DEAR DR. GOTT: I am a 43-year-old female with irregular periods. When I finally went to my doctor, he told me that I have perimenopause. Can you tell me what this is?
DEAR READER: Simply put, perimenopause is an introduction to menopause. It commonly occurs when a female is in her 40s, but can happen to some women in their mid-30s. It generally lasts between two to eight years and is a natural part of the aging process. Estrogen levels rise and fall in an erratic pattern, and women may experience problems sleeping, hot flashes, vaginal dryness, mood changes and more. Repeated menstrual irregularity, however, is one of the most widely recognized initial phases of the condition. As long as the irregularity isn’t accompanied by extremely heavy bleeding, breakthrough bleeding between cycles, bleeding that lasts longer than eight days and cycles that occur fewer than 21 days apart, you can usually consider things as progressing normally. However, complications outside these guidelines should be brought to your primary-care physician’s or gynecologist’s attention.
There are several circumstances that have a bearing on when perimenopause or menopause might begin. Smoking, for example, is known to trigger menopause up to two years earlier than in those without a history. Other signs of an earlier-than-normal occurrence are chemotherapy for childhood cancer, never having delivered a baby, hysterectomy and pelvic radiation therapy.
Therapy might include the use of oral contraceptives for the purpose of regulating cycles, and reducing vaginal dryness and hot flashes. A progestin-containing IUD (intrauterine device) might control heavy bleeding, while progestin therapy might regulate cycles.
If you are satisfied with the information you already received, I recommend you continue as you are, eat well, exercise, avoid alcohol and caffeine, which can trigger hot flashes, and enjoy each day to the fullest. If you are dissatisfied, either jot down a list of questions and return to your physician for an explanation, or request a second opinion.
In the interim, I am sending you a copy of my Health Report “Menopause.” Other readers who would like a copy should send a self-addressed stamped No. 10 envelope and a $2 check or money order to Newsletter, P.O. Box 167, Wickliffe, OH 44092-0167. Be sure to mention the title or print an order form off my website at www.AskDrGottMD.com.
About Dr. Gott