This is the second in a series of three articles written by Dr. Metten on perimenopause. In this article she discusses the changes happening in yourmenstrual cycle and how this might affect your daily life.

In my previous article, What is Happening in My Ovaries?, I described the changes that take place in your ovaries during perimenopause. Perimenopause is a transition time of several years before menopause. 

• There has been a major reduction in eggs in your ovaries through the years and now there is only a small number remaining. 

• The ovaries slowly stop responding to direction from the brain and eggs are less frequently ovulated.

• Fluctuating hormones, estrogen and progesterone, can cause physical and emotional complaints.

There is not a definite age when every woman will begin perimenopause.

Some women might notice changes as early as their late 30’s, but for most women it begins at about 40 years of age and lasts until about 50 years old. It is not clear what triggers the beginning of this transition, but there seems to be a genetic component to it. Often, women follow their mother’s pattern.

One of the first signs that will alert you that you have entered perimenopause is a change in your menstrual cycle. This change is because the ovaries are winding down and not responding in the same way to direction from the brain.

• The number of days between each period begins to vary. For some women the days become longer and for others they become shorter.
• The number of days of you period might also vary becoming either longer or shorter.
• The intensity of the period might also change. Most women complain of more blood loss than usual.
• You might even skip a period and not be pregnant.

These variations can cause a woman to feel that she is not in control of her body because she cannot anticipate her next period or what it might be like.

Once you begin to notice a change in your menstrual cycle, all kinds of fears can surface.

Am I pregnant? Do I have cancer? Am I leaving my youth behind?

This might be a great time to see your doctor and discuss the changes you are experiencing and determine if they are due to perimenapause.

A common question I am asked by women in this phase is, can they still get pregnant?

The answer is yes.

The number of eggs ovulated in each year of perimenopause decreases but there are still ovulations happening. As long as you are having a period, you can get pregnant. Because you cannot predict as easily when you might be ovulating, surprise pregnancies are fairly common. We all know women who had twins (non-identical) as they approached 40 years of age because the crazy hormone environment resulted in two eggs being released at the same time!

Perimenopause is a natural transition in life.

It can also be uncomfortable at times.

Here are some of the more bothersome things most women have expressed:

• Difficulty sleeping
• Absentmindedness
• Mood swings
• Hot flashes
• Painful intercourse due to vaginal dryness
• Urine leakage when coughing, laughing, sneezing
• Weight gain
• Anxiety

Because perimenopause is a natural transition, I would encourage you to try natural methods first to help ease these symptoms.

Here are some suggestions that physicians and holistic health experts have shared with me.

• Daily exercise, make sure to include Kagel exercises to support the pelvic floor
• Reduce your stress through meditation, yoga, massage therapy
• Eat a healthy diet and keep your weight in an acceptable range
• Reduce sugar intake
• Strive for 7-8 hours sleep every night, try a cup of chamomile tea before bed and it might help and sleep in a dark cool room to be comfortable
• Acupuncture
• Consider adding these natural items to your diet.
  • Vitamin B6
  • Vitamin B12
  • Vitamin D
  • Vitamin E
  • Soy foods
  • Flax seed (1-2T/day)
  • Black cohosh
  • Evening primrose oil or black currant oil

Another great suggestion is to have frequent sex! On many levels this is a great idea, but a practical reason for frequent sex is that glandular secretions released help maintain healthy vaginal tissue.

Probably the most useful suggestion I can give you is to strive for a positive mental attitude. This is a great suggestion but I also realize it can be difficult to accomplish. Your children are possibly in puberty now and with that transition comes turmoil for you and for them. If you are married and your husband is in his 40’s, he is probably also experiencing hormonal changes that can effect his emotions and perspective on life. One way to combat anxiety is to gain knowledge. Understanding what is happening in your body can take away the mystery and give you confidence.

Supportive friends who are going through a similar time as well as adding MORE FUN to your life will work wonders to keep your spirits up and gracefully move through perimenopause! Consider this your permission to add more Girls Nights Out to your life!

In the next article, Dr. Metten explains emotional changes you might experience during perimenopause.