Perimenopause - Symptoms and causes - Mayo Clinic

Declining estrogen levels may lead to unfavorable changes in your blood cholesterol levels, including an increase in low-density lipoprotein ( ... COVID-19:Advice,updatesandvaccineoptions FindoutaboutCOVID-19,COVID-19vaccines,andMayoClinicpatientandvisitorupdates. Skiptositenavigation SkiptoContent ThiscontentdoesnothaveanEnglishversion.ThiscontentdoesnothaveanArabicversion. SectionsforPerimenopauseSymptoms&causesDiagnosis&treatmentDoctors&departmentsCareatMayoClinic Print OverviewPerimenopausemeans"aroundmenopause"andreferstothetimeduringwhichyourbodymakesthenaturaltransitiontomenopause,markingtheendofthereproductiveyears.Perimenopauseisalsocalledthemenopausaltransition. Womenstartperimenopauseatdifferentages.Youmaynoticesignsofprogressiontowardmenopause,suchasmenstrualirregularity,sometimeinyour40s.Butsomewomennoticechangesasearlyastheirmid-30s. Thelevelofestrogen—themainfemalehormone—inyourbodyrisesandfallsunevenlyduringperimenopause.Yourmenstrualcyclesmaylengthenorshorten,andyoumaybeginhavingmenstrualcyclesinwhichyourovariesdon'treleaseanegg(ovulate).Youmayalsoexperiencemenopause-likesymptoms,suchashotflashes,sleepproblemsandvaginaldryness.Treatmentsareavailabletohelpeasethesesymptoms. Onceyou'vegonethrough12consecutivemonthswithoutamenstrualperiod,you'veofficiallyreachedmenopause,andtheperimenopauseperiodisover.Products&ServicesBook:MayoClinicTheMenopauseSolution SymptomsThroughoutthemenopausaltransition,somesubtle—andsomenot-so-subtle—changesinyourbodymaytakeplace.Youmightexperience: Irregularperiods.Asovulationbecomesmoreunpredictable,thelengthoftimebetweenperiodsmaybelongerorshorter,yourflowmaybelighttoheavy,andyoumayskipsomeperiods.Ifyouhaveapersistentchangeofsevendaysormoreinthelengthofyourmenstrualcycle,youmaybeinearlyperimenopause.Ifyouhaveaspaceof60daysormorebetweenperiods,you'relikelyinlateperimenopause. Hotflashesandsleepproblems.Hotflashesarecommonduringperimenopause.Theintensity,lengthandfrequencyvary.Sleepproblemsareoftenduetohotflashesornightsweats,butsometimessleepbecomesunpredictableevenwithoutthem. Moodchanges.Moodswings,irritabilityorincreasedriskofdepressionmayhappenduringperimenopause.Thecauseofthesesymptomsmaybesleepdisruptionassociatedwithhotflashes.Moodchangesmayalsobecausedbyfactorsnotrelatedtothehormonalchangesofperimenopause. Vaginalandbladderproblems.Whenestrogenlevelsdiminish,yourvaginaltissuesmayloselubricationandelasticity,makingintercoursepainful.Lowestrogenmayalsoleaveyoumorevulnerabletourinaryorvaginalinfections.Lossoftissuetonemaycontributetourinaryincontinence. Decreasingfertility.Asovulationbecomesirregular,yourabilitytoconceivedecreases.However,aslongasyou'rehavingperiods,pregnancyisstillpossible.Ifyouwishtoavoidpregnancy,usebirthcontroluntilyou'vehadnoperiodsfor12months. Changesinsexualfunction.Duringperimenopause,sexualarousalanddesiremaychange.Butifyouhadsatisfactorysexualintimacybeforemenopause,thiswilllikelycontinuethroughperimenopauseandbeyond. Lossofbone.Withdecliningestrogenlevels,youstarttolosebonemorequicklythanyoureplaceit,increasingyourriskofosteoporosis—adiseasethatcausesfragilebones. Changingcholesterollevels.Decliningestrogenlevelsmayleadtounfavorablechangesinyourbloodcholesterollevels,includinganincreaseinlow-densitylipoprotein(LDL)cholesterol—the"bad"cholesterol—whichcontributestoanincreasedriskofheartdisease.Atthesametime,high-densitylipoprotein(HDL)cholesterol—the"good"cholesterol—decreasesinmanywomenastheyage,whichalsoincreasestheriskofheartdisease. WhentoseeadoctorSomewomenseekmedicalattentionfortheirperimenopausalsymptoms.Butotherseithertoleratethechangesorsimplydon'texperiencesymptomssevereenoughtoneedattention.Becausesymptomsmaybesubtleandcomeongradually,youmaynotrealizeatfirstthatthey'reallconnectedtothesamething—hormonefluctuationsofthemenopausaltransition. Ifyouhavesymptomsthatinterferewithyourlifeorwell-being,suchashotflashes,moodswingsorchangesinsexualfunctionthatconcernyou,seeyourdoctor.   Thereisaproblemwith informationsubmittedforthisrequest.Review/updatethe informationhighlightedbelowandresubmittheform. FromMayoClinictoyourinbox Signupforfree,andstayuptodateonresearchadvancements,healthtipsandcurrenthealthtopics,likeCOVID-19,plusexpertiseonmanaginghealth. Email ErrorEmailfieldisrequired ErrorIncludeavalidemailaddress LearnmoreaboutMayoClinic’suseofdata. Toprovideyouwiththemostrelevantandhelpfulinformation,andunderstandwhich informationisbeneficial,wemaycombineyouremailandwebsiteusageinformationwith otherinformationwehaveaboutyou.IfyouareaMayoClinicpatient,thiscould includeprotectedhealthinformation.Ifwecombinethisinformationwithyourprotected healthinformation,wewilltreatallofthatinformationasprotectedhealth informationandwillonlyuseordisclosethatinformationassetforthinournoticeof privacypractices.Youmayopt-outofemailcommunicationsatanytimebyclickingon theunsubscribelinkinthee-mail. Subscribe! Thankyouforsubscribing OurHousecalle-newsletterwillkeepyouup-to-dateonthelatesthealthinformation. Sorrysomethingwentwrongwithyoursubscription Please,tryagaininacoupleofminutes Retry RequestanAppointmentatMayoClinic CausesAsyougothroughperimenopause,yourbody'sproductionofestrogenandprogesterone,keyfemalehormones,risesandfalls.Manyofthechangesyouexperienceduringperimenopausearearesultofdecreasingestrogen. RiskfactorsMenopauseisanormalphaseinlife.Butitmayoccurearlierinsomewomenthaninothers.Althoughnotalwaysconclusive,someevidencesuggeststhatcertainfactorsmaymakeitmorelikelythatyoustartperimenopauseatanearlierage,including: Smoking.Theonsetofmenopauseoccurs1to2yearsearlierinwomenwhosmokethaninwomenwhodon'tsmoke. Familyhistory.Womenwithafamilyhistoryofearlymenopausemayexperienceearlymenopausethemselves. Cancertreatment.Treatmentforcancerwithchemotherapyorpelvicradiationtherapyhasbeenlinkedtoearlymenopause. Hysterectomy.Ahysterectomythatremovesyouruterus,butnotyourovaries,usuallydoesn'tcausemenopause.Althoughyounolongerhaveperiods,yourovariesstillproduceestrogen.Butsuchsurgerymaycausemenopausetooccurearlierthanaverage.Also,ifyouhaveoneovaryremoved,theremainingovarymightstopworkingsoonerthanexpected. ComplicationsIrregularperiodsareahallmarkofperimenopause.Mostofthetimethisisnormalandnothingtobeconcernedabout.However,seeyourdoctorif: Bleedingisextremelyheavy—you'rechangingtamponsorpadseveryhourortwofortwoormorehours Bleedinglastslongerthansevendays Bleedingoccursbetweenperiods Periodsregularlyoccurlessthan21daysapart Signssuchasthesemaymeanthere'saproblemwithyourreproductivesystemthatrequiresdiagnosisandtreatment. ByMayoClinicStaff PerimenopausecareatMayoClinic RequestanAppointmentatMayoClinic Diagnosis&treatment Aug.07,2021 Print Shareon:FacebookTwitter Showreferences LoboRA,etal.Menopauseandcareofthematurewoman:Endocrinology,consequencesofestrogendeficiency,effectsofhormonetherapy,andothertreatmentoptions.In:ComprehensiveGynecology.7thed.Elsevier;2017.https://www.clinicalkey.com.AccessedMarch5,2021. AskMayoExpert.Menopausalhormonetherapy(adult).MayoClinic;2020. AskMayoExpert.Bioidenticalhormones.MayoClinic;2019. 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Topquestionsaboutmenopause.OfficeonWomen'sHealth.https://www.womenshealth.gov/menopause.AccessedMarch5,2021. WarnerKJ.AllscriptsEPSi.MayoClinic.Feb.25,2021. JohnsonA,etal.Complementaryandalternativemedicineformenopause.JournalofEvidence-BasedIntegrativeMedicine.2019;doi:10.1177/2515690X19829380. MinkinMJ.Menopause:Hormones,lifestyle,andoptimizingaging.ObstetricsandGynecologyClinicsofNorthAmerica.2019;doi:10.1016/j.ogc.2019.04.008. AmericanCollegeofObstetriciansandGynecologists.PracticeBulletinNo.128:Diagnosisofabnormaluterinebleedinginreproductive-agedwomen.ObstetricsandGynecology.2012;doi:10.1097/AOG.0b013e318262e320.Reaffirmed2016. AmericanCollegeofObstetriciansandGynecologists.PracticeBulletinNo.141:Managementofmenopausalsymptoms.ObstetricsandGynecology.2014;doi:10.1097/01.AOG.0000441353.20693.78.Reaffirmed2018. Blackcohosh.NationalCenterforComplementaryandIntegrativeHealth.https://www.nccih.nih.gov/health/black-cohosh.AccessedMarch8,2021. BasuP,etal.Phytoestrogensandbreastcancer:Invitroanticanceractivitiesofisoflavones,lignans,coumestans,stilbenesandtheiranalogsandderivatives.BiomedicineandPharmacotherapy.2018;doi:10.1016/j.biopha.2018.08.100. BurnettTL(expertopinion).MayoClinic.May5,2021. ZhaoT-T,etal.Dietaryisoflavonesorisoflavoine-richfoodintakeandbreastcancerrisk:Ameta-analysisofprospectivecohortstudies.ClinicalNutrition.2019;doi:10.1016/j.clnu.2017.12.006. Related AssociatedProcedures Endometrialablation NewsfromMayoClinic MayoClinicQandA:Spotting,perimenopauseandmenopause Dec.21,2020,06:54p.m.CDT Products&Services Book:MayoClinicTheMenopauseSolution PerimenopauseSymptoms&causesDiagnosis&treatmentDoctors&departmentsCareatMayoClinic Advertisement MayoClinicdoesnotendorsecompaniesorproducts.Advertisingrevenuesupportsournot-for-profitmission. Advertising&Sponsorship Policy Opportunities AdChoices MayoClinicPress Checkoutthesebest-sellersandspecialoffersonbooksandnewslettersfromMayoClinicPress. 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