There are a few key signs of perimenopause that women notice before the start of menopause. Some of these include feeling tired or weak, having mood swings and erratic emotional outbursts, experiencing vaginal dryness, thinning hair in the head, a deepening of the voice, and not being able to achieve orgasm.
Sometimes these signs of perimenopause don’t occur until much later, or they happen in waves. For instance, experiencing a loss of hair in the head may be accompanied by vaginal dryness, but it doesn’t necessarily occur until after six months or so.
Another of the signs of perimenopause is severe hot flashes. This is when a woman will experience intense and sudden heat in the chest, often combined with lightheadedness, sweating, and chills. While some women only have a few hot flashes, others have severe hot flashes for days on end.
These hot flashes can also bring on heart palpitations, sweating, and dizziness. Some women also report that their skin changes, such as getting rashes or hives, which are normally associated with menstruation, also occur during menopause.
Mood symptoms become a problem during menopause, including irritability and depression. Someone who used to be happy may suddenly become sad or depressed. Someone who used to be energetic may become suddenly tired and unable to concentrate.
Someone who used to laugh a lot may suddenly be unable to do so. All of these mood symptoms are due to lower levels of estrogen. Some menopause signs of changes in the menstrual cycle include irregular periods, heavier bleeding, lighter bleeding after sex, and a shorter time between periods.
Another perimenopause symptom is night sweats which usually affect the arms and legs. These night sweats are due to extreme heat that occurs during perimenopause. A man who used to have hot flashes might suddenly experience cool flashes. Someone experiencing perimenopause may also begin to have mood symptoms such as
- Anxiety, and
Mood changes due to the reduction of estrogen levels are also known as cyclical depression. This type of depression typically begins around middle age and continues well into old age. Some cases of this type of depression are caused by chemical imbalances in the brain, while other cases are caused by hormonal imbalances.
Along with estrogen and progesterone, another hormone produced by the ovary, and an important player in a woman’s menstrual cycle, comes another hormone – vasodilatation. Vasodilatation is also an important player in a woman’s monthly cycle.
It helps to trigger menstruation by preparing the endometrial lining to accept the fertilized egg. And as you can imagine, as estrogen levels decrease during perimenopause, so does the amount of vasodilatation. A woman’s breast tissue may become larger, but the overall volume of blood produced during menstruation will stay the same.
Other signs of perimenopause may include
- Irregular menstrual periods, heavier than normal bleeding, and
- Discomfort in the pelvic region
- Moodiness, depression, and feelings of stress may become common
There will probably be an increase in the production of fish, a hormone that triggers hot flashes. In addition to hormonal changes, physical changes will occur as well, and many women feel a loss of interest in sex as well as cramping in their abdomen or lower back.
Many women will begin complaining of headaches and may experience urinary incontinence. Many women will notice that they have difficulty sleeping. For many women, the emotional rollercoaster that goes along with perimenopause is one of the most difficult parts of the menopausal transition.
Best perimenopause treatment
The most common type of treatment is a combination of medicines (antidepressants and cream) that are applied directly to the scalp.
- Hormone therapy. Systemic estrogen therapy — which comes in pill, skin patch, spray, gel or cream form — remains the most effective treatment option for relieving perimenopausal and menopausal hot flashes and night sweats. Depending on your personal and family medical history, your doctor may recommend estrogen in the lowest dose needed to provide symptom relief for you. If you still have your uterus, you’ll need progestin in addition to estrogen. Systemic estrogen can help prevent bone loss.
- Gabapentin (Neurontin). Gabapentin is approved to treat seizures, but it has also been shown to help reduce hot flashes. This drug is useful for women who can’t use estrogen therapy for health reasons and for those who also have migraines.
- Antidepressants. Certain antidepressants related to the class of drugs called selective serotonin reuptake inhibitors (SSRIs) may reduce menopausal hot flashes. An antidepressant for the management of hot flashes may be useful for women who can’t take estrogen for health reasons or for women who need an antidepressant for a mood disorder.
- Vaginal estrogen. Estrogen can be administered directly to the vagina using a vaginal tablet, ring or cream. This treatment releases just a small amount of estrogen, which is absorbed by the vaginal tissue. It can help relieve vaginal dryness, discomfort with intercourse and some urinary symptoms. Source
Before deciding on any form of treatment, talk with your doctor about your options and the risks and benefits involved with each. Review your options yearly, as your needs and treatment options may change.
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