“During perimenopause you might have symptoms such as hot flushes, night sweats, joint and muscle pain, vaginal dryness, mood changes and a lack of interest in sex”.1

Umbrella
What may the Perimenopause Umbrella include?

Depending on the Source (DotS) this Umbrella may include:

  • Climacteric
  • Menopausal Transition/Transitional Phase
  • Menopause Transition/Transitional Phase
  • Perimenopausal/Peri-menopausal Changes
  • Perimenopause/Peri-menopause
  • The Transition To Menopause
  • Time Leading Up To Menopause

Terminology

Can perimenopause mean different things to different people?

I think the term perimenopause can be like the terms diet, love and menopause and mean different things, to different people, at different times, in different places.

When I use the term perimenopause what I mean may be different to what someone else means or what is meant in medicaltalk.

It can therefore be important when the term perimenopause is used to be clear about what is meant, so we may work out whether we are on the same page meaning the same thing or not.

Definition

What is perimenopause?Perimenopause

DotS the definition of perimenopause may vary. The World Health Organization’s and the International Menopause Society’s definition is:

“Perimenopause – the term perimenopause should include the period immediate prior to the menopause (when the endocrinological, biological, and clinical features of approaching menopause commence) and the first year after menopause”.2

The North American Menopause Society’s (NAMS) definition is:

“A. The gradual transition between the reproductive years and menopause is called perimenopause (meaning around menopause). It is generally a transition lasting many years and can be associated with shorter menstrual intervals, irregular menses, hot flashes, night sweats, and other symptoms. In some women, these symptoms are troublesome enough to require medical intervention”.3

The Australasian Menopause Society’s (AMS) definition is:

“Peri-menopause refers to the time leading up to menopause when a woman may start experiencing changes in her menstrual periods such as, irregular periods or changes in flow. Cycles can be shorter or longer in length. Symptoms may also include hot flushes and night sweats, aches and pains, fatigue or irritability as well as premenstrual symptoms such as sore breasts”.4

Features

What are some features of perimenopause?

According to the (Australian) Jean Hailes for Women’s Health (JH) some features of perimenopause include:

  • “Periods start to ‘wind down’ and become less regular
  • Periods can be lighter or heavier, last for longer or finish earlier than they used to
  • Menopausal symptoms often gradually begin during this time”.5

Periods

Do a woman’s periods simply stop or not?

Not usually. The NAMS explain:

“As a woman reaches perimenopause, changes in menstrual flow and frequency are common. A few women simply stop menstruating one day and never have another period. However, about 90% of women experience 4 to 8 years of menstrual-cycle changes before their periods are gone for good. Most report irregular periods”.6

Signs and Symptoms

What are some common signs and symptoms of perimenopause?

In Are We There Yet? Navigate Now With Our Guided Menopause Tour – First Point of Interest: Perimenopause the NAMS elaborate on:

Perimenopause

“Some common, normal signs include irregular periods, hot flashes, vaginal dryness, sleep disturbances, and mood swings—all results of unevenly changing levels of ovarian hormones (estrogen) in your body”.7

In Menopause: Diagnosis and Management – Information for the Public: Menopause – Symptoms published in November 2015, the (British) National Institute for Health and Care Excellence’s (NICE) explain about Symptoms:

“During perimenopause you might have symptoms such as hot flushes, night sweats, joint and muscle pain, vaginal dryness, mood changes and a lack of interest in sex”.8

Different Differences

Do all women experience the same perimenopause?

No. Perimenopause is not one size-fits-all. Different women experience different symptoms, at different times, in different ways, for different lengths of time, before their final menstrual period. Some women may be unaware they are going or have been through perimenopause and others may be aware of nothing else.

Start

When may perimenopause start?

In Perimenopause: Symptoms & Causes – Overview the Mayo Clinic elaborate on:

“Women start perimenopause at different ages. You may notice signs of progression toward menopause, such as menstrual irregularity, sometime in your 40s. But some women notice changes as early as their mid-30s”.9

The NAMS also note:

“Physical signs of menopause—also called perimenopausal changes—usually start during a woman’s 40s but may start earlier”.10

Duration

How long may perimenopause last?

In What Is Menopause? What Is Perimenopause (the Menopausal Transition)? the AMS elaborate on:

“Some women can experience menopausal symptoms for 5-10 years before their final menstrual period. There is no way to predict the age at which a woman’s menopausal symptoms will start or how long they will last”.11

The JH also note perimenopause:

  • “Lasts an average of 4-6 years, but can be as short as one year or as long as 10 years”.12

In Menopause 101: A Primer for the Perimenopausal: The Basics the NAMS elaborate on:

  • “Physical changes begin years before the final menstrual period. This transition phase is called perimenopause and may last for 4 to 8 years. It begins with changes in the length of time between periods and ends 1 year after the final menstrual period”.13

Menopause

When does perimenopause stop and menopause officially start?

According to the Mayo Clinic:

“Once you’ve gone through 12 consecutive months without a menstrual period, you’ve officially reached menopause, and the perimenopause period is over”.14

Treatment

How may perimenopause be treated?

The JH explain:

“Depending on your symptoms and medical history, the following may be suitable treatment and management options:

  • Combined oral contraceptive pill (OCP)
  • Menopause hormone therapy, or MHT (formerly called hormone replacement therapy, or HRT)
  • Mirena® – progestin-releasing intra-uterine device (IUD) for heavy bleeding
  • Natural therapies (see an accredited naturopath)”.15

Health Care Provider

What if I would like help with perimenopause?

If you would like help with perimenopause, it may be in your best interest to choose to talk to your health care provider about this.

In Menopause: Overview – When To See Your GP the (United Kingdom) NHS (National Health Service) elaborate on:

“It’s worth talking to a GP if you have menopausal symptoms that are troubling you or if you’re experiencing symptoms of the menopause before 45 years of age”.16

Who is a GP?

DotS and/or DotC (Depending on the Country) a GP may be a qualified and registered general practitioner, a medical practitioner, a medical doctor or a doctor.

On page two in Menopause: What Can You Do To Help With Menopause? the JH also encourage us to seek help:

“Depending on your symptoms, you may like to see a general practitioner, a gynaecologist, endocrinologist (hormone specialist), registered naturopath, psychologist or dietitian”.17

On page two in Menopause the JH also note:

“See Your Doctor If:

  • You are troubled by less regular periods
  • You have symptoms of menopause that interfere with daily life
  • You have symptoms of depression and anxiety, including changes to your thinking, eating, sleeping and enjoyment of activities”.18

In Menopause: Diagnosis & Treatment – Treatment the Mayo Clinic elaborate on:

“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”.19

Health Topics A-Z

Where may I find Health Topics related to Perimenopause?

In Health Topics A-Z you may find:

Links

Where may I find Links related to Perimenopause?

Your Country may have Links similar to:

Sources

Where may I find the Sources quoted above?

You may find the Sources at:

Sources

  1. Menopause: Diagnosis and Management – Information for the Public: Menopause – Symptoms. Published Date: November 2015. National Institute for Health and Care Excellence https://www.nice.org.uk/guidance/ng23/ifp/chapter/Menopause Accessed: 02 September 2019
  2. Menopause Terminology: Definitions. International Menopause Society http://www.imsociety.org/menopause_terminology.php Accessed: 02 September 2019
  3. Menopause FAQs: An Introduction To Menopause – Q. What is perimenopause? North American Menopause Society http://www.menopause.org/for-women/menopause-faqs-an-introduction-to-menopause Accessed: 02 September 2019
  4. What Is Menopause? What Is Peri-Menopause (the Menopausal Transition)? Content Updated February 2016. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/185-what-is-menopause Accessed: 02 September 2019
  5. About Menopause: The Stages of Menopause – Perimenopause: Features. Last Updated 04 February 2019 — Last Reviewed 17 December 2017. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/menopause/about-menopause Accessed: 02 September 2019
  6. North American Menopause Society. Menopause Guidebook: 3. Menopause Signs, Symptoms, and Strategies – Changes in Menstrual Periods. 8th Edition 2015:9
  7. Are We There Yet? Navigate Now With Our Guided Menopause Tour – First Point of Interest: Perimenopause. North American Menopause Society http://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/are-we-there-yet-navigate-now-with-our-guided-menopause-tour Accessed: 02 September 2019
  8. Menopause: Diagnosis and Management – Information for the Public: Menopause – Symptoms. Published Date: November 2015. National Institute for Health and Care Excellence https://www.nice.org.uk/guidance/ng23/ifp/chapter/Menopause Accessed: 02 September 2019
  9. Perimenopause: Symptoms & Causes – Overview. 07 May 2019. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666 Accessed: 02 September 2019
  10. Changes At Midlife: Definitions. North American Menopause Society http://www.menopause.org/for-women/sexual-health-menopause-online/changes-at-midlife Accessed: 02 September 2019
  11. What Is Menopause? What Is Perimenopause (the Menopausal Transition)? Content Updated February 2016. Australasian Menopause Society https://www.menopause.org.au/hp/information-sheets/185-what-is-menopause Accessed: 02 September 2019
  12. About Menopause: The Stages of Menopause – Perimenopause: Features. Last Updated 04 February 2019 — Last Reviewed 17 December 2017. Jean Hailes http://jeanhailes.org.au/health-a-z/menopause/about-menopause/ Accessed: 02 September 2019
  13. Menopause 101: A Primer for the Perimenopausal: The Basics. North American Menopause Society http://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/menopause-101-a-primer-for-the-perimenopausal Accessed: 02 September 2019
  14. Perimenopause: Symptoms & Causes – Overview. 07 May 2019. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666 Accessed: 02 September 2019
  15. About Menopause: The Stages of Menopause – Perimenopause: Management of Perimenopause. Last Updated 04 February 2019 — Last Reviewed 17 December 2017. Jean Hailes for Women’s Health http://jeanhailes.org.au/health-a-z/menopause/about-menopause/ Accessed: 02 September 2019
  16. Menopause: Overview – When To See Your GP. Page Last Reviewed: 29 August 2018. NHS (National Health Service) https://www.nhs.uk/conditions/menopause/#when-to-see-your-gp Accessed: 02 September 2019
  17. Menopause: What Can You Do To Help With Menopause? Updated September 2018:2 Jean Hailes for Women’s Health http://jeanhailes.org.au/contents/documents/Resources/Fact_sheets/Menopause.pdf Accessed: 02 September 2019
  18. Menopause: See Your Doctor If. Updated September 2018:2 Jean Hailes for Women’s Health http://jeanhailes.org.au/contents/documents/Resources/Fact_sheets/Menopause.pdf Accessed: 02 September 2019
  19. Menopause: Diagnosis & Treatment – Treatment. 07 August 2017. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401 Accessed: 02 September 2019
Topic Last Updated: 19 October 2019 – Topic Last Reviewed: 02 September 2019
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