Can we talk? The first reaction to the signs that women may be transitioning to menopause is as varied as the women experiencing it.

Emotions can range from sadness to happiness; from doubt to denial. This part of your life signaled the beginning of womanhood and has been a constant for decades. However, with the advent of time, your body is changing and it’s trying to tell you that.

Perimenopause lasts an average of four years, but for some women this stage may last only a few months or continue for 10 years. Perimenopause begins several years before menopause  - when the ovaries gradually begin to make less estrogen. It usually starts in your 40s, but can start in your 30s or even earlier. During the final stages of perimenopause, your body will produce less and less estrogen.

Changing something that is so integral to your daily life can be as life-changing as its onset when you were 12 or 13 years old. Decades later, concern and sadness over the loss of fertility (which is in fact what is beginning to occur) can give way to a sense and feeling of freedom knowing that the chance of pregnancy is decreasing and will eventually end. Remember, despite the sharp drop in estrogen, it’s still possible to get pregnant.

Ultimately, perimenopause is officially over when a woman has gone 12 months without having her period and has now entered menopause.

Most people think about the symptoms more than anything else. These can include those infamous hot flashes, but there are many other changes you might experience during this transition. So, what are the signs that you have entered this new phase of your life? Women in perimenopause have at least some of these symptoms.

• Hot flashes
• Breast tenderness
• Worse premenstrual syndrome
• Lower sex drive
• Fatigue
• Irregular periods
• Vaginal dryness; discomfort during sex
• Urine leakage when coughing or sneezing
• Urinary urgency (an urgent need to urinate more frequently)
• Mood swings
• Trouble sleeping

How Is Perimenopause Diagnosed?

Often your doctor can make the diagnosis of perimenopause based on your symptoms. A blood test to check hormone levels may also help, but your hormone levels are changing during perimenopause. It may be more helpful to have several blood tests done at different times for comparison.

Perimenopause and menopause can also increase cholesterol levels. This is one reason why women in postmenopause are at an even higher risk for heart disease. Continue to have your cholesterol levels measured at least once a year.

When to Call a Doctor

You don’t necessarily have to call your doctor to obtain a perimenopause or menopause diagnosis, but there are instances when you should definitely see your OB/GYN. You might already be experiencing some early symptoms, but there are other signs that should be addressed with a doctor. Call right away if you have:

• spotting after your period
• blood clots during your period
• bleeding after sex
• periods that are much longer, or much shorter than normal

Some possible explanations are hormonal imbalances or fibroids, both of which are treatable. However, you also want to rule out the possibility of cancer, too.

You should also call your doctor if the symptoms of either perimenopause or menopause become severe enough to interfere with your daily life.

The physicians in the Women’s Health Specialists at Johnson Memorial Hospital are here to answer your questions and provide you with information and treatments. They have the experience and knowledge to help make this transition a healthier and more comfortable one for you.