Perimenopause Is it menopause or not?

By Dr Ho Choon Moy,Consultant Gynaecologist, Pantai Cheras Medical Centre, Immediate Past President, Malaysian Menopause Society

Hot flushes, night sweats, sleeplessness, mood swings, lethargy, depression and loss of libido. All these and more are common symptoms of menopause, the period of life when a woman’s reproductive phrase comes to an end.

But wait, you have just celebrated your fortieth birthday recently. Isn’t menopause supposed to happen only at 50 years and beyond?

Shock and disbelief are common reactions when women in their late thirties and early forties are told that they are experiencing menopausal symptoms.

What they may not realise is that there is a condition known as peri-menopause- the transitory stage that is literally a countdown to menopause.

What is peri-menopause?

The peri-menopause or pre-menopause years can be a bewildering time for many women. While they experience some or all of the symptoms associated with menopause, they are still having their monthly periods, although it may be less regular.

Peri-menopause may last about 4 to 5 years and can begin any time before or after a woman’s fortieth birthday. For most women, the symptoms can cause a lot of distress because it is happening at a time when they are at their peak of their social and career progress. The physical and psychological symptoms affect focus and emotional balance, creating a lot of frustration and anger.

The symptoms happen because the ovaries are slowly losing their ability to produce estrogen, the hormone responsible for feminine characteristics.

Estrogen is the hormone that gives a woman her curves, firm skin and breasts. As estrogen also protects the bones and heart, women after menopause are at a higher risk of heart problems and osteoporosis.

What’s dangerous is when women think they have achieved menopause at this in-between stage and assume they are not reproductive any more. It is important to continue taking the necessary birth-control precautions until you are confirmed to have reached menopause.

So how can you know whether you have really reached menopause? Generally, menopause is when you have not had a period for twelve consecutive months. All the other symptoms do not indicate real menopause.

Managing the peri-menopausal years

As mentioned earlier, birth control continues to be an important element during the peri-menopausal years to prevent accidental pregnancies. Apart from that, it helps to change your lifestyle to reduce symptoms and enjoy a better quality of life. Here are some useful tips:

  • Exercise and maintain a healthy weight
  • Learn to de-stress with yoga, taiqi, meditation or breathing techniques
  • Increase intake of fruits and vegetables
  • For hot flushes, dress in layers that can be easily removed. Use cotton sheets and clothing to let your skin ‘breathe’

Your doctor may also recommend menopause treatment to get your hormones back into balance. As you are still having your periods and is not entirely menopausal yet, some women opt for natural hormone-free remedies for symptom-control as nobody knows how long it will be before you reach menopause.

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