Guide | Early Signs of Perimenopause: Do Not Wait Until Menstruation Stops
Hot flashes, night sweats, and mood changes are often associated with menopause. Yet many women begin experiencing these changes in their 30s or early 40s. This is not menopause itself, but a transitional stage called perimenopause.
"Many women are confused at this stage: 'I still have periods, so why do I have menopausal symptoms?'" said Dr. Laura Corio, a gynecologist at Mount Sinai Medical Center in New York and author of The Change Before the Change. "Doctors used to say, 'You are still menstruating, so I cannot help you.'"
That dismissive approach is changing. Dr. Corio said women may enter perimenopause at around age 35. "I understand my patients very well. This can be a difficult time," she said.
Perimenopause Is Different for Everyone
Symptoms vary widely. Some women have almost no discomfort, while others experience many symptoms: irregular periods, hot flashes, vaginal dryness, mood changes, fatigue, palpitations, and reduced libido. These symptoms are real, not imagined.
Dr. Elizabeth McGee, associate professor of obstetrics and gynecology at Magee-Womens Hospital in Pittsburgh, said: "Decades ago, doctors told women that menstrual pain was all in their heads. We now know it is a real condition with treatment options. The same is true of perimenopause."
Some Infertility May Be Associated with Perimenopause
Dr. Corio noted that many women aged 35 or 37 seek care for fertility problems without realizing they are already in perimenopause and their egg quality has declined. "Female fertility begins to decline significantly after age 24," she said. "Eggs may still be present, but quality is critical."
Estrogen Is Central
Dr. Bill Meyer, professor of obstetrics and gynecology and an endocrinologist at University of North Carolina Hospitals, explained that large fluctuations in estrogen are the main mechanism of perimenopause. These changes may cause irregular periods and vaginal dryness and may significantly affect mood.
"When estrogen is high, the brain has more 'feel-good chemicals' such as dopamine and serotonin, so people naturally feel better," Dr. Corio explained. "When estrogen falls, low mood is more likely."
Some women are diagnosed with mild depression and prescribed antidepressants while the underlying hormonal cause is overlooked. Dr. Meyer added that low estrogen may worsen existing depression, while thyroid dysfunction can cause similar symptoms.
The key is for clinicians to assess overall health rather than prescribe medication too quickly. "Testing hormone levels is important," Dr. Corio said. "In some cases, an appropriate amount of estrogen may also improve the effectiveness of antidepressants."
Not a Disease, but a Turning Point for the Body and Lifestyle
Perimenopause is not a disease, but it is an important transition in a woman's health.
Dr. Corio cautioned: "At this stage, declining estrogen and progesterone contribute to bone loss, while the risks of breast, uterine, and ovarian cancer, heart disease, and diabetes rise."
Dr. McGee emphasized that women in their 40s face social as well as physical changes. "They may be caring for both parents and children during one of life's most stressful periods. Perimenopause is not simply a medical diagnosis; it is a life stage."
You Can Take Action Instead of Enduring Symptoms
"I often tell patients not to be martyrs. There is no need to suffer through everything," Dr. Corio wrote. "Many approaches may ease perimenopausal symptoms, including selected vitamins, minerals, herbal products, and lifestyle changes."
She also noted that synthetic and natural bioidentical estrogen options are available, including low-dose oral medications and patches. Weight management is also important: "I do not believe estrogen therapy necessarily causes breast cancer, but I do believe obesity is a greater risk factor."
The Beginning of a Longer Life Stage, Not the End
"Women now live much longer than in the past," Dr. McGee said. "Age 40 is really life's midpoint. You may spend one-third or even half your life after menopause."
She encouraged women to care for their health now: check blood lipids, eat well, stop smoking, exercise daily, and take a multivitamin as appropriate.
Guide | Early Signs of Perimenopause: Do Not Wait Until Menstruation Stops
Guide | Early Signs of Perimenopause: Do Not Wait Until Menstruation Stops
Hot flashes, night sweats, and mood changes are often associated with menopause. Yet many women begin experiencing these changes in their 30s or early 40s. This is not menopause itself, but a transitional stage called perimenopause.
"Many women are confused at this stage: 'I still have periods, so why do I have menopausal symptoms?'" said Dr. Laura Corio, a gynecologist at Mount Sinai Medical Center in New York and author of The Change Before the Change. "Doctors used to say, 'You are still menstruating, so I cannot help you.'"
That dismissive approach is changing. Dr. Corio said women may enter perimenopause at around age 35. "I understand my patients very well. This can be a difficult time," she said.
Perimenopause Is Different for Everyone
Symptoms vary widely. Some women have almost no discomfort, while others experience many symptoms: irregular periods, hot flashes, vaginal dryness, mood changes, fatigue, palpitations, and reduced libido. These symptoms are real, not imagined.
Dr. Elizabeth McGee, associate professor of obstetrics and gynecology at Magee-Womens Hospital in Pittsburgh, said: "Decades ago, doctors told women that menstrual pain was all in their heads. We now know it is a real condition with treatment options. The same is true of perimenopause."
Some Infertility May Be Associated with Perimenopause
Dr. Corio noted that many women aged 35 or 37 seek care for fertility problems without realizing they are already in perimenopause and their egg quality has declined. "Female fertility begins to decline significantly after age 24," she said. "Eggs may still be present, but quality is critical."
Estrogen Is Central
Dr. Bill Meyer, professor of obstetrics and gynecology and an endocrinologist at University of North Carolina Hospitals, explained that large fluctuations in estrogen are the main mechanism of perimenopause. These changes may cause irregular periods and vaginal dryness and may significantly affect mood.
"When estrogen is high, the brain has more 'feel-good chemicals' such as dopamine and serotonin, so people naturally feel better," Dr. Corio explained. "When estrogen falls, low mood is more likely."
Some women are diagnosed with mild depression and prescribed antidepressants while the underlying hormonal cause is overlooked. Dr. Meyer added that low estrogen may worsen existing depression, while thyroid dysfunction can cause similar symptoms.
The key is for clinicians to assess overall health rather than prescribe medication too quickly. "Testing hormone levels is important," Dr. Corio said. "In some cases, an appropriate amount of estrogen may also improve the effectiveness of antidepressants."
Not a Disease, but a Turning Point for the Body and Lifestyle
Perimenopause is not a disease, but it is an important transition in a woman's health.
Dr. Corio cautioned: "At this stage, declining estrogen and progesterone contribute to bone loss, while the risks of breast, uterine, and ovarian cancer, heart disease, and diabetes rise."
Dr. McGee emphasized that women in their 40s face social as well as physical changes. "They may be caring for both parents and children during one of life's most stressful periods. Perimenopause is not simply a medical diagnosis; it is a life stage."
You Can Take Action Instead of Enduring Symptoms
"I often tell patients not to be martyrs. There is no need to suffer through everything," Dr. Corio wrote. "Many approaches may ease perimenopausal symptoms, including selected vitamins, minerals, herbal products, and lifestyle changes."
She also noted that synthetic and natural bioidentical estrogen options are available, including low-dose oral medications and patches. Weight management is also important: "I do not believe estrogen therapy necessarily causes breast cancer, but I do believe obesity is a greater risk factor."
The Beginning of a Longer Life Stage, Not the End
"Women now live much longer than in the past," Dr. McGee said. "Age 40 is really life's midpoint. You may spend one-third or even half your life after menopause."
She encouraged women to care for their health now: check blood lipids, eat well, stop smoking, exercise daily, and take a multivitamin as appropriate.
Story source:
Collected online