Perimenopause - Symptoms, causes and treatment

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Perimenopause - Symptoms, causes and treatment
Perimenopause - Symptoms, causes and treatment

Perimenopause is a transition period that women go through when they enter menopause. During the perimenopause period, women may experience several symptoms, such as irregular menstrual cycles and hot flashes

Perimenopause can last for 4–10 years before menopause occurs. This condition generally begins at the age of 30-40 years, but can also appear earlier, for example due to certain diseases or there is a history of early menopause in the family.

perimenopause - allodokter
perimenopause - allodokter

Causes and Risk Factors of Perimenopause

Perimenopause occurs because the levels of the hormones estrogen and progesterone in a woman's body decrease with age. This condition can occur in women who enter the age of 30-40 years.

Perimenopause is a normal condition experienced by every woman. However, there are several factors that can cause women to enter the perimenopause phase more quickly, namely:

  • HysterectomySurgery to remove the uterus or hysterectomy can increase a person's risk of going through menopause early, especially if both ovaries are also removed.

  • Hereditary factorsWomen who have family members with a history of early menopause are more at risk of experiencing a similar condition.

  • Smoking habitWomen who smoke may experience menopause 1-2 years earlier than women who do not smoke.

  • Cancer treatmentChemotherapy or radiotherapy to the pelvic area can cause premature menopause.

Perimenopause Symptoms

When going through the perimenopause phase, some symptoms will appear due to changes in hormone levels in the body. This condition is often mistaken for second puberty.

The main symptom of perimenopause is irregular menstrual cycles, which can be:

  • Menstruation arrives sooner or later
  • Menstruation lasts shorter or longer
  • Menstruation is getting less frequent as menopause approaches, even once every few months

In addition to menstrual disorders, other symptoms of perimenopause or the imminent signs of menopause are:

  • Hot flashes, ie hot or hot sensations that appear suddenly
  • Sleep disorders, which may be accompanied by or without sweating at night
  • Mood changes, such as irritability
  • Headache in early perimenopause
  • Cognitive disorders, for example, difficulty concentrating and forgetfulness
  • Pain during sexual intercourse, due to reduced vaginal lubricating fluid
  • Decreased sex drive and fertility
  • bone loss which can increase the risk of osteoporosis
  • Changes in cholesterol levels, namely increasing levels of bad cholesterol (LDL) and decreasing levels of good cholesterol (HDL)

When to see a doctor

Please note, the symptoms of perimenopause above can be heavy for some women so that it interferes with daily activities. If you experience this condition, please consult a doctor.

In addition, you also need to immediately consult a doctor if you experience the following symptoms of menstrual disorders:

  • Vaginal bleeding after intercourse
  • Bleeding a lot during menstruation, for example, until you have to change sanitary napkins every hour
  • Blood clots coming out of the vagina during menstruation
  • Bleeding outside of menstruation.

Perimenopause Diagnosis

To diagnose whether a woman is in perimenopause, the doctor will ask her age, symptoms or changes felt, and menstrual history.

The doctor will also do a blood test to determine the hormone levels in the patient's body. This test must be done several times to see any changes in hormone levels during perimenopause.

Perimenopause Treatment

Perimenopause is a natural condition that cannot be avoided. Therefore, there is no need for drugs to treat it. However, to relieve the symptoms of perimenopause, your doctor may prescribe the following medications:

hormone replacement drugs

The hormone estrogen remains the most effective option for relieving perimenopause symptoms, especially hot flashes and night sweats. Estrogen can be given in the form of pills, patches on the skin, to gels or creams.

To reduce the risk of cancer due to the use of the hormone estrogen, estrogen hormone replacement therapy can be combined with the hormone progesterone.

Vaginal estrogen medication

To treat vaginal dryness, the hormone estrogen can be directly inserted into the vagina using vaginal tablets, rings, or creams. Vaginal estrogen can also reduce pain during sexual intercourse and urination during perimenopause.


In addition to treating seizures, gabapentin can also reduce hot flashes. Doctors will give gabapentin to women who cannot be given the hormone estrogen.


Some types of antidepressants can reduce hot flashes due to perimenopause. This drug is generally prescribed to women who cannot undergo estrogen hormone therapy due to he alth reasons.

In addition to using drugs prescribed by a doctor, women who experience perimenopause symptoms can take the following measures to relieve their symptoms:

  • Stop smoking and don't drink alcohol
  • Reduce consumption of caffeinated drinks
  • Exercise regularly, but avoid exercising at night
  • Avoid napping if you experience sleep disturbance symptoms
  • Eat a complete and balanced nutritious diet, especially vegetables, fruits, whole grains, and he althy fats
  • Do activities that make you calm or relaxed, such as yoga or taking a warm bath, especially before bedtime

Perimenopause Complications

There are several diseases whose risk of occurrence can increase after women experience menopause, including:

  • Osteoporosis
  • Heart disease
  • Depression
  • Alzheimer's Disease

Perimenopause Prevention

Menopause is a natural process that every woman will experience. Some women feel the symptoms since perimenopause, but do not feel bothered. While others can feel very disturbing symptoms and even experience complications.

To reduce severe perimenopause symptoms and prevent complications, the following steps can be taken:

  • Maintaining ideal body weight
  • Consuming he althy and balanced nutrition
  • Enough drinking water
  • Exercise regularly, at least 30 minutes every day
  • Manage stress well
  • No smoking and no alcoholic drinks
  • Get enough rest and sleep

In addition, consult with your doctor about using estrogen hormone replacement therapy to treat perimenopause symptoms. This is because hormone replacement therapy is at risk of causing breast cancer.

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