{"id":38796,"date":"2021-03-30T11:38:08","date_gmt":"2021-03-30T17:38:08","guid":{"rendered":"https:\/\/www.uchealth.org\/today\/?p=38796"},"modified":"2023-06-23T10:32:45","modified_gmt":"2023-06-23T16:32:45","slug":"perimenopause-the-slow-shift-to-menopause","status":"publish","type":"post","link":"https:\/\/www.uchealth.org\/today\/perimenopause-the-slow-shift-to-menopause\/","title":{"rendered":"Perimenopause: The slow shift to menopause"},"content":{"rendered":"
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On average, women are age 51 when they enter menopause, which is defined as going a full year without menstruation. Perimenopause typically lasts for five to 10 years. Photo by Getty Images.<\/figcaption><\/figure>\n

The shift into menopause doesn\u2019t happen overnight. In fact, this transition, also known as perimenopause, can take years.<\/p>\n

\u201cPerimenopause is the time leading up to when the ovaries cease to function, but it\u2019s not like putting on the brakes,\u201d said Dr. Diane E. Petersen<\/a>, an OB\/GYN with UCHealth Women\u2019s Care Clinics in Steamboat Springs<\/a> and Craig<\/a>. \u201cThe ovaries start to fail gradually.\u201d<\/p>\n

Below, Petersen explains what you can expect through perimenopause and how to treat troublesome symptoms.<\/p>\n

A woman’s regular cycle<\/strong><\/h2>\n

Petersen describes the menstrual cycle as a \u201cdance\u201d between the brain and the ovaries. Changes in ovarian hormones alert the brain that the ovary is working, while the brain gives instructions on what to do.<\/p>\n

A number of hormones are involved: for instance, estrogen and progesterone stimulate the uterus and breasts in preparation for a possible pregnancy, while FSH (follicle stimulating hormone) stimulates the development of eggs.<\/p>\n

Approaching menopause<\/strong><\/h2>\n

Eventually, this cyclical communication and response start to change.<\/p>\n

\u201cThe eggs in the ovary gradually decline and when you reach a certain point, some of the eggs aren\u2019t going to respond and develop, so you don\u2019t get estrogen,\u201d Petersen said. \u201cThe brain shouts louder and louder, and the FSH gets higher and higher, and eventually the ovary may kick back in. You may get a surge of estrogen because the brain is shouting so loudly, but then it plummets again.\u201d<\/p>\n

During perimenopause, swings in hormone levels mean normal menstrual cycles may be followed by times without a cycle or even overlapping cycles.<\/p>\n

Symptoms of perimenopause<\/strong><\/h2>\n

With dynamic changes in estrogen levels, women may experience symptoms such as emotional changes, difficulty sleeping, hot flashes and acne. \u201cMany women don\u2019t have issues, but for those who do, it can be very disruptive to their quality of life,\u201d Petersen said.<\/p>\n

On average, women are age 51 when they enter menopause, which is defined as going a full year without menstruation. Perimenopause typically lasts for five to 10 years.<\/p>\n

\u201cIncreasingly for women in their 40s, they\u2019ll have a rise in premenstrual dysphoria, or feeling off and irritable, before their menses,\u201d Petersen said.<\/p>\n

Treatments to help with perimenopause<\/strong><\/h2>\n

Various treatments are available to help women through the symptoms of perimenopause. Some women stay on an oral contraceptive until menopause, which provides steady levels of hormones.<\/p>\n

\u201cThere are benefits of that: it\u2019s simple, it can control heavy bleeding and it will often take care of those dips in estrogen,\u201d Petersen said. \u201cThere is a downside, as it\u2019s an oral estrogen, and as women get older, there are co-morbidities with the pill, such as an increased risk of blood clots in the legs and migraines.\u201d<\/p>\n

Petersen\u2019s preferred method of addressing perimenopause symptoms is to give a patient a very small amount of estrogen delivered through a low-dose patch. As the body slowly makes less estrogen through the perimenopausal years, the estrogen dose increases.<\/p>\n

\u201cIt\u2019s complicated and requires a lot of conversations between the doctor and patient, but when it works, it\u2019s really great,\u201d Petersen said.<\/p>\n

An IUD (intrauterine device) that delivers hormones locally can help address issues with heavy periods.<\/p>\n

Since the decreased estrogen levels impact the function of neurotransmitters, a low dose of an SSRI (selective serotonin uptake inhibitor<\/a>) antidepressant may help address cyclical mood changes and hot flashes.<\/p>\n

\u201cThere shouldn\u2019t be a stigma in using an SSRI,\u201d Petersen said. \u201cThe brain cells need to have neurotransmitters, or chemicals that live in between cells and transmit or talk. SSRIs allow that to continue.\u201d<\/p>\n

Petersen acknowledges the concern that taking estrogen may contribute to breast cancer, but points out that causes of breast cancer are likely varied and complex.<\/p>\n

\u201cWe have to make these decisions as intelligently as we can,\u201d Petersen said. \u201cPerimenopausal treatment is tailored to each woman \u2013 what she\u2019s feeling, what her family history is, what scares her and keeps her up at night, and what will help her feel better.\u201d<\/p>\n

This story first appeared in the Steamboat Pilot & Today.<\/em><\/p>\n","protected":false},"excerpt":{"rendered":"

The shift into menopause doesn\u2019t happen overnight. In fact, this transition, also known as perimenopause, can take years. \u201cPerimenopause is the time leading up to when the ovaries cease to function, but it\u2019s not like putting on the brakes,\u201d said Dr. Diane E. Petersen, an OB\/GYN with UCHealth Women\u2019s Care Clinics in Steamboat Springs and […]<\/p>\n","protected":false},"author":2163,"featured_media":38805,"comment_status":"closed","ping_status":"closed","sticky":false,"template":"","format":"standard","meta":{"_acf_changed":false,"_relevanssi_hide_post":"","_relevanssi_hide_content":"","_relevanssi_pin_for_all":"","_relevanssi_pin_keywords":"","_relevanssi_unpin_keywords":"","_relevanssi_related_keywords":"","_relevanssi_related_include_ids":"","_relevanssi_related_exclude_ids":"","_relevanssi_related_no_append":"","_relevanssi_related_not_related":"","_relevanssi_related_posts":"","_relevanssi_noindex_reason":"","footnotes":""},"categories":[6],"tags":[32,9187,212,23],"class_list":["post-38796","post","type-post","status-publish","format-standard","has-post-thumbnail","hentry","category-healthy-living","tag-gynecology","tag-readysetco","tag-womens-care","tag-womens-health"],"acf":[],"yoast_head":"\nPerimenopause: The slow shift to menopause - UCHealth Today<\/title>\n<meta name=\"description\" content=\"The shift into menopause, known as perimenopause, can take years. 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