What to expect when you’re expecting … perimenopause

There are commercials about it, ads in magazines about it, even skits on “Saturday Night Live” about it. We hear about menopause more often than we’d like, especially if we’re fast approaching it. But what we don’t often learn about is perimenopause, the period preceding menopause that lasts four years, on average.

Dr. Catherine Sundsmo, a family medicine doctor with Sharp Rees-Stealy, recently took some time to explain perimenopause and all that comes with it. Here are her top five tips on what to expect when you’re expecting perimenopause:

1. Expect to wait a while. Natural menopause is defined as the permanent cessation of menstrual periods, determined after a woman has experienced 12 months of no menstrual periods. The average age of menopause is 51. Once menopause is complete, a woman can no longer get pregnant. Perimenopause, now commonly known as menopausal transition, occurs during the approximately four years preceding menopause.

2. Expect those dreaded night sweats. Menopause does not happen suddenly. Many women experience several years of changes during the menopausal transition before their periods stop completely. The natural decline in estrogen in the body during perimenopause can cause symptoms such as hot flashes, night sweats, drastic mood changes, depression, anxiety, weight gain, forgetfulness, insomnia, exhaustion, headaches, irregular periods, breast pain, decreased libido and vaginal dryness. Many of these symptoms improve once the menopausal transition is complete, but some symptoms may persist.

3. Expect that you might need a little help. Perimenopause and menopause are a normal part of a woman’s life and do not need to be treated medically. However, if symptoms are bothersome to you and disrupting your life, there are several treatments available. Some include anti-depressants, supplements, hormonal medications such as low-dose birth control or low-dose hormone therapy, and “natural” remedies such as black cohosh and soy.

4. Expect to feel like you’re pregnant (even if you’re not). Perimenopause and pregnancy share several of the same symptoms including lack of periods, vaginal bleeding or spotting, weight gain, breast tenderness, headache and nausea. Even though the chance of getting pregnant between the ages of 45 to 49 is roughly 3 percent, the possibility of pregnancy must always be considered in any female who is experiencing these symptoms, is sexually active and does not use regular contraception.

5. Expect to stay active. Although several factors such as genetics, smoking, obesity, ethnicity and reproductive history contribute to when you might see signs of perimenopause, there are things you can do to make the transition more comfortable. Exercise regularly to maintain cardiovascular health and weight, and to strengthen your pelvic floor muscles; enjoy a nutritious diet; drink lots of water to stay hydrated; practice relaxation methods to decrease stress; take 1,200 mg calcium and 800 to 2,000 IU vitamin D daily; and use a lubricant to ease intercourse discomfort.

Talk with your doctor if you have concerns about menopause. Together you can plan appropriate ways to address your symptoms.