They range in severity from a fleeting sense of warmth to a feeling of being consumed by fire "from the inside out." A major hot flash can induce facial and upper-body flushing, sweating, chills, and sometimes confusion. Hot flashes tend to come on rapidly and can last from one to five minutes. They're also a regular feature of sudden menopause due to surgery or treatment with certain medications, such as chemotherapy drugs. Hot flashes - sometimes called hot flushes and given the scientific name of vasomotor symptoms - are the most commonly reported symptom of perimenopause. Most women don't expect to have hot flashes until menopause, so it can be a big surprise when they show up earlier, during perimenopause. If pregnancy doesn't occur, progesterone falls, menstruation takes place, and the cycle begins again. As these hormone levels rise, the levels of FSH and LH drop. The leftover follicle produces progesterone, in addition to estrogen, in preparation for pregnancy. This in turn stimulates the ovary to release the egg from its follicle (ovulation). When estrogen reaches a certain level, the brain signals the pituitary to turn off the FSH and produce a surge of LH. FSH stimulates the follicles - the fluid-filled sacs in the ovaries that contain the eggs - to produce estrogen. Estrogen levels are largely controlled by two hormones, follicle-stimulating hormone (FSH) and luteinizing hormone (LH). The physical changes of perimenopause are rooted in hormonal alterations, particularly variations in the level of circulating estrogen.ĭuring our peak reproductive years, the amount of estrogen in circulation rises and falls fairly predictably throughout the menstrual cycle. Fortunately, as knowledge about reproductive aging has grown, so have the options for treating some of its more distressing features. Periods may end more or less abruptly for some, while others may menstruate erratically for years. Some women feel buffeted by hot flashes and wiped out by heavy periods many have no bothersome symptoms. The average duration is three to four years, although it can last just a few months or extend as long as a decade. Perimenopause varies greatly from one woman to the next. Perimenopause has been variously defined, but experts generally agree that it begins with irregular menstrual cycles - courtesy of declining ovarian function - and ends a year after the last menstrual period. It's also sometimes referred to as the menopausal transition, although technically, the transition ends 12 months earlier than perimenopause (see "Stages of reproductive aging" below). Menopause is a point in time, but perimenopause ( peri, Greek for "around" or "near" + menopause) is an extended transitional state. Many women experience an array of symptoms as their hormones shift during the months or years leading up to menopause - that is, the natural end of menstruation. What are the signs of perimenopause? You're in your 40s, you wake up in a sweat at night, and your periods are erratic and often accompanied by heavy bleeding: Chances are, you're going through perimenopause.
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