Health News Articles

Perimenopause: A Critical Stage for Women

Mar 15, 2014

Menopause is the result of a woman’s ovaries no longer producing estrogen, which ends the menstrual cycle and marks the end of a woman’s reproductive ability, says Luc Lemmerling, MD, a board certified gynecologist with Princeton Medicine. When it happens varies from woman to woman, but menopause usually occurs between the ages of 45 to 58 years. Doctors today also look closely at the years transitioning into menopause, since the onset of symptoms may adversely affect the quality of a woman’s life.

Perimenopause vs. Menopause
“While menopause is marked by the absence of a menstrual period for 12 consecutive months with no identifiable cause,” says Alectis Santiago, MD, FACOG, a board certified gynecologist with Princeton Medicine, “the time prior to menopause, otherwise known as perimenopause, has been divided into an early transitional stage in which women may first notice irregularity in their periods with varying cycle lengths and heavier flow, and a later stage, in which periods may be skipped all together. The length of a menstrual cycle may double from 29 to 60 days. When women have two 60-day cycles, menopause often occurs 12 months later.”

Perimenopause, often occurring in a woman’s 40s, is an important stage for many women. Dr. Santiago notes, “Paying attention to the symptoms of this stage is crucial, since many of the same symptoms could be caused by serious medical problems.”

What Should I Look For?
Symptoms during perimenopause may include hot flashes and night sweats, symptoms that are also linked to menopause. Other symptoms in the early stages of perimenopause include joint pains, breast tenderness, fatigue, sleep disturbances, and sometimes even palpitations and irritable bowel symptoms. As women move into menopause, they may experience diminished libido, vaginal dryness, and urinary leakage.

Some factors, such as cigarette smoking and being overweight, can accelerate the transition to menopause by two to five years. Having lower economic status, family history and stress have also been linked to early menopause. Taking oral contraceptives, on the other hand, delays menopause by an average of about six months.

“At this time in a woman’s life,” says Dr. Santiago, “it is important to be aware of physical changes and to continue, or rethink, healthy practices such as regular exercise, a healthy diet, cutting out smoking and alcohol intake, and losing weight if needed.”

When to See a Doctor
Since several of the symptoms associated with this phase could also be caused
by other medical problems, it is a good time to see a primary care physician to determine if heart palpitations, irritable bowel symptoms, mood changes and sleep disturbances may be caused by another medical condition.

For relief of perimenopause or menopause symptoms, women might need to speak with their OB/GYN about the best options. Possible treatments include menopausal hormone therapy (or hormone replacement therapy) and over-the-counter or prescription medications. If your symptoms are making you uncomfortable or affecting your daily life, speak to your OB/GYN about the best treatment for you.

To find a physician affiliated with Princeton Medicine, call 1.800.FIND.A.DR (1.800.346.3237) or visit