YOUR CYCLES DURING PERIMENOPAUSE

 

 

Dr Steven R. Goldstein is a Perimenopause Specialist in NYC who has written extensively on Perimenopause and treated many patients going through this stage of life.

 Menopause is defined as when there is no more ovarian function. The ovaries no longer make estrogen, and you no longer ovulate. Pre-Menopause means you are still making estrogen, though you may not be ovulating on a regular basis. Perimenopause is technically the first break in cyclicity.

 In other words, in the reproductive years most women have very regular cycles, and as you come off the reproductive years into perimenopause, the cycles can become somewhat irregular. To most patients, all the blood that comes out of their vagina is their period, but to Dr Goldstein, a menses is a bleed that is preceded two weeks before by ovulation. And so, if you don’t ovulate, you can still bleed. Those cycles are referred to as anovulatory, the “an” meaning without. You are making estrogen, but not any progesterone.

 So, Perimenopause is a time of fluctuating estrogen in a woman’s body without ovulation and without progesterone. This can cause some real havoc in the bleeding pattern, cycles, and also some havoc in what we call psychosocial symptoms such as worsening PMS, free floating anxiety, mood swings, inability to concentrate, sleep disturbances, brain fog, and so on, due to fluctuating levels of unopposed estrogen, rather than the absent estrogen of menopause.

 By the time most women have what we call vasomotor symptoms, hot flashes and night sweats, they kind of understand what’s going on. Hot flashes and night sweats can also happen in Perimenopause, though not necessarily from a lack of estrogen but from the precipitous drop in estrogen.

 A top gynecologist, he is the co-author of the book “Could it be….Perimenopause?” which was one of the first books ever written on the topic. Dr Goldstein is a past President of the International Menopause Society, past President of the North American Menopause Society and a Certified Menopause Practitioner.

 When it comes to Perimenopause, it affects many women in their thirties or forties, but many are unaware of what is going on with their bodies. It can be a confusing time, not only because of the symptoms, but the irregularity of the cycles. Sometimes women in Perimenopause are told it’s “all in their head”. It’s not. There is a change in the body’s hormones leading to vasomotor symptoms and irregularity in menstrual cycles.

 If you are a woman experiencing these symptoms, then schedule a consultation with Dr Steven R. Goldstein, a Perimenopause Specialist in NYC