Menopause happens on 1 day, which is the 1 year anniversary from your last menstrual period. It usually occurs between ages of 45-55 and in North America the average age is 52 years.
The terms Perimenopause, Menopause and Postmenopause are often used interchangeably but in fact define different time frames in a woman's life. Symptomatic years before Menopause are considered Perimenopause, Menopause is the day that marks 12 months from your last menstrual period and anything after Menopause is considered Postmenopause.
Early symptoms often include irregular periods, sleep disruption, brain fog and mood changes. Vaginal dryness and vasomotor symptoms (hot flashes and night sweats) typically occur in mid to late Perimenopause.
Symptoms often last between 7 to 10 years. This timeframe can vary quite significantly between women within and between different races and ethnicities. For example vasomotor symptoms (hot flashes and night sweats) tend to last longer and be more severe in African American and Hispanic women compared to Caucasian women and have the lowest duration and prevalence in Asian women.
Hormonal fluctuations, particularly declines in estrogen (estradiol) can impact our muscle mass and metabolic function. During perimenopause, more women notice difficulty maintaining or losing weight despite using strategies that have worked for them in the past. There are often other factors that increase your risk of weight gain such as sleep disturbances, fatigue and lower motivation for physical activity.
There are a number of options that can reduce the heat intolerance many women feel. Lifestyle changes such as caffeine and alcohol reduction, regular exercise and stress reduction can make a difference. Some natural health products can be effective but hormone therapy and certain non-hormone pharmaceuticals would be the most effective and research-based options.
For most women, HRT is a safe and effective option to manage troublesome symptoms during Perimenopause and Postmenopause. It is most effective when commenced in perimenopause or in early postmenopause. The decision to start in late Postmenopause depends on your health history and risk factors, particularly relating to your heart health, diabetes status, smoking status and obesity.
Hormonal fluctuations that occur in Perimenopause often impact mood. Many women notice new onset depression or anxiety, or an aggravation of existing mental health concerns. There are other indirect risk factors for mood changes such as sleep disruption, fatigue and cognitive changes.
Yes. A decline in estrogen (estradiol) contributes to a decline in bone mineral density and can increase your fracture risk. Estradiol also helps to regulate lipid metabolism and thus can impact cardiovascular risk factors. The decline in estradiol often contributes to changes in lipid profiles such as an increase in total cholesterol, LDL cholesterol and triglycerides.
Yes. Although Perimenopause can be a very challenging time for some women, there is light at the end of the tunnel. After perimenopause, hormonal fluctuations reduce and eventually stabilize resulting in most menopausal symptoms to subside. The only exception to this would be genitourinary symptoms of menopause (vaginal dryness and painful intercourse) where low dose vaginal estradiol products are often continued to address this.