What is perimenopause?

The menopause is when a woman stops having periods and can no longer conceive a baby naturally.  We consider that menopause is established either when the woman has been a whole year without her period and without any symptoms or when she has not had her period for six months, but she has experienced climacteric symptoms such as hot flushes, sweats,  mood swings,  insomnia…

Perimenopause is the time just before the definitive menopause. It can last up to two years, causing changes in her period cycles and producing some climacteric symptoms.

For women with perimenopause, when their periods do eventually stop menopausal symptoms can continue for a prolonged length of time afterwards – with the average woman’s symptoms lasting for around four years from her last period.

How do I know when I’m going through it?

If you begin to notice menopausal symptoms – such as changes in period cycle, loss of sex drive, hot flashes, sleep disturbances or mood swings – you might be experiencing perimenopause.

As a rough guideline, perimenopause can occur approximately from the age of 45 years before you are due to officially hit menopause.

If you are a smoker, have undergone cancer treatments or have a family history of early menopause, it might increase your chances of perimenopause.

What does it mean for my fertility?

During the first half of a woman’s menstrual cycle, the reproductive hormone, Follicle-Stimulating Hormone (FSH), is responsible for the growth of the follicles, where the eggs are growing. However, as perimenopause sets in and menopause approaches, these eggs can become more resistant to FSH, and the ovaries dramatically reduce their production of the hormone, Estrogen. So, a higher FSH level will be necessary to achieve the ovulation.

Consequently, if you’re going through perimenopause, your egg count and their quality will begin to decrease; lowering your chances of conceiving a baby naturally.

Women who are experiencing perimenopause are advised to take care of their health and wellbeing, so that they can produce the best possible quality of eggs to improve chances of conception.

If you are trying to fall pregnant and you have perimenopause, talk to your GP or visit a fertility clinic to find out the best options for you.

For many women going through perimenopause, IVF treatment using donor eggs can result in the best chance of success.

Can I test to see if I am perimenopausal?

Perimenopause is a gradual transition to menopause. Because of this, there isn’t one set sign or reliable and specific test that can help to determine if you are going through it.

Although there are a variety of at-home self-tests which claim to give a good indication, it’s always best to speak to your doctor or GP if you are experiencing any of the symptoms associated with this condition.

As well as assessing your medical history, age, menstrual cycle and symptoms, a blood test will be taken to determine whether your levels of Follicle-Stimulating Hormone are increasing and Estrogen decreasing – both signs that you are experiencing perimenopause. This way, the doctor will be able to know if the perimenopausal period has already started.

Dr. Carles Catllà, Assisted Reproduction Service Director from the internationally leading Assisted Reproduction centre, Institut Marques

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