Everyone has heard of menopause and women generally know what to expect: around the age of 50, their periods stop and there is a risk of problems such as the famous hot flashes. What is less known is that this phase of life rarely occurs suddenly. There is a transition period that is more or less unpleasant to live through. We often speak of “premenopause,” but it is more accurate to speak of “perimenopause,” as this transition continues even after menstruation ends.

From puberty to middle age, women’s bodies experience the rhythm of hormonal changes associated with the menstrual cycle, especially those that affect estrogen production progesterone. At the beginning of each cycle, about ten ovarian follicles (small cocoons, each containing an immature egg) are stimulated and produced estrogen, especially to prepare the uterus to receive an embryo. In the middle of the cycle, the largest of the stimulated follicles releases a mature egg (this is ovulation), then starts the synthesis of progesterone to promote the implantation of a possible fertilized egg. However, you should know that women are born with a limited number of follicles in their ovaries. Over the years, this supply begins to be depleted, so that an egg cell is no longer necessarily released in every cycle and this whole beautiful mechanism eventually comes to a standstill: the hormone production of the ovaries becomes irregular, which is usually initially accompanied by a lack of progesterone. This is when the first signs of perimenopause appear.

Periods become quite unpredictable, with menstrual cycles becoming shorter and then longer, often preceded by menstrual bleeding premenstrual syndrome (sore breasts, swelling, bloating, tiredness, irritability, etc.) that were previously not noticeable or were less intense. Other symptoms may occur: first hot flashes, night sweats, vaginal dryness, discharge and/or urinary tract infections, difficulty sleeping and concentrating. (Brain fog)… In terms of mental health, this transition represents a period of vulnerability, particularly for women who have suffered from anxiety or depression in the past.

This transition period can begin 2 to 4 years before the follicular reserves are completely exhausted, when the ovaries stop producing estrogen, leading to the absence of periods, i.e. menopause itself. It lasts about 12 months after the last menstrual period while the body (partially) adapts to this new situation. The good news, therefore, is that some of the manifestations of perimenopause are only temporary: they disappear or are reduced with this adjustment.

However, in the face of these disorders, which doctors call “climatic symptoms” or “climatic disorders”, not all women are the same: some experience no bothersome symptoms, or only a few, and in a fleeting and discreet way. For others, however, these symptoms can be very stressful and have a more or less lasting impact on the quality of life. In this case, medical treatment is possible. Before the period stopped, Gestagens or a low-dose oral contraceptive (prescribed unless there is a medical contraindication) may relieve the problems. Herbal medicine, acupuncture, or even hypnosis sometimes help against hot flashes. Later, when menopause is proven, the prescription of hormonal treatment is necessary, which a estrogen has a progestin Depending on the type and intensity of the climatic disturbances experienced by the patient, his state of health, his individual risks and his personal and family history, treatment can be considered.

To learn more about menopause and its impact on women’s health, as well as the benefits and risks of hormone treatment, Consult our information file.

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