What are the chief features of perimenopause?

Most women tend to worry when the menstrual cycles suddenly start to change in length and flow. Perimenopause is a normal physiologic event experienced by most women and is not a life threatening condition. The hallmark of perimenopause is irregular periods. On most cases, the periods start to become longer and the blood flow is scant. However, this is nothing to worry about it especially if it occurs in the 40s. During the initial phase of perimenopause, periods can be heavy and one may have to frequently change the pads, but soon the flow will become scant. In some cases spotty bleeding may last anywhere from 4-8 days. Another feature of perimenopause is that the periods tend to occur less than 21 days apart.

Often these changes prompt women to visit their doctor to ensure that nothing sinister is going on. If one is worried about the symptoms, a visit to the doctor is justified. Unfortunately, there is no one test that can make a diagnosis of perimenopause. The doctor can only make a diagnosis of this disorder based on the individual's history, symptoms and physical exam. The body symptoms experienced generally are the strongest clue that perimenopause has set in. Rarely some doctors may order hormonal levels to confirm the diagnosis, sometimes thyroid hormones are also checked because deficiency of thyroid hormone can also present with similar changes.

In any case, the majority of women go through perimenopause, which may last 3-9 months and enter menopause.

Is menopause and perimenopause the same thing?

Perimenopause is the transition period or the interval before one truly becomes menopausal. The perimenopausal time period is a natural shift of the hormonal cycle to irregular cycles and finally towards permanent infertility – the loss of eggs. The timing of perimenopause is variable and starts at different ages. For most women it starts in the 40s but in some cases, it may even start in the late 30s.

A woman may notice that her periods are becoming irregular and may vary in length of days from longer to shorter; and the actual menstrual cycle may also vary. This may go one for several months and eventually lead to permanent cessation of the menstrual cycle.

Associated with the perimenopausal period is the start of some symptoms like hot flashes, difficulty sleeping and vagina dryness. In most cases, the perimenopausal period lasts about 9-12 months. Once a woman has gone through 12 consecutive months without a menstrual period, she has then medically reached the stage of menopause.