Summary
Physician Assistant Hope Placher explains the often-overlooked stage of perimenopause, highlighting its symptoms, the biological processes involved, and the importance of seeking proper medical guidance. She underscores that perimenopause is a natural part of a woman's reproductive life, characterized by hormonal fluctuations leading to symptoms like irregular periods, hot flashes, and mood swings. Placher emphasizes the Couri Center's commitment to supporting women through this transition, offering personalized care and acknowledging the uniqueness of each woman's experience.
Understanding Perimenopause
Many women only understand what perimenopause is with the gift of hindsight. Most of us were educated in biology class or sex education that menstruation begins when we first have a period, usually somewhere between 11-14 years of age. Eventually, around the age of 50, our monthly cycles will permanently end. Not much, if anything, is explained about what happens to your body in the transitional years leading up to the cessation of periods. This is perimenopause, a natural progression in a woman’s reproductive life.
The Biology of Perimenopause
Perimenopause occurs as the ovaries inconsistently mature and release an egg every month. This creates irregular production of estrogen and progesterone. These hormonal fluctuations can make you feel like you’re on a roller coaster, and I’ll discuss common symptoms in just a moment. Some women may only be in this stage for a few months, while others will be in this transitional phase for 4-10 years. Reminiscing back to puberty, please remember your ovaries did not ‘turn on’ overnight to establish a perfectly curated hormone production machine, and likewise, they will not ‘turn off’ in a single month (or even a year) to completely stop your periods.
Recognizing the Symptoms
Physical changes and symptoms occur as your body adjusts to variable hormone levels. Generally, the first sign may be irregular periods. Your cycles may begin to change in length, and how many days you bleed and the amount of blood you shed may vary greatly from month to month. You may experience hot flashes, night sweats, mood fluctuations, body composition changes, vaginal dryness, and insomnia. (I think it’s also important to note that other health conditions can cause significant changes in the presentation of your periods, so please do not hesitate to reach out to your practitioner to determine if these changes are expected or something to be concerned about.)
How Perimenopause is Diagnosed
As this is a gradual transition to menopause, there is no single test or sign that can definitively diagnose it. We consider various factors, including symptoms, age, health history, lab work, and physical exam.
Supporting Women Through Perimenopause at the Couri Center
If you are in the season of perimenopause, please know that your body is not broken. You are not alone. For many years, women suffered in silence as they faced these changes with little to no acknowledgment from the medical community at large. At the Couri Center, we take great pride in supporting and treating women during this phase of life, acknowledging that no two women may go through perimenopause the same.
Looking Ahead: Strategies for Managing Perimenopause
I look forward to sharing part two of this article, which will reveal strategies for supporting your body during perimenopause.
Hope Placher, Physician Assistant, Couri Center
References:
- Mayo Clinic: Perimenopause
- The Pharmaceutical Journal, PJ, January 2023, Vol 310, No 7969;310(7969):: DOI:10.1211/PJ.2023.1.172202
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