Understanding Perimenopause in Women

Perimenopause is an expected, natural part of ageing, not a disease. Some women have no or very mild symptoms.

However, in many women ovarian insufficiency leads to insomnia, fatigue, weight gain and many other problems.

Symptoms

Some women have no or very mild symptoms. However, in many women perimenopause leads to:

Subfertility

During perimenopause you are not infertile although you may have difficulty getting pregnant. If you postponed pregnancy until your career was well established, you can still become pregnant, but may require assistance from a fertility expert. Irregular periods are a clue that you are subfertile. No periods mean you are infertile.

Menstrual Irregularities

You may skip menstrual periods. Your flow changes, and may become either heavier (menorrhagia), or lighter, or irregular and infrequent (oligomenorrhea). Iron deficiency anemia from excessive blood loss (if you suffer from menorrhagia) causes

• chronic fatigue,
• withdrawal,
• cognitive problems (loss of mental capabilities)and
• irritability

Three of the most bothersome menstrual irregularities in perimenopausal women are:

1. Menorrhagia, which means heavy bleeding more than 80 ml per cycle, or 16 soaked sanitary pads per cycle. Menorrhagia is serious because it eventually leads to iron deficiency anemia. See your doctor if bleeding has increased dramatically!
2. Metrorrhagia, which means irregular uterine bleeding between expected menstrual periods
3. Menometrorrhagia, which means heavy and irregular uterine bleeding. The woman with menometrorrhagia bleeds excessively during her expected menstrual period and also at irregular intervals, usually around two weeks apart, instead of the normal cycle of 28 - 35 days.

Women with menorrhagia, metrorrhagia, or menometrorrhagia are very likely to develop anemia from excessive blood loss. Most of the time, these three problems occur because of a hormonal imbalance. They can also occur due to:

• Benign (non-cancerous) uterine tumors, called fibroids (see www.understandinguterinefibroids.com)
• Endometriosis (the womb’s lining grows outside the uterus) (see www.understandingendometriosis.com)
• Cancer
• A genetic bleeding disorder, like von Willebrand’s disease

Sleep, Headaches and Cognition

You may develop night sweats and disturbed sleep from low progesterone and varying estrogen levels during perimenopause. Insomnia is common. You may not achieve deep slumber, and probably awaken feeling tired.

During the day, your fluctuating hormones create

• hot flashes,
• depression and
• irritability.

Low progesterone levels lead to

• lack of concentration,
• irritability,
• mood changes and
• poor short term memory.

Proceed to Treatment #

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