What is Perimenopause and How is it Different from Menopause?
Perimenopause is a transitional stage where estrogen produced by the ovaries begins to fluctuate resulting in changes in menstrual flow and length of cycles. Perimenopause can begin in some individuals as early as in their 30’s but more often we see individuals have symptoms in their 40’s and 50’s. Each individual is unique and the transitional phase can range from 4-8 years. Symptoms range widely from each individual and some may experience no symptoms, mild symptoms, severe symptoms, or a mixture of them.
Menopause is a point in time when an individual who was menstruating no longer is having menstrual periods and the ovaries have stopped making estrogen. A person must have gone 12 consecutive months of no menstruation to be officially in menopause; this marks the end of the reproductive stage. The average age of the beginning of menopause in the United States is 51 years old.
Although perimenopause and menopause are different in their definition individuals report very similar symptoms and they may include:
Irregular periods: Cycles may become shorter or longer than usual and the amount of blood flow may be lighter or heavier, you may even start to begin skipping periods or having no periods for many months
Hot flashes: a sudden feeling of heat that is felt in the body-usually the face. Hot flashes may be short or last for several minutes. Hot flashes can occur any where on the body and vary from several times a day to several times a month
Sleep disturbances: Insomnia, night sweats, and waking up several times throughout the night are commonly reported by individuals going through perimenopause
Emotional shifts/depression: Dipping estrogen and progesterone levels can cause mood swings and some individuals are more sensitive to hormone shifts than others. Individuals who have struggled with depression in their past are more likely to develop depression again during perimenopause and menopause
Thinning and drying of vaginal tissues: When estrogen levels decrease the lining of the vagina becomes less elastic, thinner, and dryer. Vaginal dryness may cause pain during sex and an increase in vaginal infections. The urethra also becomes more inflamed, dry, and irritated which may result in urinary urgency, frequency, urinary tract infections, and incontinence
Weight gain: Fluctuation in hormones (especially estrogen), metabolic changes, and a decrease in muscle mass, and a decrease in physical activity are all contributors to weight gain during perimenopause and menopause
Joint pain due to bone loss: As we age small amounts of bone loss is common, however during perimenopause/menopause a decrease in estrogen causes bones to break down faster than they rebuild which may lead to joint pain. In the first 4-8 years after menopause bone loss is more rapid due to the lack of estrogen
Hormonal shifts and changes can cause a change in the pelvic floor musculature as well. These muscles support the bladder, uterus, and rectum and can have a significant impact on a person’s quality of life if not addressed.
A Pelvic Floor Therapist can be an essential part of an individuals health care team to help manage the symptoms of perimenopause and menopause. As specialist in pelvic floor health we can off many interventions to help individuals manage symptoms through:
-Education on the impacts of hormonal shifts and changes on the pelvic floor. An assessment will be performed to analyze if muscle strength, endurance, coordination, tightness, or weakness is present and can be addressed during sessions
-Exercise recommendations and strategies to help maintain bone health and muscle mass
-Recommendations on lubrication, moisturizers, ergonomics, sexual positioning, and education on sexual function as we age
-Education on maintaining healthy bowel and bladder habits
-Tools to decrease stress, anxiety, and emotional shifts through relaxation techniques
-Provide resources to outside health care providers in the community to support individuals who may need hormone replacement therapy, psychiatry, and alternative medicines
If you are experiencing pelvic floor dysfunction associated with these issues please reach out to us at Vibrancy Pelvic Health to set up an evaluation and treatment today!
Resources:
The Menopause Years. (n.d.). ACOG. https://www.acog.org/womens-health/faqs/the-menopause-years
In-Text Citation: (The Menopause Years, n.d.)
Menopause & Depression, Mood Changes | The North American Menopause Society, NAMS. (n.d.). https://www.menopause.org/for-women/menopauseflashes/mental-health-at-menopause/depression-menopause
In-Text Citation: (Menopause & Depression, Mood Changes | the North American Menopause
Society, NAMS, n.d.)
Written by Beck Hall