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In the course of a female’s life, she experiences a series of reproductive stages, beginning from puberty and ending in menopause. In between these stages is one which is hardly talked about, and that is PERIMENOPAUSE. It is simply the transition between the fertile period (during and after puberty) to the period where pregnancy is not likely to occur again (menopause).
Almost every woman or young girl is familiar with the term 'ovulation' and the body changes that occur during the period. Ovulation occurs in every menstrual cycle and is when an egg is released to be fertilised.
As a woman, transitioning from one reproductive stage to another will come with differences in how your body feels. A woman in the early reproductive stage will not experience ovulation or menstruation the same way an older woman in perimenopause would. A woman in menopause has nothing to do with menstruation anymore.
However, in this article, we’ll focus on the ovulation symptoms during perimenopause and how different it is from ovulation in a young woman.
Ovulation is a part of the processes of the menstrual cycle. After the bleeding ends, the uterine lining that was expelled during menstruation starts to build up again.
After this stage, called the Proliferative Stage, your ovaries begin to work to develop egg-containing follicles. These follicles produce estrogen, which helps rebuild the lining of the uterus.
These activities prepare the uterus for the egg that would be released and result in the rise of the estrogen level which was lowered during menstruation. As the estrogen level rises, an egg prepares to be released.
This stage intercepts menstrual bleeding and ovulation, which is the process that involves the release of a matured egg from the ovary.
If ovulation doesn't occur, pregnancy cannot. That is why it plays a major role in conception.
When the egg is released, it may or not be fertilized depending on various factors. These factors include whether or not there was sexual intercourse and also the strength of the sperm.
If fertilization fails to occur, you have another period. And if it does, the fertilised egg goes to implant in the uterus, and that's how a pregnancy develops.
Nobody just jumps from being all reproductive and fertile to menopause. That is where perimenopause comes in.
As the name implies, Perimenopause is the normal progression and natural transition into menopause. It usually begins as early as your mid-30s or as late as your mid-50s.
During this period, the reproductive hormones that prepare your body for ovulation ~ progesterone, estrogen, and testosterone ~ begin to slow down. Your menstrual cycles become unpredictable. You can still get pregnant during this period, but your fertility begins to decline, so the chances of pregnancy decrease.
When you start noticing these signs, together with changes in your flow and the regularity of your period, you might just be in perimenopause.
Some women experience perimenopause for a short time. But for many others, it lasts four to eight years before the onset of menopause.
During menopause, your body begins to produce fewer hormones that control the menstrual cycles, which include ovulation. Because of this, you will experience irregular periods, menstrual flows, and ovulation becomes random.
If you are trying to avoid an unplanned pregnancy, you can implore contraceptive measures because, at this point, your fertility is unpredictable.
Due to estrogen dominance, estrogen-based oral contraceptives (the pill) frequently make perimenopausal symptoms worse.
As a result of decreased or absent ovulation, the progesterone levels in the body reduce, giving rise to perimenopausal symptoms.
As you go through this menopausal transition, some little and some not-so-minor changes to your body may occur. Of all the symptoms you may experience, you may also encounter:
During perimenopause, your sexual arousal and drive may likely reduce. But the good part is if you had an up-to-par sexual life or intimacy before your perimenopause, it wouldn’t be difficult to keep up through perimenopause to menopause and beyond.
As ovulation becomes more erratic, the duration between your periods may get longer or shorter, your flow may vary from light to heavy, and you’ll have more missed periods. If the length of your menstrual cycle changes for seven days or more, you may be in early perimenopause.
On the hand, if you get a period within a 60-day interval or more, you are likely in late perimenopause.
Hot flashes are unexpected waves of body heat accompanied by sweating lasting about 5-10 minutes. About 35%-50% of women in perimenopause experience this very often at night as well as in the daytime.
The heat buildup initiates in the scalp, to the face, neck, or chest. The intensity, duration and frequency differ dramatically among women. For some women, hot flashes come as a slightly warm feeling. Meanwhile, for others, it may feel like fire burning from within. Most times, hot flashes last for about a year or two.
An estimated 40% of perimenopausal women develop sleep problems. Some studies have established a relationship between night sweats/hot flashes and loss of sleep.
Generally, sleep cycles change as we advance in age, so sleep problems during perimenopause cannot be based totally on hormone oscillations alone.
About 10%-20% of perimenopausal women experience mood swings, irritability or even increased risk of depression. Some studies show that oestrogen activity during the menopausal transition is linked to depression, but there is no substantial evidence that depression in women during their midlife stems from these hormonal declines. Actually, women have a higher rate of depression before age 45 than after.
Periods of irritability may occur as a result of the unpredictable nature of perimenopause, which can be stressful.
In addition, hormonally-related mood swings may affect some women more than others. Life stress, poor general health, and a history of depression are the best indicators of mood problems in their midlife.
Some studies, however, link these mood swings to sleep deprivation caused by hot flashes.
When estrogen levels drop in late perimenopause, your vaginal tissues weaken and lose lubrication and suppleness, making intercourse painful, which is one of the reasons for decreased sexual desire. Itching and irritation might result from vaginal dryness (which usually worsens after menopause).
Low estrogen levels may also make you more prone to urinary or vaginal infections. The loss of tissue tone may contribute to urine incontinence.
Fertility is solely dependent on the body’s ovulation. So technically, when ovulation becomes erratic, the probability of conception lessens. However, this doesn’t mean pregnancy becomes a castle-in-the-air situation.
As long as you continue to have menstrual flow, pregnancy is still possible. But if you wish to avoid pregnancy, you can choose from the many birth control options.
As you transition into menopause, the uterine lining may thicken before it is expelled, as there is less progesterone to control endometrial growth. This change results in excessively heavy periods.
In addition, fibroids and endometriosis (endometrial tissue migration to other pelvic structures), which are both fuelled by estrogen, may also become more problematic.
When you begin to see symptoms that feel out of place such as:
Reach out to your healthcare provider for a thorough investigation.
Symptoms of perimenopause vary from one woman to another. However, when you go 12 consecutive months without a menstrual period, you have finally transitioned from perimenopause to menopause.
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