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Perimenopause and Your Periods

Perimenopause Bleeding

Once you reach a certain age, you may notice that your periods start to become erratic and irregular. You may notice that your menstrual periods are shorter or longer. You may experience spotting in between your periods, and you may even go a month or two between periods. Every woman is different, but you should expect period changes once you near the end of your reproductive life.

When you hit your 40s, you may want to start paying attention to the signs and symptoms of perimenopause.

Perimenopause Definition

Perimenopause – which is also called “menopausal transition” – refers to the final years of your reproductive life, before you officially reach menopause. During your menopausal transition, your body begins a natural transition from having regular ovulation cycles to less-than-normal cycles. For this reason, most women can expect their periods to change and become more irregular . . . until one day, your periods stop all together.

Although it’s rare, some women can have regular menstrual periods until their very last menstrual period.

If you have gone through 12 months in a row without having one menstrual period, you are no longer in perimenopause. You have entered menopause.

The average age of menopause is 51 years, but this is just the average. Some women experience menopause earlier, others later. In general, a majority of women will reach menopause between age 45 and 55, but it’s also possible for women to enter menopause early – maybe in their late 30s or early 40s.

To figure out when you might enter menopause, ask your mother when she experienced hers. Women generally tend to have menopause at a similar age as their mothers.

Because of the wide range of age for menopause, you’ll want to be on the lookout for perimenopause symptoms in your early 40s, or even your late 30s. Women can experience perimenopausal symptoms up to 10 years before their last menstrual period. For the lucky ones, perimenopause only lasts a few months. The average length of this menopausal transition is four years.

How Does Perimenopause Change Your Menstrual Periods

You should expect to have erratic periods during perimenopause. During the years leading up to menopause, hormonal shifts and a decline in your ovarian function can cause you to experience irregular menstrual cycles. Period changes are one of the most common symptoms that you’re in perimenopause.

Once women hit their late 30s, they don’t produce as much progesterone – a hormone required to prepare the body for pregnancy. Progesterone also regulates the growth of your uterine lining. Women are less fertile, and it’s harder for them to get pregnant. The number and quality of follicles (the fluid-filled sacs in the ovaries that contain our eggs) also declines. This causes a decline in estrogen, and women ovulate less frequently. All of these changes can begin to change a woman’s cycle length and menstrual flow. For this reason, by the time a woman reaches 40, it’s not uncommon for her periods to become irregular.

During perimenopause, some women’s menstrual flow can become very heavy –due to less progesterone regulating the growth of the uterine lining after ovulation, so the uterine lining can become thicker before it’s shed, resulting in very heavy menstrual bleeding.

On the other hand, menstrual bleeding can also be very light. Some women may have their long periods that last for two or three weeks – but the flow is usually light when it lasts this long.

Your period can come two times a month, or it can come every two or three months. The intervals between each period can become shorter or longer. Many women do not have regular once-a-month periods in their menopausal transition.

Perimenopause Symptoms

In addition to irregular periods, you may also experience the following symptoms during your perimenopause years:

Hot Flashes and Night Sweats  – Up to 50 percent of all perimenopausal women will begin to experience sudden hot flashes that come with flushing and sweating. These hot flashes can last up to 10 minutes, and they can also strike at night. You may feel slightly warm, or you can end up sweating profusely. Unfortunately, hot flashes often continue for a year or two after menopause. An estimated 10 percent of women experience hot flashes for years after menopause.

A survey of 15,000 American women found that African American women typically experienced more hot flashes than Caucasian women. Out of all the ethnicities surveyed, Asian women had the fewest hot flashes. Previous research studies have also noticed that hot flashes are associated with a greater body weight, stress, and smoking.

  •  Vaginal Dryness – In late perimenopause, you may experience uncomfortable vaginal dryness, due to decreased estrogen levels that cause your vaginal tissues to lose their elasticity and lubrication. As a result, having sex may become more painful. These lower estrogen levels may also make you more at risk for urinary tract infections, or vaginal infections.This perimenopause symptom can become even worse after you reach menopause. Your vagina may feel itchy and irritated. To help alleviate your symptom, you may consider low-dose contraceptives, or even applying vaginal moisturizers.
  • Sleep Problems – Because of hot flashes and night flashes, you may notice that you have problems sleeping through the night. However, your sleep can also become erratic without these other symptoms. Sleep cycles change as we get older. Men experience insomnia as they age too, so problems sleeping may also be related to your growing age.At a 2005 National Institute of Health conference, data presented suggested that up to 40 percent of perimenopausal women experience sleep disturbances.
  • Mood Swings and Irritability – During perimenopause, your other symptoms (sleep disturbances, hot flashes, vaginal dryness, and etc.) can contribute to you becoming increasingly irritable and uncomfortable. As a result, mood changes are common during your menopause transition. An estimated 10 to 20 percent of all perimenopausal women experience mood symptoms.There’s also research that suggests low estrogen also puts you at a slight risk for depression. You are more likely to become depressed and moody if you have a lot of stress in your life, you’re in overall poor health, and you have a history of depression.
  • Short-Term Memory Problems – Some perimenopausal women experience short-term memory problems and a harder time concentration. There are few studies on memory problems and perimenopause, but scientists do know that estrogen and progesterone do play in maintaining brain information.

Should I Worry about Irregular Periods if Premenopausal?

Although irregular periods are common and normal when you’re premenopausal, there are many other health conditions that can cause you to experience long periods and irregular menstrual bleeding. For this reason, it’s a good idea to contact your doctor if you are worried. He or she can diagnose you with perimenopause based on the symptoms that you’re experiencing.

It’s also possible that you have something else going on, so it’s always a good idea to go for a check-up.

Pregnancy and Perimenopause

Although you experience a decline in your fertility during your premenopausal years, it is still possible to become pregnant during perimenopause. If pregnancy is not something that you want, you need to continue to use birth control when you’re having sex. It is harder to get pregnant once you reach perimenopause, but it is not impossible.


NOTE: The information provided in this article should not be construed as providing medical advice of any kind. It offers general information about perimenopause, how your menstrual cycles change, and other related information. Please contact your healthcare provider if you have questions about your individual situation.

About the author: DP Nguyen is founder and editor of Hip Chick’s Guide to PMS, Pregnancy and Babies. She’s an expert pregnancy and women’s health blogger. She is NOT a medical doctor and does NOT offer medical advice. Connect with her on Google+, Twitter and Facebook.

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