Perimenopause is the phase prior and leading up to menopause. There is no clear and accepted definition for this time. There is usually a change in the patterns of menses and an increase in periods of amenorrhea (the absence of menstruation).

Menopause is technically the menstruation that marks the permanent cease of menstrual activity, the final period.

Statistics indicate that menopause occurs naturally in:
                                25% of women by age 47
                                50% of women by age 50
                                75% of women by age 52
                                95% of women by age 55

Surgically induced menopause occurs in:
                                30% of US women by age 50 and over

This time of life is a natural normal occurrence for women as they pass from the childbearing years to the non-childbearing years of life. Women's fertile energy moves from the biological realm to the mental, emotional, and spiritual arenas. It is potentially an incredible time of life.

While technically men do not go through menopause since they do not menstruate, they do have a corresponding period of hormonal change around the same time in life. Animals do not go through menopause. Anthropologists suggest that menopause benefited our species during evolution as it released women from the stresses and dangers of childbearing, freeing them up to raise the late born children and to transmit cultural knowledge to the younger ones.

The perimenopause phase is different for each woman. The following is a list of possible symptoms a woman may experience while in perimenopause:

• Vasomotor instability - pertaining to the nerves having control of the blood vessel walls
  

• Hot flashes
  

• Chills
  

• Excitability
  

• Fatigue
  

• Apathy
  

• Mental depression
  

• Crying episodes
  

• Insomnia
  

• Palpitation-rapid and/or throbbing pulsation in the heart or along an artery
  

• Vertigo
  

• Headache
  

• Numbness & tingling in areas of the body
  

• Myalgia-tenderness or pain in the muscles
  

• Urinary disturbance such as an increase in frequency, incontinence or urgency
  

• Gastrointestinal disturbances
  

• Vaginal dryness

Each woman's experience has its own unique complexities and diversities. Often a woman's perspective on menopause is influenced by her family's experience of it (mother, grandmother, and aunts) and the cultural messages given to her as she grows up. A woman's view of aging is intimately tied into this. In the west, there is a focus on youth, equating it with beauty, thus aging and menopause is viewed as a loss and decline. In many non-western countries an aging menopausal woman gains increased status in her family and a greater freedom in the culture at large. It makes a difference if she is seeing menopause as a crisis and a medical event or if she is seeing it as a natural and positive event in her life.

What actually happens hormonally?

Before perimenopause:

               First two weeks of cycle = ovaries produce estrogen = thick uterus lining grows

               Mid cycle = ovulation = ovary released = travels to uterus

               Last 2 weeks = ovaries produce progesterone = uterus lining preps for pregnancy

               No pregnancy = menstruation

In perimenopause:

               Ovaries produce hormones at varied rates and times
               Menstruation is no longer predictable = sometimes lighter, sometimes heavy, sometimes none
               Eventually menstruation is further and further apart
               After 1-2 years of no bleeding, menopause considered complete

Some common stresses that effect symptoms, especially bleeding, during this time is:

• Emotional upset - effects the part of the brain that controls ovarian function
  

• Alcohol - directly causes the ovaries to decline hormone production
  

• Smoking - damages the ovaries and can cause early menopause. It also causes the adrenal glands to function less effectively thus leading to tension and easy exhaustion
  

• Caffeine - causes chronic stress on the CNS which disturbs outputs of hormones

It is important to continue to have regular GYN exams to check on anemia and to rule out fibroids and cervical or uterus cancer because these conditions cause irregular bleeding also.

After menopause:

Ovaries still produce androgens, a substance that effects general health and sexuality. Muscle strength, the elasticity of the vagina and energy levels are affected. In the male body, androgens are responsible for male characteristics. In the female body, androgens convert estrogen into adipose tissue, accounting for the post (after) menopausal women's tendency to gain some weight. Note that this is only a tendency and not a given.

Margaret Mead said, "The most creative woman in the world is the menopausal woman with zest." Most women after menopause feel a rise in energy and motivation, making this a fabulous, highly productive and fun time.