Most women are familiar with the term “change of life,” a euphemism for that time in life which means they are advancing into old age, or menopause. The term menopause is defined as the “period of natural cessation of menstruation occurring usually between the ages of 45 and 50″ (Merriam-Webster Inc., 1990). Less familiar is the developmental phase of perimenopause, the phase which precedes menopause,”peri” literally meaning ” all around or surrounding.”
Perimenopause is often confused with menopause. It refers to the transition years leading into menopause. In biomedicine, a woman is considered to be in menopause after a period of 12 consecutive months have passed after the appearance of menstrual blood. In other words, a woman has not had a menstrual period for at least one year.
The duration of perimenopause varies among women and can begin as early as age 35, but a majority of women don’t notice the effects until they are in their late 40’s. Thus, depending on when a women enters perimenopause, the process of physical and psychological changes that accompany it can be as brief as a few years or as long as ten or more years.
During perimenopause, a woman’s ovaries begin to shut down resulting in less production of certain hormones such as estrogen and progesterone. This change is a natural part of the aging process, and it signals the end of a woman’s reproductive years.
The body’s production of hormones becomes more irregular and can result in widely varying fluctuations in levels. Even though fertility grows gradually less during this time, it does not officially disappear until a women is in menopause. While menopause is thought to be the period of physical and psychological upheaval signified by a range of different symptoms, hot flashes the most commonly associated symptom, these changes are really prognostic of perimenopause.
The subject of perimenopause has become a topic of women’s health and development that is more widely researched and discussed. It has been referred to as “a wake-up call,” a “rite of passage,” a “second adolescence,” suggesting not only the importance of it in women’s development and life span, but also to educate women on the myriad of symptoms that can be experienced and managed to reduce the sense of confusion, alarm and distress that it can entail.