Perimenopause

A woman has reached menopause when she has not had a period for one year, but before this happens certain steps and changes happen within the menstrual cycle.

 

Signs of perimenopause:

  1. Changes is the menstrual flow: The amount of bleeding can be scant or very heavy. The length of the menstrual period/bleeding can also change, be it longer of shorter.

  2. Changes in the duration of the menstrual cycle: The first phase of perimenopause is marked by a general shortening of the length of the cycle compared to that of previous years. In the second phase of perimenopause, menstrual cycle lengths become more irregular; some cycles much shorter than expected and others much longer, eventually the cycles become longer and longer.

  3. Changes in cervical mucus: The presence of fertile quality mucus are present for less time and there is more vaginal dryness, lesser quality fertile cervical mucus. There can be long time frames of no cervical mucus as ovulation happens later in the cycle. Nearing the later stages of perimenopause, there is little to no cervical mucus at all and can only be detected by the sensation felt and can no longer be found at the vulva.

  4. Bleeding throughout the cycle: Spotting, or even regular or heavy bleeding, can happen in the preovulatory phase, especially in longer cycles. If ovulation was not confirmed within two weeks preceding this bleeding, this is NOT considered a true period therefore the same menstrual cycle continues.

  5. Hot flashes and night sweats: Hot flashes are a subjective sensation in a perimenopausal woman of intense heat mainly to the face and chest. Often times the sensation of heat is accompanied by redness. These transient hot flashes come on abruptly and sporadically. Night sweats also come on abruptly and sporadically and can negatively impact a woman's quality of sleep. 

  6. Vagina dryness: Vaginal dryness is due to the atrophying of the mucus membrane in the vagina caused by the lower levels of estrogen. This can be especially bothersome and sometimes painful during vaginal intercourse due to lack of lubrication. The dryness can also cause severe vaginal itchiness and constant burning sensation.

Serena Quebec offers a specific workshop for the perimenopausal woman to help determine the periods of fertility, despite the complexity given all the changes that happen in this stage.