What Is Perimenopause?

After reviewing your family history for age of menopause and occurrence of PMS and depression, you should complete a symptom diary or calendar. This will be a unique record of your feelings on a daily basis. For three months keep track of your menses along with a daily record of your symptoms. Ideally, you should review your calendar with a health care provider but first there may be a lot you can learn on your own. There are two things you should look for. First look for patterns. In PMS you will generally see an increase in emotional symptoms beginning at mid cycle (around day 14). In the week before your period emotional symptoms will increase and physical symptoms may begin. In the last few days emotional symptoms will peak and then rapidly disappear after your menses start. There are variations of this pattern, but the key is symptoms that increase BEFORE and are relieved AFTER your period. Now that you have your symptoms calendar before you, look for depression that lasts most of the month. This could be a clue that you are depressed and need professional evaluation.

If your menses are occurring sooner than 21 days it may be perimenopause or a more serious gynecological condition and you need to be evaluated by your health care provider. Menses occurring later than 45 days is more consistent with menopause or perimenopause. If physical symptoms predominate, especially hot flashes, vaginal dryness and night sweats, and if they last throughout the month unrelated to menses think more about menopause. Remember menopause before the age of 40 is called premature menopause and is rare. However perimenopause can begin before age 40. Surgical removal of the ovaries is the most common cause of premature menopause. Hopefully you know if your ovaries have been removed, but you may not. Years ago doctors routinely removed ovaries in women undergoing a hysterectomy (removal of the uterus). Now many gynecologists do not remove the ovaries.