Perimenopause
Perimenopause means “around menopause” and refers to the time during which your body makes the natural transition menopause, marking the end of the reproductive years. Perimenopause is also called the menopausal transition.
Menopausal transition, begins several years before menopause.It is the time when the ovaries gradually begin to make less estrogen.It’s the time when the Ovaries gradually begin to make less estrogen.It usually start in women’s 40s, but can start in their 30s or even earlier.
Perimenopause lasts up until menopause, the point when the ovaries stop releasing eggs. In the last 1-2 years of perimenopause, this drop in estrogen speeds up. At this stage, many women have menopausal symptoms.
The average length of perimenopause is 4 years, but for some women this stage may last only a few months or continue for 10 years.Perimenopause ends when women have gone 12 months without having their period.
Symptoms –
Some of the following symptoms should be present in women susceptible for perimenopause –
• Hot flashes
• Breast tenderness
• Irregular periods
• Nausea
• Vaginal dryness, discomfort during sex
• Lower sex drive
• Decreased fertility
• Night sweats
• Urine leakage when coughing or sneezing
• Urinary urgency
• Weight gain
• Loss of bone density
• Mood swings
• Trouble sleeping
• Fatigue
Causes-
Every woman is endowed at birth with a set number of eggs within each ovary. As she enters adolescence, the higher brain centers that are responsible for the onset of puberty begin to mature and function in a coordinated fis him. Menstrual cycles begin and once a month, one of the ovaries will release an egg, which may be fertilized if intercourse occurs during the days when the egg is viable.If fertilization does not occur, the egg, which is composed of a single cell, degenerates and dies within the abdominal cavity. Without fertilization of the egg, the uterine lining is shed off approximately two weeks after ovulation.This cycle is repeated monthly unless a pregnancy is conceived. As a woman ages, her ovaries become depleted of eggs. At this point, ovulation may become erratic. This results in irregular bleeding episodes that may be heavy and unpredictable.
Throughout the normal menstrual cycle, hormones are produced from the ovaries. As the ovaries become depleted of eggs and bleeding episodes become more erratic, there are alterations in the quantity and frequency of ovarian hormone production, which can lead to numerous physical manifestations.The time period when the depletion of ovarian eggs results in irregular bleeding and other related symptoms has been termed perimenopause.
Risk factors –
Menopause is a normal phase in life of a women, but it may occur earlier in some women than in others may be due to following reasons-
• Smoking
• Family History
• Cancer treatment
• Hysterectomy
Lifestyle changes –
• Healthy diet having fresh vegetables, whole grain products and low calorie dairy products rich in calcium.
• Weight control
• Exercises such as walking, jogging, pranayam etc.
• Smoking cessation
• Take calcium and vitamin supplements.
• Stress management from YOGA and meditation.
• Get more sleep.
Diagnosis-
Most often treatment of perimenopause is based on the symptoms of the patient. A blood test to check hormones such as FSH, LH, Prolactin, Testasterone, thyroid profile levels may also help.
Treatment-
There are a variety of medication that may ease perimenopausal symptoms in women. These include –
• Birth control pills
• Hormonal products
• Vaginal estrogen
• Anti depressants such as Sertraline, fluoxetine e Itc.
• Testosterone
• Gabapentin (Neurontin)
There is no cure for perimenopause.
Complications –
Irregular periods are a hallmark of perimenopause.Most of the time this is normal and nothing to be concerned about. However. see your doctor if-
• Bleeding is extremely heavy
• Bleeding lasts longer than seven days
• Bleeding occurs between periods
• Periods replarly occur less than 21 days apart .
Ayurvedic Perspective –
Perimenopause can be correlated under Rajonivrutti in Ayurveda.Rajonivrutti in characterized by an aggravation of the Vata dosha, thereby leading to an imbalance in the three doshas – Vata, Pitta & Kapha. As a result, Dhatu Kshaya or decline in body tissue mass occurs, being a gradual consequence of ageing.
Beneficial Herbs-
• Arjuna-
• Cardamom –
• Fennel –
• Guggul –
• Garlic –
Effective Medications –
• Chandanasava
• Moti Pisti
• Ushirasava
• Giloya sat
• Praval Panchamrit
• Kamdugdha Ras
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