Perimenopause by Dr. Jerilynn C. Prior, Scientific Director, Centre for Menstrual Cycle and Ovulation Research. Dr Prior is an outstanding authority on the subject.
During perimenopause women are often most engaged in work or vocation or may be just getting back to full time work after childcare years. Many changes in relationships, home life and the needs of parents characterize women’s mid-life.
Perimenopause lasts from six to 10 years for most women. This stage begins gradually during regular cycles and ends when a year has passed since the final menstrual period. The onset of perimenopause is different for different women but is characterized by cycles that become closer together. Approximately 25% will begin to have night sweats. An unknown percentage of women with regular cycles will have increased breast tenderness and enlargement. About 20-30% will have abnormally heavy flow for one or more cycles. Most women experience some middle of the night sleep disturbances, mood swings and less ability to predict flow. Some women will experience nausea, new or recurrent and severe migraine headaches ,weight gain and palpitations.
Later stages of perimenopause begin with irregular cycles that may involve alternating short and long cycles. During this portion of perimenopause more women will have night sweats and some will start having daytime hot flushes.
Sleep disturbances may increase and rapid bone loss begins with the onset of irregular cycles. The final year of perimenopause is from the final menstrual period for one year. By then breast tenderness is improving, and hot flushes for some, but sleep disturbances and night sweats/hot flushes are at their maximal.