Dear Lucy: How will I know when I’m in perimenopause? Will I still ovulate even if I am not menstruating? What’s a good resource for information about symptoms or changes to look out for regarding this time period? —I’m Peri Curious
Dear Peri: You are not the first to ask these questions, and you won’t be last, but Lucy thanks you for asking these questions in this forum, where so many other readers will benefit. To get some answers, Lucy knew just who to ask — MIT Medical Gynecologist Annie Liau.
Liau tells Lucy that “perimenopause” — or “menopausal transition” — generally begins about four years before a woman has her final menstrual period. “For most women, that’s around age 47,” she says.
But, she emphasizes, women experience perimenopause in a variety of ways. “Not everyone experiences same perimenopausal changes,” Liau says. “But most women will notice that their periods become less regular, and they have shorter menstrual intervals. You may also notice that you have less vaginal lubrication, and you may begin to experience an occasional warm sensation or hot flash. You might also notice a difference in the quality of your sleep — many women begin to have difficulty falling asleep or staying asleep. Emotional changes, especially feelings of depression, are not uncommon.”
But even though your periods may be irregular, it would be a mistake to assume you can’t get pregnant, Liau says. “You might not ovulate with every cycle,” she says, “but ovulation will occur sporadically until you’ve stopped menstruating completely.” How and when will you know that’s happened? Way after the fact, according to Liau. “Twelve months without a period is considered to represent clinical menopause,” she says. In other words, you’ll know that you’ve stopped menstruating completely a year after you’ve stopped completely. For most women, this happens between age 51 and 52, Liau says, but the timing of menopause for any individual woman is affected by a number of factors, including genetics and smoking. (Smoking is correlated with earlier menopause and more hot flashes — a great reason to quit, thinks Lucy.)
For more information, Liau recommends this FAQ from the American College of Obstetricians and Gynecologists and the many articles and FAQs you’ll find in the “For Women” section of the North American Menopause Society website.
“If symptoms are recurring and are interfering with your wellbeing and quality of life, I encourage you to have a discussion with one of our providers,” Liau adds. “There’s a lot we can do to lessen bothersome symptoms, so women can continue to flourish during this part of life.” Lucy seconds this advice. While your experience of perimenopause will be unique, Lucy hopes that you and other readers will remember that your primary care provider and the excellent clinicians of MIT Medical’s OB/Gyn Service will be there for you. —Lucy
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