LEARN THE course
Perimenopause is actually when the hormonal fluctuations and changes occur, says Dr Chrisandra Shufelt, director of The Women’s Hormone & Menopause Programme at Cedars-sinai Medical Centre and president of the North American Menopause Society (NAMS). ‘Once you officially hit menopause, it’s smooth sailing,’ she adds. Interesting. Here’s a timeline to clue you in to where you’re at:
1 First lap
Referred to as early perimenopause, this is the period that surrounds the final years of your reproductive life, says Dr Shufelt. It lasts anywhere from two to seven years before your last period.
Key signs Your cycle is mostly regular, but you may start to notice it lengthen by a week or longer – and you may skip the occasional period.
When it happens On average, perimenopause sets in around the age of 44 or 45. However, just like how you got your period before or after some of your friends, there’s no telling when it’ll be gone for good, notes Dr Pinkerton.
2 Second lap
You’re nearing your final period, when oestrogen is consistently low. This signals the brain to produce follicle-stimulating hormone (FSH). If you don’t produce an egg, your progesterone won’t rise.
Key signs Your usual 28-ish-day cycle might get shorter or longer and you’ll start to skip more cycles. This is also when unpleasant symptoms such as sleep changes, night sweats, hot flushes, weight gain and mood changes begin.
When it happens Hard to say. But when you start skipping two periods in a row, it’s likely you’re in late perimenopause and that your final period may be within the next four years.
3 The final stretch
You’ve reached the big M when you’ve gone a full year sans periods. (It can also happen earlier, if you have a hysterectomy with bilateral oophorectomy – the removal of both ovaries). ‘Most women dread menopause, but this is when hormones stop fluctuating,’ says Dr Shufelt. Plus, you can’t get pregnant naturally.
Key signs No more flow. If you still have symptoms such as hot flushes, speak to your doctor.
When it happens Anywhere from 40 to 58. ‘It’s variable,’ says Dr Elissa M Gretz Friedman, director of the Menopause Centre at the Mount Sinai Health System.