Perimenopause symptoms can be subtle.By Deborah A. Wilburn
Hot flashes, vaginal dryness, irritability. These are all common signs of perimenopause -- the five- to 10-year period during which your estrogen levels fluctuate and egg production becomes erratic until your menstrual cycle stops completely. One year after your very last period, you're considered to be in menopause. The average woman enters menopause at age 52, so you could start developing symptoms anywhere from your early 40s to your late 50s.
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There are other perimenopause symptoms that many women overlook, says JoAnn Pinkerton, MD, ob/gyn professor and director of the Midlife Health Division at the University of Virginia. If any of these is familiar, you may be in perimenopause:
1. Your period stops for 3 to 6 months, then starts again. Some women may think they're pregnant, and when they turn out not to be, write it off as nothing in particular. But sporadic menstruation is a surefire sign that your ovaries have started producing eggs on an erratic basis. "Another signal is flooding," says Pinkerton. "You start to become irregular, may have a spotty period, and then go through times of very heavy periods."
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2. Breast tenderness intensifies. Because your period is erratic, you may not link tender breasts to perimenopause.
3. Migraines worsen. Some women get bad headaches before or after their periods. During perimenopause, migraine headaches could get worse. "If you go to your doctor complaining of headaches, she may think it's more serious than a side effect due to hormonal changes," says Pinkerton. Make sure your doctor knows about all your perimenopause symptoms.
4. Anxiety increases. If you suffer from anxiety already, you may start to have panic attacks, where you feel fear disproportionate to the circumstances. Symptoms include difficulty breathing, a racing heart, dizziness, and sweating.
5. Mental illness becomes more acute. This is especially true of women who suffer from depression or bipolar disorder.
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Because you've lost the predictability of your periods and symptoms, it's important to keep a menstrual calendar, advises Pinkerton. "Note when you have a period and come up with shorthand for a headache, breast tenderness, heavy flow," she says. This is especially key because the symptoms you experience may not be the same from cycle to cycle. So if you have heavy flow one month, or an especially bad migraine, it doesn't mean you'll have the same symptoms with your next period. If your perimenopause symptoms get really bad, you can discuss solutions with your doctor, including whether hormone replacement therapy is a good option for you.
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