Menopause refers to a specific point in time 12 months after a woman’s last period. The years leading up to menopause are marked by hormonal fluctuations known as perimenopause, or the menopausal transition. Perimenopause lasts an average of seven years. However, some women may experience menopausal symptoms for up to 14 years.
What causes menopause symptoms?
During childbearing years, most women will have blood estradiol—or estrogen—levels between 30 and 400 pg/mL. These levels typically fluctuate in a predictable rhythm consistent with her menstrual cycle, peaking in certain phases and declining in others. Blood progesterone levels also fluctuate with phases of the menstrual cycle, between 0.1 ng/mL to 25 ng/mL. These normal, predictable estrogen and progesterone fluctuations often coincide with premenstrual symptoms (PMS) in premenopausal women.
During perimenopause, hormonal fluctuations become less predictable and more extreme. Estrogen and progesterone levels may spike or fall in a way that is inconsistent with your premenopausal menstrual cycle. These unexpected changes in hormone levels correlate with what are commonly known as menopausal symptoms.
What are common menopause symptoms?
Changes in your menstrual cycle
During perimenopause, you may experience changes to your typical menstrual cycle. Your period may last longer, or the length of time between periods may change. You may even miss periods for months at a time. Perimenopausal women are still ovulating, however. You can still become pregnant even if you have irregular periods due to perimenopause.
Vasomotor symptoms (hot flashes)
Vasomotor symptoms, or hot flashes, are the menopausal symptom for which women seek treatment most often. While the exact cause of hot flashes is not well understood, they are causally related to decreasing estradiol concentrations. Hormone replacement therapy is an FDA-approved option for the treatment of hot flashes.
Vaginal health and sexuality
You may experience changes to your vaginal health and sex drive during perimenopause. For this, doctors can recommend various treatments, from over-the-counter lubricants to prescription estrogen creams, sprays, or gels.
Changes in your body
Researchers are currently exploring how physical changes are related to hormones and growing older. However, you can expect changes in your body during perimenopause, including changes to your skin and weight. You may also experience headaches, aches and pains, memory problems, and heart palpitations.
Changes in your mood
Just like premenopausal hormone fluctuations can cause premenstrual symptoms (PMS), hormone changes during perimenopause can cause mood changes as well.
If you are having perimenopausal symptoms, read more about whether you should seek treatment from a gynecologist or an endocrinologist.
To learn more from those experiencing similar symptoms, visit The Body Agency's Online Women’s Sexual Health and Wellness Community, and start a discussion.