Perimenopause: it can catch you off guard

Everyone knows about menopause, but perimenopause? It comes early, so Ahram Online interviews an expert to help readers master the art of dealing with it efficiently

Although almost every woman is quite acquainted with the term menopause, they are much less familiar with the fairly common perimenopause, which can occur quite earlier and cause significant inconveniences.
"Setting aside surgery or chemotherapy as reasons for disturbance or end of normal menstrual cycles, menopause usually, and naturally, hits women on average at 50 to 55 due to fluctuating levels of estrogen and progesterone as the vitality of the ovaries begin to slow down," explains Dr Ahmed Guinena gynecology and obstetrician consultant.
"We, as a society, fail to increase the woman's awareness that this major change can come much earlier - and we are talking here about 40s or even 30s - with all its psychological and physical implications, and it is called perimenopause.
Symptoms of perimenopause:
“The changes usually come as follows: periods become shorter and closer as progesterone lessens, followed by decrease in estrogen. The change in the period pattern may go both ways: the flow could be heavier or lighter, and the in-between intervals can become longer or shorter.
The common factors accompanying or preceding these stages include irritability and mood swings, hot flashes, especially at night, exhaustion, weight gain, vulnerability to some diseases due to decrease in bone density and changes in the blood cholesterol levels, thus increasing probabilities of osteoporosis and heart disease, and other discomforts, like dryness of the eye and thinning of vaginal tissues which causes dryness, as well.”
Dr Guinena advises strongly that prior to taking it for granted that they are in a new perimenopausal phase, that any woman should get checked up by her gynaecologist to ensure that other serious causes are off the radar, such as cancer.
Abnormal bleeding can also be caused by cervical cancer, which can be detected by a pap smear or uterine cancer, which can be indicated through an autopsy.
How to balance it out?
The hormonal symptoms accompanying perimenopause can be hugely irritating and sometimes even crippling, especially if the effects are long-lasting.
The gradual deterioration of bone density has to be met by fortifying your diet with calcium-rich foods, like dairy products soya beans, almonds and vegetables with deep green leaves.1000 milligrams daily of calcium is a minimum must for every woman, according to the American National Osteoporosis Foundation.
Cholesterol level fluctuations can develop into heart disease, but can be combated by decreasing the daily intake of fats and exercising more. Exercise can also boost the metabolic rate, which tends to decline at this stage, thus prompting weight gain.
As for other discomforts, like hot flashes and drenches of sweat at night, difficulty in falling asleep, dryness of the vagina and eye area, Dr Guinena recommends opts for natural alternatives that have to do more or less with lifestyle. He does not advocated Hormone Replacement Therapy, especially for those who have a history of tumors or blood clots in their family.
Dryness can be counteracted with lubricants and eye drops. Decreasing the caffeine intake and exercising in the first half of the day not the second and maintaining a sleeping pattern can get you over the insomnia.
Hot flashes can really nag and can last for years, so accommodate your lifestyle to minimise such irritations, for instance, by wearing loose, cotton outfits and avoiding spicy foods and decreasing caffeine that constrict blood vessels. Finally, taking deep, slow breaths at the beginning of a hot flash can help a lot.