Understanding Peri-Menopause

Peri-Menopause is the time in a woman’s life near menopause when the ovaries are no longer producing estrogen in the usual amount. For some women, this transition can begin in the early to mid-forties and cause very bothersome symptoms for years. The average age at menopause is 51-52 years. Peri-menopause symptoms are numerous and varied. Mood changes or increased PMS, irregular or heavy periods, hot flashes, and even symptoms of hair loss or urinary control problems may occur. In fact, any symptom known to occur during menopause can also be present during peri-menopause. (See our web page “What is Menopause” for a more complete list of symptoms.) If a menopause hormone (FSH) level is drawn, it will probably be normal. This does not mean that the symptoms are not real. Large up-and-down swings of estrogen levels cause many of these problems. In the past, many women did not receive treatment for these symptoms, unless a hysterectomy was performed.

Low-dose hormone therapy is often helpful in relieving peri-menopausal symptoms. This therapy involves both estrogen and progestin in most cases. With the approval by the FDA of the use of oral contraceptives past age 45 until menopause, women who have heavy bleeding in the peri-menopause time have another good option for non-surgical treatment.