PRE, PERI AND POST MENOPAUSAL PERIOD

Menopause is described as cessation of
menses. Pre is a suffix used to describe
before, Peri describes during and post is
after. Therefore the term simply means
before, during and after menopause.
Menopause is when a woman stops having
periods, signaling the end of her ability to
have children.Women usually do not have
regular periods that suddenly stop one day.
There is a period of transition from regular
periods to menopause, during which most
women have irregular cycles. They may go
one or more months without a period, then
begin again. It is not an abrupt event.
Menopause is a process. The different
phases of reproductive cycles can be
inconsistent and confusing, especially since
it varies in each woman.
So when can you be relatively certain that
your periods have ended? Practically
speaking, it’s the test of time. If you haven’t
had a period for a year, chances are that you
have gone through menopause. Having
symptoms of menopause, such as hot flashes
and/or vaginal dryness, supports this
diagnosis. But these symptoms can occur
before, during and after your last period.
Transition into menopause occurs first as
periods change in length, then as you skip
periods or have very heavy bleeding.
Menopausal symptoms usually occur in the
late stage of the transition.
Pre menopause is the active reproductive
years of a womans life. From her first
period( Menarche)to the last.
since the last menstrual period. This phase
often lasts several years. In addition to
irregular periods, women can experience
hot flashes, vaginal dryness, and mental or
psychological symptoms. The average age
for the onset of perimenopause is 47, but
some women experience changes as early
as their late 30′s.
The postmenopause stage begins after
your last period. But since you don’t
know for sure it’s your last period until a
year has passed, it is better to wait until
twelve months after your last period to
say you are postmenopausal. During those
months between what you think is your
last period it is better to think of yourself
as in perimenopause. The average age
women enter menopause is 51, but this
can vary widely. Women who had their
first cycle early in life will most likely
have a late menopause and vice versa.
The following table illustrates the various
stages.

Perimenopause is that transitional phase

between the time periods become
irregular and when one year has passed
Stages Menopausal
Reproductive Postmenopause
Transition
Pea
Early Late Early Late Early Late
k
Perimenopause
4 until
Duration
variable variable 1 year year deat
of stage
s h
variable
more than
cycle
2 skipped first full
length
regular cycles and year of
Mentrua (more
to 260 no
l regular than 7 none
variabl consecutiv mentrua
cycles days
e e days l
differen
without a periods
t than
period
normal)
FSH risin consistently above
normal rising
levels g 40

Source: Adapted from the Stages of
Reproductive Aging Workshop
BETTER UNDERSTANDING OF
THE TERMS
When a woman over 50 years is asked ,
“Have you gone through menopause, or
the change of life?” I follow it up with,
"When was your last period?" because
some women don’t realize they are in the
transition to menopause if they have
irregular periods. Similarly, I ask women
in their 40s if their periods are regular,
and if they are having any symptoms.
If a woman believes she has gone through
menopause and answers that her last
period was less than one year ago, the
next question is, "Are you having hot
flashes, vaginal dryness, memory
problems, irritability or mood changes?"
If yes, she could be in the final months of
transition to menopause and her last
period. If no, she may or may not be in the
transition to menopause. Either way, she
should make sure to continue methods of
birth control, as she can still get pregnant.
If a woman says her last period was more
than a year ago, then she is
postmenopausal. (But if you are a woman
who never had regular periods and can
skip almost a year, this may not apply to
you.)
Why do we say that you can still get
pregnant if you’re in menopause? Well,
this usually means you are actually in the
perimenopause. Although one month your
hormone levels may be low, your ovary
might make one last egg in the following
month. If you don't have a period for a
full year, you can feel quite confident that
you will not get pregnant.
How ironic that you need to consider
pregnancy while your body is sending
signals of transition to a very different
phase!
This transitional period is often called
“change of life,” a term that resonates
with many women and works well, given
the way stages can overlap. Occurring at
an average age of 51, menopause is often
a time of life changes, physically, socially
and emotionally. Your children may be
leaving home; you may be promoted in
your work life, contemplating retirement
or working part time.
Menopause also marks a period of time
when health risks increase, especially for
heart disease, breast cancer and
osteoporosis. If you are perimenopausal or
postmenopausal it is important to see your
health care professional to talk about ways
to lower your risks and screen for the
early signs of problems.
Menopause t is often a welcome relief, but
the accompanying symptoms of
menopause can be difficult. Hormone
replacement therapy is available to help
make the transition lest drastic. Some
people wouldn't carry on without their
replacement therapy; others decry the use
of artificial hormones.
Menopause affects women physically and
mentally. Sadly, many women feel they are
aging and no longer worthwhile as a woman
when they begin to enter menopause. That is
not true. You are every bit the woman you
were before you entered menopause. Stay
away from women who wear the badge of
menopause as a sign that their life as they
knew it is over. Consider postmenopause a
new chapter in your life, in which you are
able to redefine yourself. Re-evaluate your
goals, and make plans for the future.
Symptoms of menopause that are difficult to
deal with include hot flashes, mood changes,
irritability, depression, night sweats,
insomnia, weight gain, changes in breast
size, or the development of facial, chest, or
abdominal hair. All of these are signs that
your body is no longer producing and
distributing progesterone and estrogen as it
once did.
During menopause, your body is changing.
Your uterus, ovaries, and fallopian tubes are
beginning to thin and shrink. Your body is
no longer producing eggs, so you are no
longer fertile. That doesn't meant that you
have no libido, it means that you no longer
have the ability to concieve children. Enjoy
your new found freedom, no more condoms,
pills, or intrauterine devices. Many women
view postmenopause as a time of sexual
freedom unlike any they have experienced
before.
One change that may require attention is the
stretching and thinning of the labia, the
entrance to the vagina. As the labia loses fat,
it loses flexibility. This may make
intercourse uncomfortable. KY Jelly and
Astroglide are both water based lubricants
that can restore flexibility and wetness to the
labia.
These changes aren't anything to fear. The
important thing is that you recognize them
for what they are, and discuss them with
your doctor. There are a variety of
medications that will help you deal with the
changes inevitable with the onset of
menopause.
Sometimes, the automatic response to the
onset of menopause is to turn to your doctor
for hormone replacement therapy. The
supplementary hormones can help alleviate
the symptoms for some women. Estrogen is
a standard replacement therapy, and
progestin is used in women who have not
had a hysterectomy. Progestin is used to
decrease the risk of cancer in the uterus.
Hormone replacement is available as a
cream, gel, patch, or capsule. All hormone
replacement therapy is available by
prescription only. Hormone replacement is
not for everyone. While it aleviates the
symptoms of menopause the Women's
Health Institute has concluded that long term
use can increase the risk of breast cancer and
heart disease. The benefits of hormone
replacement therapy must be weighed
against the difficulties of menopause.
General agreement in the medical field, at
this point, indicates the use of hormone
replacement therapy in as small a dose, and
for a short of a time period is necessary to
ameliorate the symptoms of menopause.

Consult with your doctor to determine the

best course of action for your health.
Express your concerns and symptoms
honestly with your doctor. He or she will be
prepared to advise you of risks and benefits
of hormone replacement therapy.

ABNORMAL VAGINAL BLEEDING :

if twelve months have passed since your

last period and you notice vaginal
bleeding it is an alarm symptom and you
must see your doctor as soon as possible It
most likely is a cancer and you need
proper re-evaluation.