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Everything You Need to Know About Perimenopause

Smiling Middle Aged Woman
Menopause doesn't happen overnight. Well before the menstrual cycle stops, most women experience perimenopause. Even though you may still get your period, all women should know what perimenopause is and what you can expect from this sometimes lengthy transitional time. Take a look at some of the common perimenopause questions and answers.
What Age Does Perimenopause Start?
This is one of the top questions that women have as they near age 40. While perimenopause typically starts at some point in a woman's 40s, it can begin almost any time. Some women, for medical reasons, go through early menopause - meaning that they experience perimenopause symptoms much younger than expected. Other women may not see signs until their 50s.
Is Perimenopause the Same Thing as Menopause?
Simple said, no, it isn't. Peri, meaning around, is the transitional time before a woman is fully in menopause. During perimenopause a woman will still get her period. Women often experience erratic menstrual cycles (either shorter or longer) during this transition, due to changing levels of estrogen and progesterone.
What Are the Symptoms of Perimenopause?
Some women have few or barely noticeable symptoms during this transition time. But others may experience heavier periods, lighter periods, change in length of the menstrual cycle (shorter or longer), missed periods, hot flashes, mood swings, or vaginal dryness.
How Long Will Perimenopause Last?
Like age of onset, the length of time that perimenopause lasts varies from woman to woman. Some women only experience a few brief months or a year of symptoms, while others have a much longer transition. On average, perimenopause takes four years.
Is Pregnancy Possible During Perimenopause?
Yes, you can get pregnant during perimenopause. Again, perimenopause and menopause differ. Perimenopausal women still have a menstrual cycle. This means they're still evaluating, or producing an egg. The presence of an egg allows a woman to get pregnant.
Even though women can still get pregnant during perimenopause, the chances aren't high. According to the U.S. Centers for Disease Control and Prevention's (CDC) National Vital Statistics Report, the birth rate for women ages 40 through 44 (in 2016) was 11.4 births for every 1,000 women. This number dropped to 0.9 births per 1,000 mothers for women ages 45 through 49.
Conception during perimenopause (presumably when a woman is in her 40s or older) also comes with increased risks of miscarriage, premature birth, and Down syndrome. Some risks, such as birth defects, decrease if the mother chooses to use a donor egg.
Should Women in Perimenopause Use Birth Control?
Again, the presence of a period means a woman can possibly conceive. If you previously used the rhythm method, a fertility awareness calendar may not help you to avoid pregnancy during perimenopause. Women in perimenopause often experience dramatic changes in their menstrual cycles. This makes calculating the time of ovulation difficult at best.
Unless you want to conceive, choosing a reliable method of birth control is necessary during perimenopause. Hormonal methods of birth control (such as the pill, ring, or patch) may even ease some perimenopausal symptoms - especially irregular or heavy periods. But women with certain pre-existing medical conditions, including high blood pressure or diabetes, should avoid these hormonal options.
Barrier methods or a nonhormonal copper IUD provides an effective alternative for perimenopausal women. Talk to your doctor about what method is safe and effective for your individual health needs.
When Is Perimenopause Over?
After missing 12 consecutive months of periods, you are technically in menopause. This excludes missing monthly cycles due to pregnancy, other medical/hormonal issues, or side effects from medications.
Are you in perimenopause? Regular gynecological care is an important part of this transitional time. Contact Jack G. Faup M.D. for more information.

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