After my last child was born when I was 37 years old, I began experiencing some symptoms, which were confusing at best, and driving me crazy at worst. At first, I suspected it was related to menopause, but I wasn’t quite sure where the problems were arising from because I was still so young. So I read a couple of books on menopause and discovered the term perimenopause. One of the minor symptoms I was having was increased facial hair growth, which was very annoying. Another symptom I was having was an increased sex drive that was keeping me awake most nights, when I needed to be sleeping. Now this may have been great in a good marriage, but I was not in a good one at the time. I was separated from my husband at the time, so this made me much more susceptible to temptations that I may not have experienced during this phase of my life otherwise. Finally, my husband and I came to an arrangement that kept us both happy for the time being – we lived apart, but came together for sexual relations when needed. Now this certainly wasn’t the best arrangement, but it kept me from going and doing something stupid against God’s Word, like having an affair and risking getting an STD. As a Christian woman, those alternative choices were not an option for me. The worst of the symptoms I was having was that I was feeling pregnant all the time. For a while there wasn’t a month going by that I didn’t purchase and use an at home pregnancy test, just to make sure. This was the symptom that was most driving me crazy. I kept thinking I was pregnant, only to find out that I wasn’t. My emotions were going haywire.
During this time of my life, I realized how little I knew about this time of change, and with all my body parts still in tact, how much I needed to know. Everyone I knew who had gone through menopause had gotten their tubes tied or had a hysterectomy, and did not experience the same kind of menopausal symptoms like I had been having. I knew of no one in the generation before mine, who like me, was still physically able to have children, and had gone through the stages of menopause. I finally heard about one aunt, who was much older than I, who had walked around in maternity clothes during this whole stage of her life. So maybe I was not the only one going crazy after all. For sanity’s sake, I did some research, and would like to share some of it with you others out there, who may be thinking your going nuts. Every woman’s story is different. Some women won’t have any problems at all, but others might have every symptom in the book. Though most women normally go through perimenopause between ages 45 and 55, some women start having symptoms much earlier, as I did. So if your one of those younger women who are experiencing symptoms and have no idea what’s happening to you, here are some details that may help you figure it all out.
Perimenopause, also called the menopausal transition or change of life, is the time in which a woman’s body makes a natural shift from regular cycles of ovulation and menstruation toward no menstruation and infertility, or menopause. In women who still have a uterus, perimenopause is the years before and after the final period, which is determined in retrospect. This stage of a woman’s reproductive life begins several years before actual menopause, when the ovaries gradually begin to make less estrogen. During perimenopause, the ovarian production of the estrogens and progesterone becomes more irregular, often with wide and unpredictable fluctuations in levels. The symptoms of menopause are caused by these changes in estrogen and progesterone levels. The ovaries make less and less of these hormones over time. As a result of the fall in hormone levels, changes occur in the entire female reproductive system. The vaginal walls become less elastic and thinner. The vagina becomes shorter. Lubricating secretions from the vagina become watery. The outside genital tissue thins, which is called atrophy of the labia. Most women start noticing these signs of perimenopause in their early 40s, or sometimes even as early as their late 30s.
The average length of the perimenopause stage is four to ten years, but can be shorter or longer for some women. The Perimenopause stage lasts up until menopause, the point at which the ovaries stop releasing eggs all together. In the last couple of years of perimenopause, the loss of estrogen happens more quickly than in the earlier years. At this stage, many women experience more severee menopausal symptoms. Their periods may become irregular, lasting longer or shorter, being heavier or lighter, with their cycle sometimes more or less than 28 days apart, and they may experience spans of time of many months with no flow at all, after which menstruation may resume again. Early in the perimenopausal stage it is not uncommon to have long episodes of spotting, and menstrual cycles as short as two weeks. Further along, it is common to skip periods for several months at a time, followed by a heavier period. The number of skipped periods in a row often increases as the time of last period approaches. Women may also experience menopause-like symptoms, such as sleep problems, memory problems, lack of concentration, hot flashes, vaginal atrophy, and skin drying. Many effects that are caused by the extreme changes in hormone levels usually improve or disappear when the perimenopause stage has ended.
If a woman has not had her tubes tied or had a hysterectomy, she may feel pregnancy-like symptoms on some months and may even be late on occasion, and believe she is pregnant. In some women, these symptoms may be an overt expression of a sense of loss related to the end of fertility. If some form of contraception isn’t used during this time, a woman can still get pregnant and may actually be pregnant. Testing is advised if there’s any question. During this time, fertility decreases, but is not considered to be impossible until after the onset of menopause. Women’s chances of becoming pregnant dwindle after about 25 or so, but 35 to 40 something-year-olds do sometimes get pregnant. The world record for a naturally conceived pregnancies stands at 59 years old for the female, with the oldest verified male at 94 years. If you do want to get pregnant, don’t give up, there’s still a chance. If you don’t want to get pregnant, precautions should be taken. If you choose to have sex during this time of your life, be aware that most forms of contraception, not even condoms or dental dams (used for oral sex) provide complete protection against STDs and HIV. The only sure protection against these diseases is abstinence (not having sex of any kind with anyone) or monogamy (sex with a mutually monogamous spouse), which is by God’s design.
Once a woman has gone a year without a menstrual period, she’s reached menopause, and the perimenopause period ends. Medically speaking, menopause is tied to a specific date. If the woman still has a uterus, menopause is defined as the day after her final menstrual flow finishes. This date is fixed once 12 months have gone by with no menstrual flow at all, not even spotting. At this point a woman is considered to be postmenopausal, to be infertile, and to no longer need to consider the possibility of pregnancy. The term postmenopause is applied to women who have not had a menstrual period for at least 12 months, assuming that they do still have a uterus, and are not pregnant or lactating. Postmenopause is the time in a woman’s life after her last period, or all of the time that follows the point when her ovaries become inactive and she is no longer fertile. In women who have no uterus, and therefore have no periods, post-menopause can be determined by a blood test which can reveal the very high levels of Follicle Stimulating Hormone (FSH) that are typical of post-menopausal women.
During the perimenopausal period many changes in a woman’s body can occur. Some things they might experience include menstrual irregularity, hot flashes, decreased fertility, feeling pregnant, breast tenderness or atrophy, increased or decreased sex drive, sleep problems and fatigue, worsening of PMS, mood swings or depression, migraines or headaches, vaginal dryness or itching, vaginal infections, discomfort during sex, joint aches and pains, rapid or irregular heartbeat, urine leakage or urgency, hair loss or thinning, more hair growth on the face, bone loss, and cholesterol level changes. Some of the more significant changes are detailed below:
• Menstrual irregularity – Early perimenopause is a change in the menstrual cycle length of more than seven days. Late perimenopause is noted by two or more missed periods.
• Hot flashes – Most women experience some hot flashes, which are a sudden temporary increase in body temperature, most commonly during late perimenopausal stage. The intensity, duration and frequency vary. In some cases hot flashes can be so strong that they raise the body temperature multiple degrees in a very short period of time. This extreme change can cause the sufferer to feel weak and break out in heavy sweating. Hot flashes are not considered harmful by physicians, though they are quite uncomfortable to some women.
• Sleep Problems – Sleep problems are often due to hot flashes or night sweats, but sometimes sleep becomes erratic even without them. Increased sex drive can also wake you up at night.
• Changes in sexual function. During perimenopause, sexual arousal and desire may increase or decrease. For most women who had satisfactory sexual intimacy before menopause, this will continue through perimenopause and beyond.
• Mood changes – Perimenopausal mood swings are often mistaken for depression. Some women experience mood swings, irritability, or depression during perimenopause, but the cause of these symptoms may be sleep disruption. A woman suffering insomnia, fatigue, weight gain, problems in concentrating, and loss of interest in sex might be diagnosed as mildly depressive when she’s actually in perimenopause.
• Vaginal and bladder problems – When estrogen levels decrease, the vaginal tissues may lose lubrication and elasticity, making intercourse uncomfortable. Low estrogen levels may also leave women more vulnerable to urinary or vaginal infections. Loss of tissue tone may contribute to urinary incontinence.
• Decreasing fertility. As ovulation becomes irregular, the ability to conceive decreases, though as long as a woman has periods, pregnancy is still a possibility.
• Loss of bone. With decreasing estrogen levels, bone loss happens more quickly than it can be replaced, increasing the risk of osteoporosis.
• Changing cholesterol levels. Decreasing estrogen levels may lead to unfavorable changes in blood cholesterol levels, which contributes to an increased risk of heart disease.
Some factors may predispose women to starting their perimenopause years at an earlier age, such as smoking, family history, being barren, or having had a hysterectomy. These are detailed below:
• Smoking. The onset of menopause occurs a couple of years earlier in women who smoke, compared with women who don’t smoke.
• Family history. Women tend to experience menopause around the same age as their mothers and sisters.
• Being Barren. Some studies show that never having had a baby may contribute to early menopause. (In my own case, I had eight children and began having symptoms at 37.)
• Hysterectomy. A hysterectomy that removes the uterus, but not ovaries, usually doesn’t cause early menopause, because ovaries still produce estrogen. But Hysterectomies that remove the ovaries, causes menopause to occur immediately. When for medical reasons the uterus has to be surgically removed (hysterectomy) in a woman, her periods will cease permanently, and she will be unable to have a baby, but as long as at least one of her ovaries is still functioning, the woman won’t go into menopause. Even without the uterus, ovulation and the release of reproductive hormones will continue until natural menopause. In circumstances where a woman’s ovaries are removed (oophorectomy), which is often done in conjunction with removal of the Fallopian tubes (salpingo-oophorectomy), even if the uterus is left intact, the woman will immediately go into surgical menopause, which is induced suddenly and totally, by removal of both ovaries prior to natural menopause.
Author Kimberly Hartfield’s A Little Redneck Theology