“The timing is so highly variable because it’s different for every woman,” says Stephanie Faubion, MD, the director of the Mayo Clinic Center for Women’s Health in Jacksonville, Florida, and the medical director of the Menopause Society. “If you go 60 days without a period, you’re probably getting closer,” she says.
Here are some signs that your reproductive years might be winding down — and how to find relief for as long as your menopausal transition lasts.
1. Your Periods Become More Irregular
“Some women’s periods just end and they don’t have another one, and some women have occasional periods for a long time,” says Dr. Faubion.
By definition, the menopausal transition is definitively concluded one year after the last menstrual period, which marks the end of perimenopause, says Mary Rosser, MD, PhD, an ob-gyn, menopause expert, and the director of Integrated Women’s Health at Columbia University’s Irving Medical Center in New York City.
2. Hot Flashes and Night Sweats Could Ramp Up
Menopausal vasomotor symptoms, which include both hot flashes and night sweats — the middle-of-the-night overheating episodes — may also kick into higher gear in the waning years of your period. But that’s not how it happens for everyone.
“Hot flashes and night sweats vary in frequency and duration throughout the menopausal transition,” says Dr. Rosser. “There is substantial variability among women in both when symptoms begin and how long they persist.”
As many as 8 in 10 women will experience hot flashes, which can involve the upper body suddenly heating up for a few seconds to minutes, along with some of these other symptoms.
- Chills
- Clammy skin
- Flushing
- Heart palpitations
- Sweating
- Anxiety
3. Vaginal Dryness and Changes in Libido May Become More Noticeable
“Vaginal dryness results directly from low levels of estrogen associated with the decline in ovarian function during the menopausal transition,” says Rosser. “The lining of the genitourinary tract (vulva, vagina, and urinary tract) becomes thin and loses elasticity, and the vaginal pH changes, altering the vaginal flora and increasing the risk of infection, such as urinary tract infections.”
4. Mood Swings and Sleep Disruptions May Increase
Faubion says mood swings are likely caused by hormonal variability — not exact levels of hormones — and women who experienced mood issues throughout their fertile years may be more likely to have this issue during the menopausal transition, too.
“Mood swings and sleep disruptions tend to increase in many women as perimenopause progresses, with an abrupt increase as women approach the later stages of the menopausal transition and experience longer times without menses,” says Rosser.
5. Changes in Skin and Hair Texture Become Apparent
Growing — and looking — older is a natural part of aging. But if these changes are dramatic and concerning to you, talk to your dermatologist about options to minimize their appearance. Protecting your skin from the sun and using skin products that contain retinol or peptides can help, as can hair-loss drugs such as minoxidil or laser treatments. Clinical guidelines don’t currently support hormone therapy solely for estrogen-deficient skin, because of a lack of robust clinical trials.
The Takeaway
- Perimenopause is highly variable and driven by hormonal shifts, so it’s difficult to know when the end is near. Going longer stretches, such as 60 days, without a period can signal you’re nearly finished with monthly periods, but menopause isn’t confirmed until you haven’t had one for 12 months.
- Symptoms often intensify or change in late perimenopause: Irregular periods (lighter or heavier), peak hot flashes and night sweats, vaginal dryness, and shifts in libido may become more noticeable. Mood, sleep, and hair and skin changes may also be signs that the transition is winding down.
- Treatments for these symptoms can range from lifestyle changes and nonhormonal medications to hormone therapy or targeted vaginal treatments, depending on symptoms and individual risk.
Read the full article here
