Hi Margot...yes, some of the issues do go away with time. Like your grandmother experienced, it can go on for many years. The change is hormones can start as early as 35...the average age for the last period is 51...and symptoms tend to begin to fade away by the early 60s. These are all averages, of course, but they'll give you a general idea. The period of time that tends to be the worst for symptoms is the 3-4 years before the last period and 3-4 after.
Take good care of you!
Sandy
Hi thank you for the artical about perimeopause I've been going through it since I was 35 and now I'm 45 and you've answered my question about perimenopause.
Thank You very much!
Hi Cindy,
One of the frustrating things about menopause is the process can be soooo long. The average age of the last period is 51-52 years old. What we know from the most recent research is that women who start on hormone therapy either before their last period or within a few years after have the most long term benefits, including lower risk of heart disease, less osteoporosis, better overall morbidity and mortality because we're healthier when we have our hormones and not a significant increase in breast cancer.
Hang in there; one thing I can guarantee is that perimenopause will eventually end and your last period will arrive...just no guessing when. 
Sandy
What kind of treatments should I ask about? I've approached my doctors (two , now) about hormone therapy - I have all the symptoms you mentioned - no one seems too concerned about the effects on my sexual health, only dryskin and hot flashes. Are doctors hesitant to address low libido, sexual/touch discomfort and vaginal dryness for some reason?
- in Michigan
If you haven't yet read my posting about Bioidentical Hormone Therapy, that's a good place to start for information on the type of treatment you need for the symptoms you describe. Dry skin and hot flashes are a result of low estrogen. Low progesterone causes poor sleep and mood issues. Testosterone is responsible for your libido...it creates our sex drive. Depending on the symptoms you're experiencing, you may need all 3 hormones replaced and the best products for doing so are those that are identical to what your body was producing. You may need to search awhile for the right clinic, but don't give up. The results will be worth the trouble. Find a provider who specializes in menopause who uses bioidentical hormones. If you're anywhere near St. Paul, MN, I'd be happy to see you. If you're not, ask friends, Google menopause providers in your area, call women's health organizations in your area, search the yellow pages. Best of luck to you, Sandy
Your hormones are what need to be evaluated. Usually, this blood testing should be done in the beginning of your cycle and then again at mid-cycle. Estradiol, progesterone, testosterone, FSH and LH would be an appropriate starting place.
I hope you have been able to locate a good gynecologist to address these issues with you.
Sandy Greenquist, CNM
Menopause Clinician
Is it possible to start this at age 27-28? I am not having periods, the last was 4-5 months ago, then I had it for about a month and then nada for about 4-5 months--not complaining though!!! I'm not really going through the rest of the symptoms except for the hot flashes. Everything else is the same. No major changes. My doctor just keeps trying to test me for pregnancy, not a big help otherwise.
Being 27-28 years old would be very early to be having perimenopausal symptoms, although I do have 3 patients who finished having periods by age 33 as had their mothers. So it is possible, but this is very unusual. I would strongly encourage you to see a gynecologist for a thorough work-up to see why you are having this sporadic pattern of periods for one so young. It may be perfectly normal for you, but it would be wise to have that verified. If the doctor who only wants to check for pregnancy is a gynecologist, find another gynecologist or an endocrinologist. Your concerns need to be addressed seriously.
Good luck, Sandy
Hi.
I have had hot flashes since I was in my 20's. It is a surge in homones and the doctors explained to me...not necessarily starting menopause, but more of a PMS concern. My moods have always been horrible before my cycle started. And I have been on and off anti-depressants since my early 30's. I am now 44, (45 in 2 days), and it seems that my best fit is Cymbalta. So it's been mood swings, hot flashes, and too much yelling for about 20 year now. It's a wonder my kids still love me. I also have fibromyalgia, rheumatoid arthritis, & psoriatic arthritis. Arthritis is arthritis,right? Wrong. Certain meds, work for the rheumatoid & others another works for the psoriatic. It seems nothing works for the fibro though. I have been on Remicade therapy, but the possible side effects scared me so, I stopped. I now have been reading that fibromyalgia & peri-menopause symtoms overlap and can mimic one another. I get very depressed at times riddled with low self esteem. I tried the gym & even yoga & BAM. I was in intense pain for 6 months straight. So no more jogging. Sounds like I'm defeated, right? No. I enrolled in college to get my Psychology degree. Even though I have this continuous brain fog, what little bit of mind that I have left had landed me on the President's list. The way I figure it, I'm fiighting the only way I know how. The diseases and menopause may have me on certain days of the week, but that one day that they leave me alone, is the day I intend to use to beat them.
I hope that this is inspiration to someone...
Your story is definitely an inspiration.
The part I want to comment on is that your symptoms started early and your doctor explained the PMS connection. I've seen a lot of this over the years and--tho it's not technically perimenopause--the mechanism is essentially the same. Many of the sx of each are caused by low progesterone and many women may be low normal in progesterone all their lives. Then, when the period approaches and progesterone drops to trigger, they get symptoms but they tend to feel better as soon as the progesterone starts to rise again. In perimenopause, because your overall levels of hormone are declining as the ovaries age, there is less predictability and symptoms can come at anytime of the cycle and may be transient or may stay for days or wks at a time. Even young women who are still menstruationg can benefit fro progesterone replacement.
Keep up the good fight and great attitude,
Sandy Greenquist CNM
Menopause Clinician
Ok well its good to put all those symptoms with a actual cause. I can handle the sleeplessness, the wacky cycles and even the cramps. I am just not sure my kids can handle the mom from hell in dealing with the foul moods that spring from no where.
I take St. John's Wort but it doesn't seem to be helping my overall moods, any suggestions?
If you are not yet menopausal, you may find that progesterone cream which you can buy over the counter can be quite helpful in stabilizing moods. I recommend you use 1/4 tsp daily 21 days each month, taking 7 days off for period. Brands that are readily available and are good include: Natural Woman, Wise Woman, ProGest, Femmenessence, and FemHRT. There are many; just be sure that whatever brand you try has at least 450mg Progesterone USP. If this doesn't help, you probably need to get a prescription for a more concentrated dose of progesterone from your healthcare provider. Good luck, Sandy
MY CRAVINGS ARE SO INTENSE THAT I RECENTLY FEEL AS THOUGH I HUNG OUT NEXT TO THE HALLOWEEN CANDY BOWL AND JUST RIPPED WRAPPERS AND ATE EVERY TYPE OF CANDY POSSIBLE, CONSEQUENCES BE DAMNED!! WHAT IS UP WITH THAT?? DURING THAT TIME, I GOT MY PERIOD. NOW THE MUNCHING WILL STOP UNTIL MY 6TH DAY OF MENSTRUATION WHEN I FEEL AS IF THE "PRE" SYMPTOMS ARE STARTING ALL OVER AGAIN SINCE MY PERIODS LAST AROUND 11 DAYS. PLEASE SAY THERE ARE OTHERS WHO HAVE CRAVINGS SO SEVERE. IT IS DO DEPRESSING AND DISHEARTENING WHEN ONE TRIES TO EAT HEALTHY THE REST OF THE MONTH.
Hi Laura, I agree...cravings are such a drag when you're trying hard to eat well and be healthy. One important contributor to cravings is low progesterone. This is why so many women with PMS or who are in the throes of perimenopause/menopause have to battle food issues. When you are cycling regularly, your progesterone drops prior to your period, actually triggering the bleed, and cravings may come before the period and last until your levels rise again. In perimenopause and beyond, the cravings are less predictable because your hormones are rising and falling at irregular intervals. Depending on where you are hormonally, you might find over-the-counter progesterone cream helpful to tame this beast. Also, the way you pattern your eating, as well as what you eat, can contribute to relief. It is very helpful to eat 5-6 small meals a day, eating every 2-3 hrs. No, this won't make you gain weight. It is actually helpful in losing as it increases your metabolism. You just have to keep your intake at a reasonable amount. At each "meal", have some protein, carbohydrate and fat...you will find that before long the cravings will diminish, if not disappear. Do your best to avoid the high glycemic carbohydrates that turn into fat very quickly in your body: breads, white potatoes, white rice, desserts, popcorn, crackers. Take a look at nutrition books by Anne Louise Gittelman. She's an excellent resource for healthy eating, including stopping cravings and losing weight. Good luck to you! Sandy
I could weep! At last someone with the same symptoms as me!. I start intense cravings 2 weeks after my period and they don't stop till I start the next one. I will eat anything, and eat so much that I can't sleep at night! Then I have to try and slim like mad during the two 'good' weeks to try to maintain my weight, but at the moment i'm losing the battle. Very depressed about it and feel there's nothing I can do.
I think I just experienced my first batch of perimenopausal symptoms. I had a period that was heavy for one day. That was it. Afterwards I still felt typical PMS symptoms. By breasts were extremely sensitive (they felt like they did when I was pregnant), I felt bloated and crampy, and my face broke out. Much to my surprise, 15 days later, I started my period again. I don't feel the symptoms of PMS any more. What the heck is going on? Is this typical of perimenopause?? By the way, I will be 45 at the end of January. Thanks.
Hi Barbara,
Yes, what you describe is very typical of perimenopause. Your symptoms are caused primarily by the lowering level of progesterone in your body, including the irregularity of your period. If you haven't read my posting on Perimenopause yet, you might find that helpful for knowing what to expect. Often the symptoms of perimenopause closely resemble those of PMS...irritability, bloating, cravings, tender breasts, sleep disturbance, and changes in your cycle as well as the bleeding itself.
The posting on Bioidentical Hormones might also be helpful as you begin to consider ways to manage symptoms.
Good luck to you,
Sandy
Dear Sandy,
I can't believe you responded to my post. Thank you for doing so as your response made me feel much better. I have an appointment tomorrow to get a pelvic exam just to make sure everything is a okay. I can't tell you how much I appreciate you responding. I have no one to talk to about this and your response really helped.
Take care,
Barb
Hi Sandy! You've been very helpful with your advice! I'm 41, and I'm starting to experience some of the symptoms you've described. My question is, if I only have one ovary (the other one was removed due to an ovarian cyst), will menopause likely happen earlier for me?
Yes, you could definitely go through menopause sooner and/or more rapidly than someone with 2 ovaries. Since your ovaries produce the majority of your hormones, your supply will be depleted faster. It you're fortunate, it may mean that the process may not continue on as long as it does for some.
Good luck, Sandy
Hi Sandy, I just turned 27 in November. For as long as I can remember, I have been experiencing slight "hot flashes" during my period. During the last year, however, I have noticed them getting much worse. (or it is possible that I am just noticing them more as I get older, am am more aware of perimenopause). I have on average a 32 day cylce, with bleeding lasting about a week. (first 2 days very heavy (always been heavy)...then 2 or three days of very light flow or spotting, then 2 days of medium red flow). I have always suffered from extreme pms symptoms, since my first period at 14. I have sore breasts, bloating, irritability (mood swings), headaches, and cramping before periods (sometimes symptoms show up up to 10 days before my period. I am not on any birth control/hormone pills, or any other medication. My periods use to be about 21 days apart, then they started getting farther apart...about 25 days between...now they are back down to 23 or 24 days...so still, fairly regular. ...I guess my question is, could this be perimenopause at such an early age, or could the hot flashes be caused by something else? I get them at random all day and night, sometimes they last for only a few minutes, but usually last quite awhile. It is the middle of the winter now, and my family is freezing on days when I am breaking out in a sweat...it feels like summer to me. I only experience this the week or so before my period (along with all the other pms symptoms) and during my period....tends to be worse the week before, and goes away when my period does. I have a 4 yr old, and desperately want another, but my husband isn't ready for another child at this time, so I am starting to worry if this is the start of menopause, how fertile I am. Any insight as to what this may Be would be extremely helpful. (as a side note, the doctor noticed swollen glands in my neck on a check up, and said it could be something that didn't go away from pregnancy. I had thyroid etc. tested, and all blood work came back normal.
Dear Anonymous,
Your symptoms sound like they are definitely hormonally-related. You are young to start these fluctuations, but it does happen early to a percentage of women. Much of what you describe is brought on by drops in progesterone which happen especially before your period. This is what causes the PMS type symptoms. Your estrogen also fluctuates through the month and when it's low you'll have more hot flashes. One difference in PMS and perimenopause is that PMS is pretty predictable. It comes the week before your period and goes away when you start to bleed or in a day or 2 after. With perimenopause, you lose the predictability and your symptoms will follow the rise and fall of hormones throughout the month. One thing you might find helpful is to try over-the-counter progesterone cream (go to a co-op or good health food market) and use it as directed. If it is not enough to balance out your hormones, you will need to see a provider who understands hormones and can prescribe progesterone at a higher concentration for you. Your lab work can show your hormones in the normal range for years before you have your last period, so don't be put off by being told you're too young. Keep pressing until you get the help you need!
Sandy
Hello Sandy,
I have been on the Depo provera injections for yrs now,I have had the menopause symtoms for yrs, since I was like 35,I will 45 in July, I try the soy supplements,soy milk, seems to work for ahwile and off and on again.
I asked my GYN about the test to see how far I am, snd she told me becuase I am on the Depo shot I have to wait till I turn 50. or stop stop the shots for ahwile and have the test done. I dont want to get pregnant, I have 2 kids already and now 2 stepsons, enough kids already ha ha. I wanted to see for certain If I was going thru menppause so I could get off the depo shots,
I have to say the depo shots have been helping me for yrs with the moods and other things that comes with it, but its coming down to the nitty gritty,, lol.. seriously I dont know if its my environment causing me more issues than the menopause or if I am in full bloom of menopause,
I get the hot cold sweats and sleepless moments, the soy suppplements Night time Soy, estroven helped before, but now its not doing to well.I am goingo strat chnaging more in my routine, was very good at taking care of myself till I got remarried 2 yrs ago, I feel like a bomb let go inside me and have no desire do do anything, like I died along the way somewhere and I dont like who I have become, yes I know I am also depressed with this as well, It does feel alot like depression, I cant stand it when my husband comes near me, and then other times Im fine, I gained some weight too and makes me feel like crap.I want to run away and not look back, ha ha, I can laugh but it isnt fun going thru this.Thank you so much for your help and all your comments have helped me a great deal in understanding me and what I am going thru.
It certainly sounds like you're experiencing significant perimenopause symptoms...along with the added stress of remarriage, 2 more kids, etc. which magnifies how much things effect you.
With all the symptoms you're having which are probably related to declining hormone levels, I would definitely recommend you go off the Depo and have your hormones tested. Depo is good for birth control, but it's not going to help manage many of the typical symptoms of perimenopause/menopause, which you're finding out. You'd be much better off on bioidentical hormones even if it means you have to use condoms or get an IUD or whatever for birth control (depending on your bloodwork). Please see my post on bioidentical hormones if you haven't already and see how many of your symptoms are the result of your ovaries no longer producing levels, especially since they are being surpressed by the shot.
Good luck. Thanks for writing,
Sandy
Hi there
I am 48 years old, and i have been experiencing Haveing symptoms of peri-menopause
for at least 4 years. I have been having fluctuations in my mentral like haveing 4 in one
month and sometimes 2, there are times i will go a month without one and, i never
know when i am going to have one. Most recently i have been haveing fuzzy-
thinking which is affecting my job. I have also had a lose in sex drive and vaginal dryness. I have talked to my
doctor some what but he didn't think it would be helpful to take hormone theropy.
I don't think he thinks i am going through Peri-menipause. Some day's are good and
someday's i can't think straight. Getting very forgetfull and it's frustraiting.
So do you know of any natural way to help with the fuzzy headedness.
I would appriciate any help i can get.
Thank you.
Sound like I am in peri, perhaps.... I am 42 and for the past two years, my periods have gone from 28 days like clockwork, 7 days long to now anywhere between 25 -29 days and 4-6 days in length. In general, cycles are lighter, but I do have some with clots. I also have a lot of cycles lately, where I have a few days wher I might just need a light pad or a pantiliner. I do have fibroids, but have been told they are not an issue ( two at 5.6 cm each) plus smaller ones. I also have an ovarian cyst, but have been told it's not hormonal ( it's at 3.1 cm) as it has shrunk and stayed the same for a little while now. I am getting cold to the bone chills ( even on 70 degree days) I always ran warmer than most people and I get very down and weeping during the week of my period and up to the week after. I am getting some dizzy spells, feeling forgetful at times, and getting night sweats. My husband tells me that I throw the covers off on him, he wakes up from being too warm and finds that my skin is freezing and puts the covers back on. I never had this issue before.
Hi. I am having dreadful palpitations mid-cycle which are getting worse each month. My periods are very irregular, I have high FSH indicating I am definitely perimenopausal. What exactly is it that casusses the palpitations to happen? Which bioidentical hormone would be recommended? Or any other treatment you can recommend? I have tried various beta blockers but they don't touch the intense palpitations I get just at this time. Thanks
Hi, Amber 2,
I also experienced heart palpitations at one point, so you're not alone.
In the book "The Cleveland Clinic Guide to Menopause," Dr. Holly Thacker wrote that heart palpitations "can be manifestations of symptoms (such as hot flashes) in the autonomic system (the nerves and muscles that cause the blood vessels to constrict or dilate), but any heart symptom needs to be checked out by a doctor before beng attributed to menopause." She notes that heart palpitations also can be a symptom of panic disorder, which is a mood disorder associated with menopause.
I'm a big believer in trying to see if the body will self-correct before resorting to taking any medications or hormone replacement. I talked to my doctor (who is an osteopath), and we decided that before heading in the direction of medication or hormone replacement, I would try the following:
- Limit caffeine. (I now only drink decaf coffee and tea.)
- Take 200 mg of CoQ10 daily.
- Work on my diet by adding heart healthy foods such as salmon.
- Exercise regularly.
- Lower stress levels. (At the time I experienced these palpatations, I was perimenopausal as well as a caregiver for my mom who had Alzheimer's disease, employed, and a graduate student.)
These proved to be perfectly effective. I also have a friend in her mid-40s who had heart palpitations. She also visited with her doctor and ended up trying the CoQ10, which worked for her although she has to be careful due to potential interactions with other medications she's taking.
Take care and keep us posted!
Dorian
Hi Dorian, thanks so much for your reply. It is so reassuring to hear that someone else has gone through this and found a cure. I hadn't heard of the CoQ10 so have ordered some straight away and hope it helps - will let you know. I Have been checked out by a cardiologist who says my heart is structurally fine, and that the palpitations are benign , just a nuisance (understatement of the year!) but sneered a bit at my theory that it was hormone related but it is such a regular pattern since I tarted to skip periods - same days each month. I cut out all caffeine many years ago and have a pretty healthy diet, don't drink or smoke etc Exercise 3 timea a week along with walking the dog every day. So sorry to hear of the stressful time you had - that was a lot to deal with all at the same time. I don't have that level of stress fortunately, and three weekas out of four I am very relaxed, but the fear of these things I know doesn't help. Anyway I hope the CoQ10 does the trick. Will let you know what progress I make! Thanks again for your help. Stay well!
I am 45 and my periods have become very sporadic. The hot flashes have also been sporadic; they come for a couple of weeks and then disappear for months. This has been happening for about 18 months. Lately I have been having a lot of indigestion, bloating and sour stomach. I have cramps all the time like my period is approaching, but it never shows. My last period was December 2010. The indigestion, bloating and sour stomach is what bothers me most latelye. I also always feel like I have to urinate, like the bloating is pushing up against my blatter. Could this all be signs of perimenopause? An older family friend said yes. I talked with my dr., but I can't even get her to acknowledge that I might be in the beginning stages of perimenopause because my hormone levels were normal when she checked. Help! thanks
I am 45 and my periods have become very sporadic. The hot flashes have also been sporadic; they come for a couple of weeks and then disappear for months. This has been happening for about 18 months. Lately I have been having a lot of indigestion, bloating and sour stomach. I have cramps all the time like my period is approaching, but it never shows. My last period was December 2010. The indigestion, bloating and sour stomach is what bothers me most latelye. I also always feel like I have to urinate, like the bloating is pushing up against my blatter. Could this all be signs of perimenopause? An older family friend said yes. I talked with my dr., but I can't even get her to acknowledge that I might be in the beginning stages of perimenopause because my hormone levels were normal when she checked. Help! thanks
Hi, KC,
Increasing incontinence can be part of the menopause as well as due to aging. I wrote about this in a recent sharepost. I've also found that GERD can be caused by menopause. I've also heard from both female and male friends that as they age, they have more difficulty with certain foods (such as alcohol) which causes digestive distress. I've definintely experienced this with fried foods and now rarely partake of foods prepared this way.
Take care and keep us posted!
Dorian
For the past six months or so, I have been increasingly been experiencing disturbing symptoms. It started with back pain and discomfort. Had an x-ray and all is fine. Also experiencing abdominal discomfort with occasional pain, bloating, flatulence and heartburn. Most recently, I have been having heart palpitations that cause me to feel like the blood is rushing to my head, I'm dizzy, and feel that I might faint. The racing heart and dizziness is really starting to worry me. I have seen my GP, due to a sinus infection I had, and he seems to think that I am still slightly congested. Also, my stress level is through the roof and my hands are always cold. I have an appointment with my gynecologist this week, so I hope to get some answers.
Oh my goodness...this is the best article I've read on perimenopause. You really hit the nail on the head when you mentioned having seemingly unrelated symptoms and doctors telling me that I either look too young or that I AM too young (at age 46? Really?! - that's PRIME peri-menopause time - although I didn't know that until recently).
Up until 15 months ago I was extremely athletic and very thin. I have been eating very healthfully for over 20 years. I was in pretty good shape. Then it all started....unexplainable, disabling back pain. I saw my primary care physician and told him about it. I also mentioned that I was having odd tremors at night, lacked energy, and seemed to be very forgetful. Honestly, I was afraid I had MS. He sent me to a physical therapist who told me I had inflammation throughout my whole body & should see a Rheumatologist. The Rheumatologist ruled out any autoimmune diseases - I was glad, but still had no answers. She guessed it was hip bursitis and gave me cortisone shots which helped a little, temporarily. I thought maybe an endocrinologist would be helpful - perhaps it was my thyroid. She looked at me and said, "You look a lot younger than your age." I said, "Thanks. Can you help me with my problem here?" She replied, "Your thyroid has always been fine so I'm not even going to check it. I have no idea what's going on with you, but it's not your thyroid." I thought I'd cry. I was getting NO HELP. I had tried trigger point therapy, massage, chiropractic....I went to a pain management specialist and got cortisone shots in my back (didn't help) & finally a spinal neurosurgeon. He tried cortisone injections into my spinal column which didn't help, so he told me that my back pain would not resolve unless I had spinal fusion surgery.
I went into depression. My anxiety worsened. THEN........ I read about a woman who had almost the same exact symptoms who tried Bio Identical Hormone Replacement Therapy and was amazed at how much better she felt. I looked it up on the computer and found article after article about how BRHT can help, and how hormones can play havoc on your body.
I got hormone tested and low and behold my testosterone was low (which explains the fat around my waist, my below zero libido, and my concetration difficulties), and my progesterone was very low (which explains my depression, the embarrassing whiskers that are growing from my chin, etc. etc. etc.) UNBELIEVABLE!!! I start BRHT on Friday and I cannot WAIT to see how it works. I may be getting my hopes up, but I really think this will FINALLY be the answer. I will post again in a few weeks with an update. 
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I was told that once I have stopped my period for a year that I am in menopause, is this true? LAst year I went 10 months without it and this year I am going on about 7 months not having it. However, I go through the motions just as if I am going to start. The chocolate cravings, the mood swings, the facial breakouts ( I only get pimples this time, usually 1-3 pimples on my face, otherwise my face is clear). I get frequent headaches, and my partner is now sexually frustrated because my interest in sex has gone out the window. I don't feel like doing anything, my body aches, joints snap, I feel really old and I am only 42. Menopause started early in my family. My mom started in her early 40's she said that it lasted till she was 51. At 65 she is doing great! What do I have yet to look forward to? I see my doctor in a few weeks, do I dump all my symptoms on her?
Hi Kat, The definition you heard is true. One year without bleeding is the technical cut-off for being labeled "menopausal". Lots of women are like you, though, will go for months or even a year or more and then bleed again. Your body is winding down, but not ready to quit. The symptoms you mentioned can all be related to the hormone changes that your body is going through. Definitely, you want to talk with your doctor about all of this. Hopefully, she/he is well-versed in the current information about menopause and hormones and will be very helpful in guiding you. If this is not the case, find someone who is. Not all health professionals are interested in or well-educated about menopause. You will need someone who is to partner with you and give you the information and guidance needed so you can make good decisions for yourself in this very important phase of life.
Good luck! Sandy