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Perimenopause – The Beginning of the End of Menstruation

Menopause is that stage in life where the ovaries no longer release eggs and menstruation ceases.  Perimenopause is the natural transition period leading to menopause.  It generally begins eight to ten years before menopause.  For many women, perimenopause begins while they’re in the 40’s, but it can start earlier than that.

Menopause is that stage in life where the ovaries no longer release eggs and menstruation ceases.  Perimenopause is the natural transition period leading to menopause.  It generally begins eight to ten years before menopause.  For many women, perimenopause begins while they’re in the 40’s, but it can start earlier than that. 

During perimenopause, estrogen levels rise and drop unevenly. This fluctuation can play havoc with your menstrual cycle.  It may lengthen or shorten, and you may experience menopause-like symptoms such as hot flashes, chills, thinning hair, irregular sleep, vaginal dryness, or mood changes.  It might also occur that you have some periods in which the ovaries don’t release an egg, which decreases fertility.  As long as you’re having periods, though, it is still possible to get pregnant so if that is something you don’t want, you should continue with birth control until your periods have stopped for 12 consecutive months.

A drop in estrogen can create health conditions such as weight gain, an increase in “bad” cholesterol and a decrease in “good” cholesterol, which is sometimes a precursor of heart disease.    Bone loss can be accelerated by low estrogen, increasing the risk of osteoporosis.  Low estrogen levels can also make you vulnerable to urinary or vaginal infection.

Wow!  Perimenopause is starting to sound more like a disease than a natural progression, but there are two things to remember.  First, not all women experience all of these symptoms or if they do, they’re not severe (and a few of the lucky ones don’t notice any symptoms at all).  The second thing to know is that there are things you can do to ease symptoms and help prevent disease.

The U.S. Department of Health & Human Services has some excellent advice for a healthy perimenopause:

(scroll down to read more)

  1. Quit smoking.  Gee, where have you heard that before?  But it’s true that, quite apart from the other health risks of tobacco products, smoking increases the risk of osteoporosis.  The nicotine impedes calcium absorption and slows the production of bone-producing cells.  It also increases the risk of heart disease.  Chemicals in cigarette smoke cause blood thickening and clot formation inside veins and arteries.  It also increases the formation of plaque in blood vessels.

  2. Eat a diet low in fat, high in fiber with plenty of fruits, veg, and whole-grain foods.  Keep clear of processed foods and fast foods; they can contain shocking amounts of refined sugar, salt, and mystery chemicals that can mess with your health in all sorts of ways.  Eating whole foods rich in nutrients is probably good advice at any time but may be even more important during perimenopause.   

  3. Get enough calcium and Vitamin D Most people know that you need sufficient calcium for strong bones but that’s only part of the story.  Your nerves need calcium to help carry messages from the brain and every other part of the body.  Your muscles, including your heart, need calcium to be able to contract.  When parts of the body need calcium to operate and it is not otherwise available to them, they will take calcium from the bones.  This leaves the bones thinner than they should be and susceptible to fracture.  Vitamin D is converted by the kidneys into a hormone called calcitriol which is indispensable to calcium absorption.  If you’re not getting enough calcium and Vitamin D in your diet, you might want to consult with a health care practitioner about taking supplements.  

  4. Maintain a healthy weight.  Many women experience weight gain during perimenopause.  According to the Mayo Clinic, the weight gain has less to do with hormonal changes and more to do with aging, lifestyle, and genetic factors.  They say that “muscle mass typically diminishes with age, while fat increases” and that “losing muscle mass slows the rate at which your body uses calories (metabolism).”  You may not be able to do much about getting older and genetic factors, but lifestyle habits and diet are controllable.  They suggest a whole foods diet high in nutrients and low in fat.  They also note that limiting alcohol and sweets is very helpful in weight control.

  5. Do some weight-bearing exercise.  The Bone Health & Osteoporosis Foundation defines weight-bearing exercises as those “activities that make you move against gravity while staying upright”.  There are some high-impact weight-bearing exercises such as dancing, jogging, tennis, hiking and other fun stuff.  If that seems out of reach, you could also try some low-impact weight-bearing exercises such as low-impact aerobics, fast walking, and using a stair step machine.  Weight-bearing exercises help to strengthen bones, improve your coordination and flexibility, and control your weight.  You may also find that you’re more relaxed and sleeping better.

If your perimenopausal symptoms are severe or worrisome, you should consult a health care practitioner.

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