“Peri” means “around” menopause.

It is normal to start having perimenopause symptoms 7-10 years before the onset of menopause. The average age of menopause is 51, which includes the range 45 - 55 years old. Menopause, by definition, simply means one calendar year without a menstrual bleed and is the lose of estrogen and progesterone production from the ovaries. Most symptoms of these hormonal changes resulting in symptoms actually occur before menopause. So 10 years before age 45, is 35 years old! If you go into early menopause, which is before age 45, you may experience perimenopause symptoms as young as 31!

So what is perimenopause? After the age of 35, most women start to have less predictable ovulation each month and reportedly have only about 3% ovarian reserve left by age 40. Ovulation is when an egg or follicle is release from one of your two ovaries to be fertilized in the fallopian tube. Ovulation is important for more than just making babies. Ovulation is the only way your body makes the hormone, progesterone. With less predictable or regular ovulation progesterone production declines. The cells in your ovaries are also aging and by age 40, their ability to produce estrogen is in fact changing. Don’t freak out if you are a fertility patient as you can very well still get pregnant over the age of 35! Egg quality does matter here and better quality usually means better hormone production. It is also important to note that if you do NOT want to become pregnant say in your 40s and you are having intercourse without a method of “birth control,” please talk to your healthcare provider about how to avoid an unwanted pregnancy. There are lots of options.

As estrogen and progesterone production from your ovaries starts to change (going up and down and sideways:)), more noticeable symptoms can arise. Symptoms of perimenopause may include:

• Vasomotor symptoms -hot flushes, night sweats (especially before your period)

• Insomnia (especially before your period)

• Mood changes (more irritability, depression, anxiety)

• Sexual dysfunction

• Joint and muscular body pain

• Dryness of vagina or painful intercourse

• Bladder problems

• Hair loss

• Weight gain

• More intense PMS

• Irregular periods -frequent or missed periods

• Change in menstrual blood flow

If you are starting to experience more intense PMS, changes to your menstrual cycle (in frequency and flow), mood changes, sleep, body, and/or relationship troubles and you are over the age of 35, it may be the start of perimenopause! Don’t worry, there are solutions. Come in for a health assessment to get worked up for other causes as well as talk about your symptoms (for more than 7 mins :) and your treatment options.