Perimenopause Article It seems as if women spend most of their life in one stage or another, with our bodies always changing. First we're growing up, getting taller and heavier. Then we hit adolescence, and another set of changes occurs. When we are in our 20s and 30s, some of us start having babies, and the associated hormonal changes kick in. Finally, when our childbearing years seem to be over, perimenopause arrives, bringing with it even more puzzling changes to our bodies. According to Marilyn Kindig, D.O., of Women's Health for Life, Inc., perimenopause is the transitional time between having regular menstrual cycles and menopause. The absence of a cycle for at least one year is the medical definition of menopause. The process of perimenopause typically begins when a women reaches her mid-40s and can last anywhere from one to three years. Beginning at puberty, each month our bodies prepare to become pregnant. The process starts with the pituitary gland in the brain sending a chemical message to the ovaries. Follicles, which nestle and secure immature eggs in the ovaries, will respond to the brain's message by maturing and releasing an egg from the ovary to be fertilized. In preparation for fertilization, a key sex hormone released by the follicle, called estrogen, thickens the lining of the uterus, or endometrium, so that the fertilized egg can be nutrured and grow. Back in the ovary, after the egg is released, that same follicle, which has undergone changes and now is called the corpus luteum, begins to produce another hormone, progestrone. Progesterone is the key hormone to sustaining a pregnancy. It further prepares the endometrium to nourish the developing embryo. But what happens if the egg is not fertilized? The lining doesn't stay thickened. The corpus luteum begins to degenerate and stops producing progesterone. Levels of both estrogen and progesterone begin to fall. The endometrium -- no longer supported by these hormones -- begins to break away from the uterine wall. The result? Menstruation. "As a women grows older, she beings to run out of eggs, and the aging follicles start to respond erratically to the chemical messages being sent from the brain," says Teresa Bechdolt, Lima Memorial Hospital Clinical Nurse Specialist in the Women's Health Center. "It may take a follicle longer to respond and mature an egg, resulting in a change in length of a woman's menstrual cycle, or a follicle may not respond at all, meaning a missed cycle. As a result, hormone levels become unstable, and signs of perimenopause appear." "Symptoms associated with perimenopause are primarily caused by the surges and wanes of estrogen and progesterone in a woman's body." relays Dr. Kindig. Hot flushing during the day and hot flashes at night are typical of perimenopause, as are breast tenderness, vaginal dryness, lack of libido and abdominal bloating. A change in hormones can also alter a woman's mental stability, making premenstrual syndrome symptoms occupy the entire cycle. According to Dr. Kindig, a woman may experience memory loss, anxiety and the blues. "Women do not need to suffer these perimenopausal symptoms," assures Dr. Kindig. "Many options are available to help women manage this transition in their lives and thrive in their menopausal years." Hormone replacement therapy cannot only relieve symptoms, it can reduce a woman's chances for heart disease and osteoporosis, a bone-weakening disease. "It's important for women to discuss this option with their physician, weighing the benefits against potential risks," says Dr. Kindig. Studies are still inconclusive in regard to hormone replacement therapy increasing a women's risk for breask cancer. More natural approaches to managing perimenopausal symptoms include soy products and yam, both organic estrogenic products made from plants. Herbal supplements include black cohosh for hot flashes and St. John's Wort for mood stability. Dr. Kindig cautions, "While natural supplements may provide symptomatic relief, they have not been studied in a controlled environment and have not been proven effective." Dr. Kindig recommends a diet rich in protein, complex carbohydrates and fat in moderation. In addition, a regular exercise program incorporating weight-bearing exercises is in order to help offset potential bone loss. "When women reach perimenopause, they should reevaluate the vitamin supplements they are taking," suggests Dr. Kindig. A daily intake of 1500 milligrams of calcium and 400 International Units of vitamin D can help offset osteoporosis. Women may also want to consider taking vitamin E to minimize breast tenderness and B-complex vitamins to protect the heart. To ensure a healthy menopuase, Dr. Kindig recommends the following yearly examinations: a physician's examination to measure height, a pelvic exam, a clinical breast exam and a mammogram. As luck would have it, some women may not experience perimenopausal symptoms. Though studies are not conclusive, Dr. Kindig suggest that this may be due to how a woman responds to hormonal changes. The less they affect her, the more likely she will be to ease throough the perimenopause stage. Dr. Kindig suggest that even though a woman may not be experiencing symptoms, she should still discuss hormone replacement therapy with her physician for the protective benefits it could potentially provide. CLICK HERE to download printable version...