Perimenopause is like a thief in the night. It creeps up silently without you knowing it's there. Before you know it, it takes away your most prized possession: Your normalcy.
I asked some of my friends what they thought about it but they were unanimous in shrugging me off. They didn't want to talk, saying it's too early to be talking about "it". One even said that she would rather be ignorant than be informed. Pressing further though, most of them admitted that now that they're in their late 30s, their periods are beginning to show signs of irregularity.
Contrary to popular belief, it is common to have 1 or 2 irregular cycles in a year. If you have more than that though, then know what the possible causes are. It maybe just stress after all. But if after a friendly visit to the doctor and they find nothing wrong with you, chances are, you're entering early menopause already.
The monthly period is actually the earliest sign of the dreaded stage. Perimenopause bleeding varies. It could be from short to long cycles, ranging from a very light to a very heavy flow.
How do menses work? For the first 10 to 12 days of the normal menstrual cycle, only estrogen is produced. In ovulation (a mature egg is released from the ovary and ready for fertilization via the fallopian tube), the body produces progesterone. If pregnancy does not occur, the body will stop making both estrogen and progesterone. At this time, menstruation will take place. By doing this, we have what we call hormone balance.
Women in their late 30s or early 40s still produce estrogen. Progesterone however is a different story as the body makes less of it. If you missed ovulation, it means there was no progesterone production. This is where hormone imbalance comes in.
What's worse is, since there is now a lot of estrogen that your body doesn't need, there is now estrogen dominance. This is definitely not good as most of the symptoms of perimenopause come from this hormone imbalance. Hair loss, mood swings, memory loss, low libido, uterine fibroids and weight gain are just some of the signs of perimenopausal hormonal imbalance.
So now that we know how our periods perform, the next thing we need to know is when our biological mothers had their menarche (first menstrual period). Why? Because most likely than not, the first time they had it was also at the age that you had it. If this is the case, then you will have the perimenopausal signs at the same age that they had it too. This is just to better prepare you for your turn at the wheel.
Irregular bleeding should be of no concern except for the following:
- Bleeding lasting for more that 2 weeks.
- Any type of bleeding after no bleeding for 6 months (unless you're pregnant - so make sure that you aren't).
- A period that requires a change of pads every hour.
- If you are high risk (diabetic, obese, high risk for uterine cancer, or with high blood pressure), it is best to consult with your doctor.
Before any treatment can be done, you need to take some tests to rule out. Hysteroscopy is the most popular choice for doctors as they will be able to check your uterus directly and see if there are "aliens" within. A vaginal probe ultrasound is also a good screening exam. The traditional endometrial biopsy may eliminate cancer as a suspect but will be helpless in diagnosing polyps or fibroids (muscular tumors that grow in the uterus).
Though surgery is one way to treat abnormal bleeding, it's not the only one available at your disposal. Before deciding on hysterectomy, fibroid or polyps removal, consider taking progesterone if the bleeding is just caused by the missing ovulation.
In any action you take, remember one thing: You decide on what to do with your body. The doctors will just be your guide. No one can force you to have surgery if you don't want to. What's important is that you know what you're going through so that you can eventually make the smart choice.
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