Perimenopause (Pre Menopause) Symptoms
Pre-menopause symptoms can start in women from the age of 37 or 38 in our (western) cultures. Usually, however, these first signs of menopause aren’t experienced by women until the age of 40.
The first signs of menopause are called perimenopause.
The word peri means ‘around’, though given that menopause officially starts when periods stop for good, this stage covers a long time.
Women with pre menopause symptoms usually have erratic periods lasting up to eight years before they stop. And the only true litmus a woman has of knowing whether her periods have stopped is after a year of no menstruation.
During this period when a woman’s menstrual cycle becomes erratic, there are also other changes to her period. Some women’s period becomes lighter or shorter, and some experience a heavier or longer blood flow. Not many women stop menstruating abruptly, though this can happen in some cases, even without an early menopause brought on by other factors like surgery or chemotherapy. This immediate cessation is not typical of pre menopause symptoms, however.
The reason for irregular periods in perimenopause is that women begin to skip ovulating in some months. In ovulation in regular menstrual cycles, women start off with what is called a primordial follicle. These ova are surrounded by a layer of cells. The ovum is what is released from the ovaries each month in the menstrual cycle.
Every month, about 6 to 12 primordial follicles, with the ovum inside, start to grow into what is called a primary follicle. This happens in response to two hormones produced by the anterior pituitary gland. These two hormones are called follicle stimulating hormone (FSH), and luteinizing hormone (LH).
So, at a certain stage of development, these 6-12 primary follicles start to accumulate a fluid inside them. This fluid has a high level of estrogen. This estrogen, in conjunction with FSH and LH, causes further growth of the primary follicles.
However, at some point, one primary follicle becomes bigger. This means it secretes more estrogen within it, which leads to even further accelerated growth for it.
At a certain point, the amount of estrogen that is being produced sends a signal to the anterior pituitary hormones to stop releasing as much FSH and LH. This affects the smaller primary follicles and they start to die.
But because of the size of the biggest primary follicle, and the amount of estrogen it is producing, it’s able to create a positive feedback cycle that means it still flourishes. And it is this primary follicle that is released in ovulation each month.
But as pre-menopause symptoms start to occur in a woman’s body, she has less primordial follicles to grow into the primary follicle that eventually ovulates.
Throughout a woman’s life, about 400 will develop and ovulate, but as women age, this number approaches zero. Because the primary follicles produce estrogen, with less primary follicles, the levels of estrogen reduce in the body also. Estrogen levels need to be at a certain level for the surge of LH hormone that triggers ovulation to occur. Without this surge, a woman will not ovulate.
Estrogen levels in the developing primary follicles causes the endometrium lining the uterus to thicken and develop new blood vessels in preparation for ovulation. More growth would occur after ovulation, and if a woman doesn’t fall pregnant, this blood and tissue would then be passed out of her body during the menstrual cycle. But if a woman hasn’t ovulated, there may not be much to pass out. And as the number of primary follicles reduces, so will the number and frequency of her periods.
Interestingly, as women age, instead of just one follicle maturing, groups of them do. That’s why multiple births have a higher chance of occurring then. But, it also means that there is an increased loss of follicles, and because of the other hormonal changes, less of these eggs actually ovulate.
It’s not just erratic periods that can give a woman a clue she may be experiencing pre-menopause symptoms. Other perimenopause symptoms include headaches, insomnia, aches in the body, tiredness, irritability, hot flushes, mood swings, a decreased sex drive, weight gain particularly around the abdomen and hips, breast tenderness, and water retention.
Fortunately, there are a lot of natural treatments designed to ease pre menopause symptoms. You can check some out here.