Team Inspiriko - August 2022
Perimenopause Periods: Everything You Need to Know
Menopause can be at times dreaded, but for many women it is a welcome change. But did you know that the years before you stop menstruating have a name and very defined signs and symptoms? If you’re noticing changes in your mood, your gut health, your sleeping patterns and, of course, your periods, then you are most likely going through perimenopause.
This is a phase that affects women in their 40s. It typically lasts 4 years (1), though it can vary between a few months and 10 years. During this period, your hormones progesterone and estrogen (2) fluctuate wildly, which brings about many effects on your health. Menopause, on the other hand, marks the end of your menstruation. After 12 months without a period, you’ll be considered to have reached menopause (3).
The years before menopause can certainly feel like a roller coaster, especially if you’re not sure about what’s going on with your body. So, if you’re experiencing changes in your menstruation and would like to know more about what’s happening and why, keep on reading and discover everything you need to know about perimenopause periods.
Why Does Your Period Change During Perimenopause?
Perimenopause is a stage of transition, where your body heads to menopause but is not there yet. As a result, it starts preparing your reproductive organs for a complete stop in ovulation, so you produce fewer hormones (4). This, in turn, has inevitable effects on your menstrual cycles, turning them erratic, irregular, shorter or longer, among many other changes.
TAKE THE MENOPAUSE ASSESSMENT
Learn where you are in your menopause / perimenopause journey with the help of a personalised report.
START ASSESSMENTChanges That You Can Expect in Your Period
So, let’s dive deep into the changes you may experience to understand more about perimenopause periods:
1. IRREGULAR PERIODS (shorter, longer and late periods)
During this stage in your life, your hormones will be out of whack, causing longer or shorter cycles than normal, which leads to irregularity and unpredictability (5). For instance, your period may last 21 days instead of 28, making the intervals shorter. Experiencing a combination of short and long periods is completely normal (6).
There’s not a lot you can do about it, just be patient with your body as it goes through perimenopause and finally stops bleeding. However, there are some measures you can take to feel more comfortable during the perimenopause years:
● Invest in period underwear (that is, underwear made of cloth ). In this way, you won’t have to worry about staining your clothes.
● Protect yourself from spotting by using comfortable panty liners.
● You can buy re-usable items, like a menstrual cup or discs, to be used when your period comes. These are especially effective when struggling with heavy bleeding.
● Try to track your periods (or the lack of them) using calendars, journals, or an app.
2. MISSED PERIODS
Due to the hormonal imbalance caused by perimenopause, you may miss cycles altogether (7). This is not a cause for concern, though you may want to check if you are pregnant to make sure these missed periods are linked to the perimenopause stage.
3. ABNORMALLY HEAVY BLEEDING:
Again, this is tied to your hormones. If you have higher levels of estrogen when compared to progesterone, your uterine lining builds up, resulting in heavy bleeding (8). This means that your bleeding may:
● Soak through your tampon or pad
● Require you to use more than one protection method
● Last more than a week.
Menstrual cups can be your best allies when dealing with heavy bleeding. They are comfortable, re-usable and healthy. Menstrual discs are also a great idea, as they can give you protection for almost 12 hours. Plus, taking over-the-counter medication can help with the pain that is usually associated with heavy bleeding, but you should always consult with your doctor in case the symptoms disrupt your daily life.
4. SPOTTING DURING PERIMENOPAUSE:
Spotting is also normal during perimenopause when your period starts or ends. This means you’ll notice some blood on your underwear but not so abundant that it requires the use of tampons or pads (9). You should consider keeping track of this spotting by using an app or a journal and note when they start, how long they last, and any other details you consider important. This can be relevant when speaking to your healthcare provider. Wearing panty liners is a great idea if you’re worried about spotting and don’t want to be using pads all the time.
5. CRAMPS WITHOUT A PERIOD:
Unfortunately, no period does not always mean no cramps. Even if you don’t bleed, you may still feel pain due to erratic hormone fluctuations that make your uterus contract even though there may be nothing to expel (10). Going for a walk, applying heat, or taking some medications for pain are many times effective when doing away with these annoying cramps.
6. PAINFUL PERIODS:
During perimenopause, your periods can be painful even if they did not use to be in the past. This happens because, during this period of hormonal imbalance, your glands produce prostaglandins, which produce painful uterine contractions (11). To relieve this pain, you can adopt any of the measures mentioned above or others like acupuncture, meditation, and relaxation techniques.
What Else Can Cause Abnormal Periods?
In addition to perimenopause, there are certain health conditions that may cause abnormal periods. Some examples include:
● Polycystic Ovarian Syndrome (PCOS), a condition that affects your ovaries and can make your periods erratic or inexistent, among other symptoms (12).
● Problems with your thyroid or pituitary gland. These are two crucial glands that produce hormones that regulate your metabolism. The pituitary gland, in particular, is responsible for producing the follicle-stimulating and luteinizing hormones (13). If these glands are not working as they should, then your periods may be affected.
● Being stressed out. In addition to taking a toll on your mental health, too much stress can affect you physically, inhibiting the production of estrogen, thus affecting your ovulation and menstruation (14).
When Is It Essential to Seek Help From a Doctor?
You should consult with your doctor any time you have doubts about your symptoms. But some signs can show there may be an underlying condition other than perimenopause. Watch out for:
● Very heavy bleeding that requires frequent pad changes (every hour or two),
● Bleeding that doesn’t stop after 6-7 days.
● Very frequent cycles that take place in less than 3 weeks.
When Can I Expect My Periods to End?
Most women experience perimenopause for about 4 years, but this is not a fixed rule (15). While you may see your perimenopause periods stopping in only a few months, other women will be in this transition stage for years and years. Consult with your healthcare provider to know more about your particular case.
Once your period has stopped for 12 months, you are considered to have reached menopause. Following that you would be considered to be in Post Menopause for the rest of your life. In this period, you will not have any periods anymore and your other perimenopause symptoms will decrease in both intensity and frequency.
TAKE THE MENOPAUSE ASSESSMENT
Learn where you are in your menopause / perimenopause journey with the help of a personalised report.
START ASSESSMENTREFERENCES
1. Cleveland Clinic. 2022. Postmenopause: Signs, Symptoms & What to Expect. [online] Available at: <https://my.clevelandclinic.org/health/diseases/21837-postmenopause> [Accessed 12 August 2022].
2. Mayo Clinic. 2022. Perimenopause - Symptoms and causes. [online] Available at: <https://www.mayoclinic.org/diseases-conditions/perimenopause/symptoms-causes/syc-20354666> [Accessed 12 August 2022].
3. Acog.org. 2022. The Menopause Years. [online] Available at: <https://www.acog.org/womens-health/faqs/the-menopause-years?utm_source=redirect&utm_medium=web&utm_campaign=int> [Accessed 12 August 2022].
4. Harvard Health. 2022. Perimenopause: Rocky road to menopause - Harvard Health. [online] Available at: <https://www.health.harvard.edu/womens-health/perimenopause-rocky-road-to-menopause> [Accessed 12 August 2022].
5. Cleveland Clinic. 2022. Postmenopause: Signs, Symptoms & What to Expect. [online] Available at: <https://my.clevelandclinic.org/health/diseases/21837-postmenopause> [Accessed 12 August 2022].
6. Paramsothy, P., Harlow, S., Greendale, G., Gold, E., Crawford, S., Elliott, M., Lisabeth, L. and Randolph, J., 2014. Bleeding patterns during the menopausal transition in the multi-ethnic Study of Women's Health Across the Nation (SWAN): a prospective cohort study. BJOG: An International Journal of Obstetrics & Gynaecology, 121(12), pp.1564-1573.
7. Chestercountyhospital.org. 2022. [online] Available at: <https://www.chestercountyhospital.org/news/health-eliving-blog/2019/april/missing-period> [Accessed 12 August 2022].
8. Hale, G., Robertson, D. and Burger, H., 2014. The perimenopausal woman: Endocrinology and management. The Journal of Steroid Biochemistry and Molecular Biology, 142, pp.121-131.
9. Astrup, K., 2004. Menstrual bleeding patterns in pre- and perimenopausal women: a population-based prospective diary study. Acta Obstetricia et Gynecologica Scandinavica, 83.
10. Barcikowska, Z., Rajkowska-Labon, E., Grzybowska, M., Hansdorfer-Korzon, R. and Zorena, K., 2020. Inflammatory Markers in Dysmenorrhea and Therapeutic Options. International Journal of Environmental Research and Public Health, 17(4), p.1191.
11. Wiqvist, N., 1979. Prostaglandins and their Synthesis Inhibitors in Primary Dysmenorrhoea. Practical Applications of Prostaglandins and their Synthesis Inhibitors, pp.217-235.
12. nhs.uk. 2022. Polycystic ovary syndrome. [online] Available at: <https://www.nhs.uk/conditions/polycystic-ovary-syndrome-pcos/> [Accessed 12 August 2022].
13. Fourman, L. and Fazeli, P., 2015. Neuroendocrine Causes of Amenorrhea—An Update. The Journal of Clinical Endocrinology & Metabolism, 100(3), pp.812-824.
14. Genazzani AD. Neuroendocrine aspects of amenorrhea related to stress. Pediatric Endocrinology Reviews : PER. 2005 Jun;2(4):661-668.
15. Harvard Health. 2022. Perimenopause: Rocky road to menopause - Harvard Health. [online] Available at: <https://www.health.harvard.edu/womens-health/perimenopause-rocky-road-to-menopause> [Accessed 12 August 2022].
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