“Changes to your periods are often the first sign of perimenopause, but other common symptoms include hot flushes and mood swings”.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

Changes

What happens at perimenopause?

In Perimenopause – Fact Sheet: What Happens At Perimenopause? the (Australian) Jean Hailes for Women’s Health (JH) explain:

“Changes to your periods are often the first sign of perimenopause, but other common symptoms include hot flushes and mood swings. Symptoms may come in waves and often get worse before your period, when oestrogen levels drop”.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 Menopause: Diagnosis and Management – Information for the Public: Menopause – Symptoms the (British) National Institute for Health and Care Excellence’s (NICE) explain about Symptoms:

Perimenopause

“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”.7

In Perimenopause – Fact Sheet: Symptoms the JH note:

“Symptoms can include any of the following:

  • Hot flushes
  • Night sweats
  • Irregular periods
  • Problems with falling asleep, staying asleep and sleep quality
  • Breast tenderness
  • Itchy/crawly/dry skin
  • Exhaustion
  • Trouble concentrating
  • Vaginal dryness
  • Loss of libido (sex drive – talk to your doctor about sexual function if this concerns you)
  • Migraines
  • More pronounced premenstrual tension
  • Mood changes, such as feeling more teary and irritable. Anxiety may also occur
  • Weight gain, despite no changes to diet or exercise, due to the metabolism slowing down”.8

Different Differences

Do all women experience the same symptoms?

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 can 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

In About Menopause: The Stages of Menopause – Perimenopause: Management of Perimenopause the JH also note:

“Perimenopause usually happens in a woman’s 40s and on average lasts 4-6 years, but can be as short as one year, or as long as 10. When you have had no period, spotting or staining for 12 months, you have reached menopause and are then considered postmenopausal. However, symptoms may continue for months or years after menopause – every woman is different”.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

Therapies

What are some perimenopause therapies?

The JH explain:

“There are many different therapies available. One type may suit better than another. There are a number of other strategies including natural therapies and prescribed medications – such as the Pill – for women who have bothersome symptoms and do not wish to, or cannot take, MHT. It is recommended that women discuss all their options with a health practitioner who has expertise in women’s health. Treatments may help some symptoms, but the changes that menopause brings will still occur”.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.

In About Menopause: When To See Your Visit Doctor the JH explain:

“You Should See Your Doctor If:

  • If you are troubled by irregular cycles
  • If you are worried about heavy bleeding/bleeding abnormal to you/bleeding between periods and/or after sex
  • If you have increased PMS (premenstrual syndrome) symptoms and/or pain
  • If you have some of the symptoms of menopause, such as hot flushes, that interfere with your daily life”.17

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”.18

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?

You may find the Sources quoted at:

Sources

  1. Perimenopause – Fact Sheet: What Happens At Perimenopause? Jean Hailes for Women’s Health https://www.jeanhailes.org.au/resources/perimenopause-fact-sheet Accessed: 05 July 2020
  2. Menopause Terminology: Definitions. International Menopause Society https://www.imsociety.org/menopause_terminology.php Accessed: 05 July 2020
  3. Menopause FAQs: An Introduction To Menopause – Q. What is perimenopause? North American Menopause Society https://www.menopause.org/for-women/menopause-faqs-an-introduction-to-menopause Accessed: 05 July 2020
  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: 05 July 2020
  5. Perimenopause – Fact Sheet: What Happens At Perimenopause? Jean Hailes for Women’s Health https://www.jeanhailes.org.au/resources/perimenopause-fact-sheet Accessed: 05 July 2020
  6. North American Menopause Society. Menopause Guidebook: 3. Menopause Signs, Symptoms, and Strategies – Changes in Menstrual Periods. 8th Edition 2015:9
  7. Menopause: Diagnosis and Management – Information for the Public: Menopause – Symptoms. Published Date: 12 November 2015. Last Updated: 05 December 2019. National Institute for Health and Care Excellence https://www.nice.org.uk/guidance/ng23/ifp/chapter/Menopause Accessed: 05 July 2020
  8. Perimenopause – Fact Sheet: What Happens At Perimenopause? Published June 2019. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/resources/perimenopause-fact-sheet Accessed: 05 July 2020
  9. Perimenopause: Symptoms & Causes – Overview. 07 May 2019. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666 Accessed: 05 July 2020
  10. Changes At Midlife: Definitions. North American Menopause Society https://www.menopause.org/for-women/sexual-health-menopause-online/changes-at-midlife Accessed: 05 July 2020
  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: 05 July 2020
  12. About Menopause: The Stages of Menopause – Perimenopause: Features. Last Updated: 04 March 2020 | Last Reviewed: 17 December 2017. Jean Hailes https://jeanhailes.org.au/health-a-z/menopause/about-menopause/ Accessed: 05 July 2020
  13. Menopause 101: A Primer for the Perimenopausal: The Basics. North American Menopause Society https://www.menopause.org/for-women/menopauseflashes/menopause-symptoms-and-treatments/menopause-101-a-primer-for-the-perimenopausal Accessed: 05 July 2020
  14. Perimenopause: Symptoms & Causes – Overview. 07 May 2019. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666 Accessed: 05 July 2020
  15. Perimenopause – Fact Sheet: Treatment Options. Jean Hailes for Women’s Health https://www.jeanhailes.org.au/resources/perimenopause-fact-sheet Accessed: 05 July 2020
  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: 05 July 2020
  17. About Menopause: The Stages of Menopause – Perimenopause: Features. Last Updated: 04 March 2020 | Last Reviewed: 17 December 2017. Jean Hailes https://jeanhailes.org.au/health-a-z/menopause/about-menopause/ Accessed: 05 July 2020
  18. Menopause: Diagnosis & Treatment – Treatment. 07 August 2017. Mayo Clinic https://www.mayoclinic.org/diseases-conditions/menopause/diagnosis-treatment/drc-20353401 Accessed: 05 July 2020
Topic Last Updated: 05 July 2020 – Topic Last Reviewed: 05 July 2020
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