No. There is a great deal of variability in the types and severity of symptoms. Genetics may play a role, so if possible, looking at your family history can help set your expectations for your own symptoms.

1. Dennerstein L, Dudley EC, Hopper JL, et al. A prospective population-based study of menopausal symptoms. Obstet Gynecol. 2000; 96:351–358. [PubMed: 10960625]

 

Menopause is recognized to have happened after one year (12 months) without a period. You can also ask your healthcare provider to measure the blood levels of Follicle Stimulating Hormone (FSH) that rise during perimenopause and stay elevated during menopause.

1.http://www.menopause.org 2. Melmed et al.Williams Textbook of Endocrinology 14 th edition.

 

Genetic factors play a role in the timing of this transition, so if you are able, look to your family history to set expectations. Lifestyle quality and your general health will also contribute to the timing. However, there is a great deal of variability amongst women so it is impossible to predict with complete accuracy.

Make sure you have a supportive and knowledgeable healthcare provider who will give you annual health screenings who is pro- active about your concerns. Physiotherapists, psychologists, trained counselors, and nutrition experts can also help you manage your physical and emotional symptoms. http://www.menopause.org is a website that can help you connect with well- trained experts in perimenopause symptoms.

1. http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocrinology 14 th edition.

3. Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

5. Dasai and Brinton_2019 Autoimmune disease in women: endocrine transition and disease across lifespan

 

Like other stages of life, eating a balanced nutritious diet, getting adequate high quality sleep, exercising regularly and maintaining a healthy body weight are key elements to good health. As well, share your experiences with family, friends and co-workers – not only does this normalize what you are experiencing and keep you from being isolated and alone, it will give your support system the information they need to assist you. Keep track of your symptoms and share these with your health care team. Take action where you can and stay positive.

1. http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocriology 14 th edition.

3. Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

5. Dasai and Brinton_2019 Autoimmune disease in women: endocrine transition and disease across lifespan

 

For most women, transition symptoms will likely fade away within one or two years of menopause. You might also still experience insomnia, memory challenges and depression. Every woman is a little different.

1. http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocrinology 14 th edition.

3. Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

5. Dasai and Brinton_2019 Autoimmune disease in women: endocrine transition and disease across lifespan

Some women gain adipose (fat tissue) around the middle even though there is no change in diet or lifestyle. You may experience bloating in your digestive system. If you have an autoimmune disease, it may become harder to manage. Migraines, depression and breakthrough bleeding are also associated with perimenopause.

1. http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocrinology 14 th edition.

3. Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

5. Minkin_2019_Hormones, Lifestyle, and Optimizing Aging

 

Many women experience hot flashes, which are sudden surges of blood rushing to the surface of your face and torso. Other common symptoms include vaginal dryness, stress urinary incontinence (release of urine when you lift or sneeze), deep fatigue, insomnia, rapid mood swings and temporary forgetfulness.

1.http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocrinology 14 th edition.

3.Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

 

Your body enters into the late reproductive stage when it begins phasing out reproduction around age 35- 40. It may be harder to get pregnant at this stage of life. You may also experience an early or “premature” perimenopause at this time.

1.http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocrinology 14 th edition.

3.Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

5. Minkin_2019_Hormones, Lifestyle, and Optimizing Aging

 

Your reproductive hormones are the main hormones changing their levels. These include estrogen and progesterone (from your ovaries), and luteinizing hormone (LH) and follicle stimulating hormone (FSH) from your hypothalamus located in your brain. During perimenopause, estrogen levels decrease overall, but might vary between very high or very low levels. These hormonal swings may account for mood disturbances (mood swings) and hot flashes.

1.http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocrinology 14th edition.

3.Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

5. Minkin_2019_Hormones, Lifestyle, and Optimizing Aging

 

Perimenopause, or the menopause transition, is a gradual, natural transition in your reproductive system that leads to menopause. It usually happens over 7-10 years and often starts around the age of 40. During perimenopause you will experience shorter and more irregular periods. The majority of women experience some troubling physical and mental symptoms.

1.http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocrinology 14 th edition.

3.Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

5. Minkin_2019_Hormones, Lifestyle, and Optimizing Aging

 

Menopause is the day you have the last period of your life, which marks the release of your last ovarian follicle. Most of the troublesome experiences happen earlier during the perimenopause transition.

1.http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocrinology 14 th edition.

3.Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

5. Minkin_2019_Hormones, Lifestyle, and Optimizing Aging

 

Regular cannabis use by mid- life women in North America is fairly new and there is not much data on the safety and effectiveness of cannabis with respect to menopausal symptoms. Make sure your care provider knows about your cannabis consumption, particularly if you are using prescription medications.

You should request a bone density exam by age 65 in order to test for osteoporosis (fragile bones). If you are at risk for low- impact fractures (because of family history) or you have had a low- impact fracture, request this exam by age 50. Low impact fractures commonly occur from falls and result in breaking a wrist or fracturing a vertebrae or hip bone). These types of fractures indicate you may be developing osteoporosis. Losing height by 1.5 inches or more also suggests that you may have some osteoporosis in your spine.

Women who are low-normal or below normal weight, who smoke, drink alcohol, and have low rates of exercise are at higher risk for osteoporosis in post- menopausal life.

 

This isn’t necessarily due to menopause! During the aging process, the lens of your eye undergoes natural changes that may make it harder to adjust your focus. However, decreasing estrogen in your blood can disrupt tear and oil secretions needed for lubricating your eyes, which can make vision blurry or dry your eyes. Your optometrist or your pharmacist can help with therapies for these symptoms.

It is suggested that women see a healthcare provider specifically about menopausal transition when you start to notice that your periods are getting irregular or you start to experience symptoms.

 

Natural menopause happens when your ovaries develop and release their last follicle and egg and stop producing estrogen. Medically induced, or treatment induced, menopause happens when there is surgical removal of both ovaries (oophorectomy). Medical menopause occurs also when a severe medical issue like breast or uterine cancer has been treated or managed with chemotherapy, radiation therapy, and/or hormonal therapy.

A hysterectomy, which is the removal of the uterus, does not necessarily mean menopause – it depends if one or both ovaries were removed at the same time. However, women who undergo a hysterectomy to treat fibroids or excessive bleeding have a nearly two-fold increased risk for developing menopause early.

 

Yes! Until you have had 12 consecutive months without a period, use contraception if you don’t intend to get pregnant.

Note that women who become pregnant after age 35 have an higher risk of miscarriage, and more than half of all pregnancies after age 45 end in miscarriage.

American Society for Reproductive Medicine

 

This life stage usually lasts 7- 10 years. If you have a high BMI, you may have a longer Menopausal transition.

No, about 20% of women have mild or no symptoms, or don’t seek medical care. About 40% of women have mild to moderate symptoms and seek medical care. Another 20 % have intense symptoms and need medical care.

Generally, women who have a high BMI and chronic stress in their lives tend to have more menopausal symptoms and those symptoms last for longer periods of time. Genetics may also impact your perimenopausal symptoms. There is a good correlation between the length and intensity of your menopausal transition and your mother’s menopausal transition.

 

No! Menopause is the life stage after the reproductive years. It is marked by the end of a woman’s menstrual cycles and is recognized when a woman hasn’t had a period for 12 months.

No! Perimenopause, also known as the menopause transition, is not a disease or a hormone deficiency disorder. All women go through this transition phase later in life (although the timing of onset does vary) and many have similar symptoms.

With medical support and the appropriate treatments many unpleasant and quality of life-impacting ‘symptoms’ can be managed. Talk to your health care provider if you are bothered by the changes you are experiencing.