1. Perimenopause is different from menopause

Menopause refers to a single episode in a woman's life, her "last" period and the end of female reproduction . Menopause is confirmed when a woman has gone one full year without having a period. The day after that one-year mark, she's now postmenopausal yet people refer to it as menopause. Typically, this occurs around age 52 but the age range runs 40–60, with many who experience it earlier or later.

Although perimenopause is defined as the time before "the change," its starting point isn't so definitive. It's a nebulous concept and you enter into it gradually and come out of it gradually. So, there is no easy, identifying place of how or when it starts. It can last for 8-10 years

Perimenopause is a result of a woman's aging ovaries, specifically when the coordinated patterns of the hormones estrogen and progesterone begin to vary, throwing the delicate system out of balance. It may take a while to detect symptoms, with a period still evident (although possibly shorter in duration, not as regular for instance), and then you may start to notice other small changes or not until you suddenly do...

Perimenopause can start when a woman is in her 30s or 40s, but the 40s are more common. It typically lasts 6–10 years and the experience varies considerably for many.

Perimenopause is marked by a drop in estrogen which is the main female hormone produced by the ovaries. The estrogen levels can also go up and down more sporadically than they do in a typical 28-day cycle. This can cause irregular periods and other symptoms.

During the final stages of perimenopause, your body will produce less and less estrogen. Despite the sharp drop in estrogen, it’s still possible to get pregnant. Perimenopause can last for as little as a few months and as long as 4 years

.

Menopause officially kicks in when the ovaries produce so little estrogen that eggs are no longer released. This also causes your period to stop

.

Your doctor will diagnose menopause once you haven’t had a period for a full year.

You may enter menopause earlier than normal

if you:

have a family history of early menopause

are a smoker

have had a hysterectomy or oophorectomy

have undergone cancer treatments.

Can you tell by a blood test if I am in perimenopause?

Most people can tell by the symptoms that they've started menopause. If you have worries about irregular periods or hot flashes, talk with your healthcare professional.

Tests most often aren't needed to diagnose menopause. But sometimes, your healthcare professional may suggest blood tests to check your levels of:

Follicle-stimulating hormone (FSH) and estrogen (estradiol).

FSHgoes up and estrogen goes down during menopause. Because hormones go up and down during perimenopause, it can be hard to tell from these tests whether you're in menopause.

Thyroid-stimulating hormone (TSH). Overactive thyroid, called hyperthyroidism, can cause symptoms like those of menopause.

You can get home tests to check FSH levels in your urine without a prescription. The tests show whether you have higher FSH levels. This might mean that you're in perimenopause or menopause, But FSH levels rise and fall during your menstrual cycle. So home FSH tests can't really tell you whether you're in menopause.

Symptoms of perimenopause and menopause

When hormone levels begin to decline in the lead-up to menopause, every system that has hormone receptors registers the change, including your brain. Ongoing fluctuation in hormone levels during this time can cause a range of symptoms, which may vary greatly between women and even change over time. Symptoms can range from mild to severe, and while some women may not experience many symptoms, others may experience a variety of issues that can significantly impact their quality of life. Even minor symptoms can have a major effect, especially if they persist over time. The long-term effects of menopause include an increased risk of osteoporosis and cardiovascular disease. If you are experiencing symptoms, it is important to discuss them with your GP or gynaecologist to explore appropriate management strategies.

As estrogen levels drop, you might start experiencing symptoms of menopause. Some of these can occur while you’re still at the perimenopause stage.

night sweats

hot flashes

depression

anxiety

irritability and mood swings

insomnia

fatigue

dry skin

vaginal dryness

frequent urination

Cholesterol

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

For a checklist on what to ask and discuss with your doctor, refer to our website at "What to discuss with your GP"

For details on Treatment options to ease your symptoms refer to our website "Treatment options"