Physical changes in menopause and perimenopause

Margaret Gradison

doi:10.1017/CBO9780511545672.008

8 - Physical changes in menopause and perimenopause

from Part II - Hormonal changes

Published online by Cambridge University Press: 21 August 2009

Margaret Gradison

Edited by

Jo Ann Rosenfeld

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Margaret Gradison: Affiliation:
Department of Community and Family Medicine, Duke University Medical Center, Durham, NC, USA
Jo Ann Rosenfeld: Affiliation:
The Johns Hopkins University

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Summary

Case: S. J. is a 47-year-old woman who presents with abnormal uterine bleeding. She had regular periods until two years ago, at which time her periods became unpredictable. Her current menses started three weeks ago; she says it alternates between needing to change pads hourly to requiring only a daily panty liner. Ms J. is obese and smokes a pack of cigarettes a day. Her only medication is thyroid supplements. Her obstetrical history is gravida three para two spontaneous abortion one (G3P2 AB 1). She uses condoms intermittently for contraception, and her first pregnancy was at age 29.

Perimenopause and menopause

Perimenopause is the time in a woman's life when she begins to experience the changes that lead to menopause. The World Health Organization (WHO) defines this as a “period immediately prior to menopause (when the endocrinological, biological, and clinical features of approaching menopause commence) and the first year after menopause.”1

This transition is caused by a decrease in gonadotropin and ovarian hormones. The ovaries produce decreasing amounts of estrogen and the target organs become less sensitive. Some women experience significant symptomatology during this time, which leads them to seek medical assistance. Menstrual changes, hot flushes, and other signs of estrogen deficiency, such as vaginal dryness, may be the first symptoms that a woman experiences. Perimenopause is a transition phase that usually lasts four to six years. This is the time when women move from a state of fertility and potential childbearing to infertility and permanent amenorrhea.

Keywords

intermenstrual bleeding menometrorrhagia menopause menorrhagia postcoital bleeding polymenorrhea perimenopause oligomenorrhea postmenopausal bleeding ultrasonography

Type: Chapter
Information: Women's Health in Mid-Life
A Primary Care Guide
, pp. 125 - 136

DOI: https://doi.org/10.1017/CBO9780511545672.008 [Opens in a new window]

Publisher: Cambridge University Press

Print publication year: 2004

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References

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8 - Physical changes in menopause and perimenopause

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