What’s perimenopause and how it should be managed

Perimenopause, which sets in years before menopause, is a widely overlooked phase among women. Dr Manju Khemani, senior director and head of obstetrics and gynaecology at Max Smart Super Speciality Hospital, Saket, New Delhi, suggests how to look after yourself.

• Can strike before menopause: When a woman hasn’t had periods for a year, she is on menopause. But this does not happen abruptly. In the four to five years before menopause, the hormones are fluctuating and the eggs might not release as regularly. The condition is known as perimenopause.
• Periods may get irregular: Normally, a woman will have periods in 28 to 30 days. But during perimenopause, she will start having periods irregularly, with shorter or longer cycles or lighter bleeding. These are normal. However, heavier or more painful periods than normal would require a medical check-up. This can happen due to thickening of the uterus lining and needs to be investigated.
• Hot flashes are a common symptom: Some women have hot flashes—breaking down into sweat, even while, say, sitting in an air-conditioned room, and then feeling cold. At night, this can disturb their sleep. Some women also get irritable or experience mood swings, palpitation or terrible anxiety. They may need medicines to handle it. These are all symptoms of menopause but can manifest in the years prior to it as well.
• Doesn’t mean you can’t get pregnant: During perimenopause, women are still vulnerable to becoming pregnant and must use contraceptives to avoid unplanned pregnancies. Due to lowered estrogen levels at the time, women may also face lowered libido. The collagen in the vagina also decreases and this can cause painful intercourse.
• Preventive testing is the key: Many women have no symptoms during perimenopause and take it in their stride. But this is also the time they are likely to have cancers. They must get tests done to protect against cervical cancer, uterine pathology and breast cancer. The best way to handle symptoms at this time is through lifestyle management. Women must maintain optimal body weight, exercise daily, stop smoking, watch their diet and reduce stress. If the symptoms continue to affect the quality of life, then one can opt for hormone therapy and other medications—but only if lifestyle changes have had no impact.

Subscribe to India Today Magazine