Premenopausal Symptoms

The onset of menopause in a woman is termed as premenopause or perimenopause. Menopause occurs when a woman's menstrual cycle permanently ceases after 12 consecutive months of amenorrhea. Most women go through this stage in their 45th year, but the symptoms of premenopause can exhibit among women of age 25 to 70 years. Estrogen and progesterone are two hormones required to regulate the menstrual cycle. Women have over 1 to 2 million follicles or egg sacs, in their ovaries. With age, the ovaries begin making less estrogen and progesterone, resulting in the creation of fewer eggs and a gradual slowdown of the reproductive cycle.

The lack of adequate progesterone, and higher than normal levels of estrogen cause hormonal imbalance, leading to premenopausal symptoms. High stress levels, environmental toxins, and poor nutrition can also cause hormonal imbalance in the female body.

Signs of Premenopause

As hormone production becomes imbalanced, women experience a wide range of physical, emotional, and cognitive symptoms. The duration of premenopause varies from one woman to the other, lasting anywhere from one to six years. The most prominent symptom noticed in premenopausal women is changes in their menstruation cycle. The cycle could be short, causing frequent periods, or it could be longer, resulting in less frequent periods. Some women are known to even skip periods completely. Other symptoms pertaining to premenopause are mentioned below.

• Physical Symptoms: Drop in the level of estrogen during premenopause causes physical symptoms such as vaginal dryness, breast tenderness, weight gain, hot flashes (also known as hot flushes or night sweats if they happen at night), heavy or scant bleeding, spotting, sleep problems, urinary tract infections, urinary incontinence (during coughing, sneezing, laughing, or exercise), hair loss, dry eyes, dry skin, fatigue, indigestion, reduced metabolic rate, and increased vulnerability to many diseases.

• Emotional Symptoms: Women also experience emotional changes like anxiety, moodiness, depression, irritability, forgetfulness, anger, nervousness, sudden inability to handle stress, and decreased libido causing frustration and helplessness.

• Cognitive Symptoms: Confusion, difficulty in multitasking, loss of concentration, and memory loss are some symptoms that reflect changes in a woman's thought process, memory, learning, judging, and reasoning ability in the premenopausal stage.

Premenopausal Management

The most important thing to be understood about menopause is that it is not a disease and hence needs no treatment. However, depending on the range and severity of symptoms, menopause can be managed medically or with a few lifestyle changes.

• Medication: Some medical practitioners prescribe oral contraceptives in low doses to reduce excessive bleeding and hot flashes. Hormone replacement therapy (HRT), phytoestrogens, antihypertensives, bisphosphonates, and lipid-lowering drugs are commonly prescribed for premenopausal women, after a careful study of risk factors and needs. Medications such as Zoloft and Prozac are also recommended to control the emotional changes.

• Nutritional Supplements: Supplements like bioflavonoids (natural pigment in fruits and vegetables), vitamin E, folic acid, vitamin C, glucosamine and chondroitin sulfate, borage oil, vitamin B12, etc., are also prescribed for easing hot flashes, lessening depressive symptoms and relieving joint pains.

• Lifestyle Changes: Premenopausal hormonal imbalances reduce bone mineral density (BMD) and lipid profile, which lead to osteoporosis and cardiovascular diseases. A diet rich in calcium, such as milk, cheese, yogurt, and other calcium fortified food helps protect a woman's body from osteoporosis. A diet full of fruits and cruciferous veggies, like broccoli, watercress, cauliflower, cabbage, etc., helps fight against the increased risk of heart disease. Soy protein or soy foods are also known to aid in reducing the severity of premenopausal or perimenopausal symptoms.

Going through menopause is a stressful time for any woman. It is difficult to accept the physical, emotional and cognitive changes caused by hormonal imbalances in the body. This phase in a woman life cannot be avoided, but a thorough understanding of its causes, symptoms and management can help one cope with the symptoms better and stay healthy.