Menopause and Perimenopause - What Happens
In your late 30s, your
egg supply begins to decline in number and quality. As a result, your
hormone production changes. You may notice a shortened menstrual cycle and some
premenstrual syndrome (PMS) symptoms that you didn't
Gradually, your periods become irregular. This can
start as early as your late 30s or as late as your early 50s. It continues for
2 to 8 years before menstrual cycles end.
During this time, your ovaries are
sometimes producing too much
progesterone and at other times too little. Your
progesterone is likely to fluctuate more than before. This can lead to
heavy menstrual bleeding. (If you have heavy or
unexpected vaginal bleeding, see your doctor to be sure it isn't caused by a
more serious condition.)
About 6 months to a year before your
periods stop, your estrogen starts to drop. When it drops past a certain point,
your menstrual cycles stop. After a year of no menstrual periods, you are said
to have "reached menopause."
During the next year or so, estrogen levels keep going down. This lowers your risk for certain types of cancers (estrogen is linked to some types of cancerous cell growth). But low estrogen
also creates some health concerns, such as:
- Bone loss. Low
estrogen levels after menopause speed bone loss, increasing your risk of
- Skin changes. Low estrogen leads to low
collagen, which is a building block of skin and
connective tissue. It's normal to have thinner, dryer, wrinkled skin after
menopause. The vaginal lining and the lower urinary tract also thin and weaken.
This condition can make sexual activity difficult. It can also increase the risk of
vaginal and urinary tract infections.
- Tooth and gum changes. Low estrogen
affects connective tissue, which increases your risk of tooth loss and possibly
Although the reasons aren't well understood,
a woman's risk of heart disease increases after menopause. Because heart
disease is the number one killer of women, consider your heart risk factors
when making lifestyle and treatment decisions.