Women's Health

A Primer on Menopause What Every Woman Should Know. Part 2

What Is This Thing Called Menopause?
Menopause is a change in the levels of hormones, in particular of the levels of estrogen, which are produced by a woman’s body. It is the result of a natural transition from having ovaries that produce large amounts of hormones — enough to bear a child — to having ones that produce much less. These hormonal changes are inevitable for every woman who lives long enough, and they have effects, both short- and long- term.

Three Stages of Menopause
Perimenopause
Perimenopause is the transition period from normal menstrual cycling to menopause itself, said Dr. Michael A. Thomas, director of the Center for Reproductive Health at the University of Cincinnati in Ohio. “It can take anywhere from two years to 10 years and can occur anytime after age 35.” It’s a process, he said, that’s different in every woman.

If a woman has her ovaries surgically removed, she does not go into a period of perimenopause, but goes directly into menopause. Chemotherapy also brings on menopause, although in some cases menstruation resumes after some time.

Perimenopause is typically a period when hormone levels fluctuate, often widely. Periods become irregular. There may be a great deal of bleeding, or very little. It’s a time, said Seaman, “of menstrual chaos.”

Love calls perimenopause “puberty in reverse.” You can feel really good one moment and low the next. Increasingly, she said, data is showing that the intense symptoms of perimenopause are caused by the shifting hormones. “You have your highest level of estrogen ever during perimenopause,” she said, as well as very low levels.

A woman can still be having a regular menstrual cycle at the same time that she starts to experience symptoms like hot flashes, vaginal dryness, mood changes and memory loss, Thomas said. And some of these symptoms are often mistaken for PMS or other conditions. Instead of being treated for hormonal fluctuations of perimenopause, women often end up with a prescription for antidepressants at this time. Studies to more accurately understand perimenopause are just getting started, he said.

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