The Road Through Perimenopause

Did you know that women are born with all of the eggs they will ever ovulate? Our fertility depends on the quantity, quality and lifespan of the eggs that we are born with. Our eggs also determine our hormone levels – the more quality eggs we have, the more balanced hormones we have.

When the body recognizes that the number of eggs remaining is low, it starts the process of shutting the ovaries down. The ovaries begin to get rid of eggs more quickly than before which can result in heavier periods, ovarian cysts and hormone imbalances. During this time, hormone levels fluctuate more than normal with wide “ups and downs” during a single month.

Menopause is when the ovaries officially stop producing hormones because they have run out of eggs. Most women will be around 50 years old when this happens, but anytime between the ages of 45-55 is considered normal.  Before periods finally stop for good, women will experience skipped cycles, hot flashes and irregular bleeding as the ovaries slowly shut down. This transition time is known as the Perimenopause.

During Perimenopause, hormones are fluctuating wildly most bothersome 2-3 years before periods finally stop. However, many women can experience the subtle changes of hormone fluctuation anywhere from 8-12 years before their periods stop. Perimenopause commonly affects women in their late 30s and early 40s as the body begins the process of shutting the ovaries down.

I like to break the Perimenopause Transition time into “Early Perimenopause” and “Later Perimenopause”. During the Early Perimenopause, periods are usually still regular but bleeding tends to be heavier, cramping more intense and PMS/PMDD symptoms can often worsen. Again, hormones rise and fall much more quickly than before. As the number of eggs gets lower and lower, hormones begin dropping and patients begin experiencing hot flashes, night sweats, poor sleep and skipped periods. This is ”Later Perimenopause”.

There are many treatments for symptoms of Perimenopause depending on what bothers the patient the most. Some women will have mild symptoms only for a few months while others may have moderate or severe symptoms for years before their cycles finally stop. Treatments can focus on making periods lighter, balancing or replacing falling hormone levels or helping to control hot flashes. Perimenopause can be a difficult time for many patients because their hormones are very unpredictable from month to month. If you think you are experiencing Perimenopause, call to schedule an appointment!

Lindsay Killingsworth MD

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