I recently did an interview for aaptiv.com about perimenopause. In this article, you will learn signs and symptoms of perimenopause as well as menopause relief and improvement of symptoms.
In general will you please explain what perimenopause is (to someone who is unaware) and how the process occurs?
Perimenopause is the process that your body undergoes as the ovaries stop functioning. When a woman is fertile and prior to menopause, the ovaries release an egg every month in response to signals from the brain- the pituitary gland to be exact. When a woman enters perimenopause, the ovaries don’t respond to the brain’s signals. These under-functioning ovaries and overzealous pituitary gland leads to dramatic hormonal fluctuations, hot flashes, weight gain, mood swings, etc.
This is all leading up to menopause when the ovaries are completely done releasing eggs and hormones, and the brain no longer tries to get them to work with hormonal signals. Ultimately the analogy is that the brain used to speak in a normal “inside voice” tone to the ovaries, but when perimenopause hits, the communication gets louder and louder and the response is less and less, which reeks a level of havok on the female body.
What are symptoms of menopause and perimenopause?
Hot flashes. Women can experience extreme, abrupt and unpredictable increases in body temperature. They can make a woman sweat and need to partially disrobe. They can last seconds to minutes and often resolve spontaneously. Some women seek hormone replacement therapy, or supplemental estrogen to decrease the frequency and severity of these hot flashes. Face and chest are common locations of symptoms. For some, they continue to happen sporadically for years.
Night sweats. Similar to hot flashes, but instead of suddenly feeling warm, the person wakes up in soaked clothing, sheets because of sweating. Management is essentially the same as that for hot flashes.
Vaginal dryness. Deceased estrogen (one of the main hormones released by the ovaries) can lead to decreased amount of secretions from the vagina and vulva. Lower estrogen levels make glands of the vagina like the bartholin and skenes glands stop functioning well. this can lead to a dry sensation with siting, walking and even having sex. There are non-hormonal vaginal lubricants that help and vaginal estrogen and estrogen-like products as well.
Painful intercourse. The mechanism by which this develops is similar to vaginal dryness, with the added discomfort caused by thinning vaginal tissues. Thus a woman can have pain without necessarily being dry.
Memory changes, weight gain and fatigue can all be side effects of menopause.
Irregular bleeding. This comes as a result of that difficult and complex communication between the brain and the ovaries. Those few and far between times that an egg is signaled to release from the put-put ovarian tissue (put-put is my old car sound) a period may come. This becomes less and less frequent. For some unfortunate women, bleeding gets more frequent. This often should be evaluated by a gynecologist to make sure no abnormal or pre-cancerous tissue is developing.
Breast changes. Pain, tenderness, lumps, etc can happen with that tumultuous hormonal communication.
Is perimenopause common?
It happens to a degree with every women whose fertility is ending. Some have very few symptoms and others have more severe symptoms that interrupt their daily life. Why does perimenopause occur? As above, it happens in the process between functioning ovaries and ovaries that are completely done releasing eggs.
Who is most likely to experience perimenopause and why?
The only person who won’t experience perimenopause to some degree is a person who never had functional ovaries. Certain genetic anomalies can cause women to have either non-functioning ovaries or no ovaries at all, despite the external features of a female. Premature ovarian failure basically means menopause that occurs early- before 40 years old.
How does perimenopause impact workouts (if at all)?
Exercise becomes even more important in perimenopause because women tend to gain weight with the hormonal changes. Cardio can help burn calories and strengthen the heart, which also is at risk of causing problems. Heart disease rates increase substantially in perimenopause and menopause.
Also bone loss increases in menopause. Weight bearing exercises like walking, jogging, light weight lifting, yoga, and to a degree cycling, can help keep bones strong, especially if used in combination with a diet rich in calcium and vitamin D. Swimming is also a great cardiovascular work out. Swimming isn’t as good for bone strength because of the lack of weight bearing involved, but for women with joint issues, it still has it’s place.
Menopause relief: What are 3-5 solutions for alleviating symptoms of perimenopause?
30 minutes of moderate, weight bearing exercise 5 days per week is a great goal and may help with symptoms and signs of perimeopause- weight gain and hot flashes.
Avoiding the consumption of simple sugars can help symptoms in some women. There are hormonal supplements that can help symptoms in the appropriate candidates who are low risk for complications. There are also many non-hormonal supplements that can help.
A low dose of SSRI or SNRI can also help with vasomotor symptoms like hot flashes. These meds are classically used as antidepressants but can help with symptoms of menopause without hormones.
There is also a bee pollen extract that evidence shows relieves some symptoms as well. Vaginal dryness and painful intercourse have a number of remedies in the form of medication- both hormonal and non-hormonal. Click here to read a post I wrote about some products to control vaginal dryness and itching. Coconut oil is also a very good vaginal lubricant for perimenopausal women to aid in skin conditioning and moisture.
Thank you as always for reading and following The Gyneco-bLogic! Don’t forget to like, comment and subscribe.
I am a board certified Obstetrician and Gynecologist with an interest in breaking down health and life topics to gain logical understanding. Be prepared for a vagina or two along the way. What can I say? I’m a gynecologist. Learn more about me at dreverywoman.com