Perimenopause: Beginning of a new inning

Change is inevitable but it hits us hard when we don’t see it coming or are caught unaware like the character of ‘Who moved my cheese?’ At the same time, awareness and alertness to sense the coming change helps to adapt to the new change.

Sunita Patel

Today we are talking about Perimenopause- a phase of physical and emotional changes that a woman starts experiencing before she actually arrives at menopause. These signs and signals, if paid attention to and dealt appropriately, help her to sail through menopause smoothly.

Perimenopause, also known as menopause transition or climacteric (critical period), takes place over several years in advance of the menopause.

Perimenopause – a gradual process of change
For most women, perimenopause is a completely normal, gradual process and not a disease to be treated. Perimenopause lasts until full menopause, i.e. the time when the ovaries stop releasing eggs. In the last one to two years of perimenopause when the body creates significantly less oestrogen and it is at this point that many women experience the symptoms of menopause typically when around 48 to 50 years of age.

abs*Throughout the menopausal transition, some subtle and some not-so-subtle changes in the body may take place like…
*Tiredness, lethargy and lack of enthusiasm
*Change in menstrual cycle – length and duration of cycle and character of flow
*Hot flushes and night sweats
*Sleep disturbances
*Mood swings, irritability, depression and anxiety
*Loss of confidence and feeling insignificant
*Decreased libido or sex drive
*Vaginal dryness
*Breast tenderness
*Increased PMS, Urine urgency or leakage
*Aches and pains in muscles and joints

Exceptional cases
Menopause and perimenopausal symptoms may occur earlier in some women than in others. Although not always conclusive, some evidence suggests that certain factors may make it more likely that you start perimenopause at an earlier age like smoking, family history of early menopause, treatment for cancer with chemotherapy or pelvic radiation therapy. A hysterectomy that removes your uterus, but not your ovaries will give you symptoms of perimenopause without periods.

When to see a doctor
absIrregular periods are a hallmark of perimenopause. Most of the time this is normal and nothing to be concerned about. However, see your doctor if:
*Bleeding is extremely heavy – you’re changing tampons or pads every hour or two for two or more hours
*Bleeding lasts longer than seven days
*Bleeding occurs between periods
*Periods regularly occur less than 21 days apart
*Signs such as these may mean there’s a problem with your reproductive system that requires diagnosis and treatment.

Take charge…
Our endocrine system is responsible for hormone production and it works to rebalance hormones and manage the changes brought on by perimenopause. However at personal level, this is the time to step back and have a close look at the lifestyle and life situation that affect our physical and emotional wellbeing and make necessary changes to adapt to the new change like maintaining weight, regular exercise, diet and nutrition, decreasing the amount of alcohol, caffeine and smoking. For some it can be easy and effortless and for those who find it difficult and too overwhelming to deal should seek help. A counsellor provides an empathic, safe and non judgemental environment to understand the issue and help in developing coping methods, which in turn empowers the women to face the challenges and welcome a new beginning.

(Dr Sunita Patel, personal counselor, psychotherapist, homeopath can be contacted on

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