, can make the process go smoother.