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Perimenopause means literally "around menopause" and represents the physical stage that most people equate with menopause: When hormonal changes begin within a woman's body and "symptoms" are most likely to be experienced. Perimenopausal changes can result in a great variety of signs and symptoms, including reduced fertility, irregular menstrual periods, hot flashes, vaginal symptoms, urinary tract symptoms, and more. No woman can predict what symptoms she will experience, or how severely. Therefore, the management of perimenopause needs to be as personalized as the symptoms themselves.

The average age for the onset of perimenopause is 47, though it is not uncommon for the changes to begin in the late 30s. Typically, perimenopause lasts 4 years, although this will vary from woman to woman. In rare instances, women move directly from premenopause to menopause, bypassing the menstrual irregularity and hormone fluctuations that characterize perimenopause.

Overview of Perimenopause Changes

As the ovarian production of the hormones estrogen and progesterone decline, a variety of feelings and physical changes may occur—which indicate how important the reproductive and endocrine systems are to many bodily processes. These changes are often called symptoms, implying that perimenopause is a "disease." In fact, some medical experts have offered alternative names for menopause that do sound as if they were describing a disease, for example, adult onset ovarian failure. For the most part, however, the medical community and laypeople alike regard menopause and perimenopause as a natural physical progression. Agreeing that perimenopausal changes are natural, however, does not diminish their importance or seriousness.

Signs of Perimenopause

Some of the signs and symptoms that occur during perimenopause include:
  • Reduced fertility

  • Irregular periods

  • Hot flashes

  • Vaginal dryness and irritation

  • Urinary tract symptoms

  • Reduced fertility
It's important to remember that fertility is determined not only by a woman's hormones and health, but by her partner as well. However, as a woman matures, fertility begins to decline. By her late 40s, infertility is generally the result of the age of the eggs. But even as fertility decreases, pregnancy may still occur.

Perimenopause is not a time to grow lax or careless with birth control. At this stage in your life, pregnancy is a complicated health challenge and should be a conscious decision. Therefore, it may be a good idea to consider other options for birth control at this time.

Irregular periods

Most women will experience menstrual changes and irregularities during perimenopause. The ovarian production of estrogen and progesterone regulates the normal process of menstruation. Changes in hormone production can be felt as a variety of changes in the menstrual cycle. These include:
  • Shorter menstrual cycle

  • Heavier bleeding than usual

  • Lighter bleeding than usual

  • Light bleeding throughout the month
Hot flashes

Fluctuating estrogen levels can cause circulation changes in a woman's body, and these changes often manifest in hot flashes, which are among the most common symptoms of perimenopause. The severity of hot flashes can vary dramatically among women. For some, they are mild and easy to endure. For others, they can be strong enough to interfere with normal functioning.

Hot flashes often have triggers—warm rooms, stress, spicy foods, alcohol, caffeine, and more—and thus can often be controlled with simple lifestyle modifications. Soy Isoflavones & Black Cohosh are natural alternatives that will help control your symptoms.

Vaginal dryness and irritation

Many women report changes in the vagina during menopause: dryness, itching, and sexual discomfort. As with irregular periods, there are many causes of vaginal symptoms beyond the hormonal changes of perimenopause. Natural Progesterone Cream is particularly effective in relieving these types of symptoms.

Urinary tract symptoms

During perimenopause and in the years after menopause, women may experience a thinning of the lining of the urethra and a weakening of the pelvic muscles. For some women, this may result in urinary tract problems such as urinary incontinence (urine leakage). As many as 40% of women in the menopause years suffer from incontinence, but fewer than half seek help for the problem. Treatment for incontinence can be as simple as regular muscle exercises (such as Kegel's exercises) or, in more difficult cases, prescription medications.

When it comes to menopause, each woman's experience will be unique. The hormone changes that begin at perimenopause can manifest in an almost infinite variety of physical changes and feelings. In addition to the symptoms discussed above, many women report:
  • Headaches

  • Occasional sleeplessness

  • Mood swings
Natural Alternatives for Perimenopause

Bioidentical Progesterone Cream with Phytoestrogens

Contains both progesterone and phytoestrogens which work together to provide women more effective control of their perimenopausal symptoms.

Menopause Formula (PhytoBalance)

PhytoBalance contains eight of the most tested and proven herbs that reduces hot flashes, night sweats, mood swings, irritability, and depression associated with perimenopause and menopause.

Recommended Herbs

Perimenopause-Condition Treatments


Double Menopause Website
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