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High on Hormones

The Perimenopause Transition

Menopause is perhaps among the most dreaded words in a woman’s dictionary. But many young women are not aware that menopause is actually a time of freedom and renewal. Christiane Northrup, author of The Wisdom of Menopause, even calls it “the renaissance of your life.” In fact, it is the phase before menopause, called perimenopose, that women should be prepared for.

Well, they wouldn’t call perimenopause “the storm before the calm” for nothing. Hot flashes, headache, weight gain… these are just among the common symptoms of perimenopause, which women experience in their late 30s or 40s.

Of Hot Flashes and Mood Swings
“Perimenopause is generally regarded as a period of around five years leading up to menopause,” explained Dr Khong Chit Chong, Senior Consultant, Menopause Service, KK Women’s and Children’s Hospital. “During this period, women may have no symptoms at all and can still have normal periods.” Dr Khong added that as women approach menopause, her periods become scantier, further apart and decreased in number of days of bleeding.
As a woman approaches menopause, her estrogen and progesterone levels drop, which leads to fluctuating hormone levels in the body. This causes the perimenopausal symptoms. For some women, the first signs of perimenopause may be subtle; others may experience the symptoms strongly.
“The most common symptom is that a woman has no more periods,” said Dr Khong. “If this occurs for three cycles or six months, then menopause is deemed to have occurred. It is also possible to confirm it by a blood test available at a medical practitioners’ clinic.” However, Dr Khong said to be mindful that an unexpected pregnancy may have occurred, “So this needs to be ruled out.”
Hot flashes are among the common symptoms of perimenopause. Some women may also experience mood changes, insomnia, and dry vagina causing discomfort during sex. “Most times, hot flashes are not troublesome and will go away from between a few months to as long as two to three years.” Other symptoms of perimenopause include irritability, heavy periods, hair loss, osteoporosis, memory lapse, palpitations, fatigue, loss of libido, anxiety and depression.

Hold the Hysterectomy
Other women experience heavy menstrual bleeding that sometimes some of them opt to have a hysterectomy, or surgical removal of the uterus. However, experts say that the best way to deal with the symptoms of perimenopause is to just be accepting and patient about it and know that this will pass.
“While most symptoms are usually tolerable, there are women who find them extremely troublesome. They will benefit from some form of treatment tailored specifically for the symptom presented,” explained Dr Khong. For hot flashes, he recommends some form of oral, injectable or transdermal hormonal support. For vaginal symptoms, local estrogens may be helpful. “And artificial lubrication during sex is useful for pain caused by dry vagina,” he added.
Lifestyle changes, such as regular exercises and relaxation, and some natural remedies also proved to be effective in managing the symptoms of perimenopause. Herbs like valerian to induce sleep; lady’s mantle for heavy periods; and Siberian ginseng to relieve depression and increase estrogen production can be helpful to relieve the discomfort brought by perimenopause. Evening primrose oil and black currant seed also help reduce the incidence of hot flashes.1 Acupuncture, yoga, aromatherapy and meditation are also known to have healing benefits for perimenopausal women.

The Freedom of Menopause
According to anthropologist Margaret Mead, “There is no more creative force in the world than a menopausal woman with zest.” A menopausal woman can do whatever she wants, wherever, whenever and however she wants it! With kids all grown up, no more career to stress over nor boss to impress, a menopausal woman has all the time and means in the world to make herself happy – including enjoying a fulfilling sex life!
Gina Ogden, sex therapist and author of The Return of Desire, conducted a sexuality survey of 4,000 men and women ages 18 to 86 from1997 to 1999, and she found that “the 50-, 60-, and 70-year-olds were having more meaningful sex than the 20- and 30-year-olds.”2 Experts attribute this to the fact that after menopause, most women feel more open, free, confident and secure to enjoy themselves.
A support system with family and friends is necessary to make the journey more tolerable. Here in Singapore, KKH ‘Woman to Woman’ Menopause Support Group provides a platform for women to share and discuss the myths and fears of menopause and their own experience with the condition. The group aims to provide comprehensive and accurate information on menopause to women. For more information, call the Menopause Hotline at 6394 1499.

1http://www.livestrong.com/article/19156-natural-remedies-perimenopause/
2http://www.more.com/health/perimenopause-menopause/reward-perimenopause-menopause

by Maripet L. Poso

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