Dr. Theresa Rohr-Kirchgraber and Dr. MargeryGass answer common questions about perimenopause and menopause.
Dr. Theresa Rohr-Kirchgraber
On when perimenopause occurs; for how long
"Perimenopause is that time period in a women's life when she is moving away from regular menstrual periods, regular menstrual cycles, to a time when they stop all together. Most of time, that occurs over the age of 40, usually somewhere between 45 and 55, to be completely done. But that pemimenopausal time slot can last up to 6 years in many women."
On how many women experience it
"It's interesting. There are some women who will go from having regular menstrual cycles monthly to done, over, not having another one. And then there others in which the cycle seems to lengthen. The periods become much more heavy, in terms of bleeding. They can have a lot of symptomatalogy with decreased sleeping ability, hot flashes, muscle aches. There are some many things that come under the guide of periomenopause. For some women, it's hard to know, because they start to feel those symptoms, but they are still having their periods regularly."
On unplanned pregnancies
"There's sort of a misconception that as you get older, your chances of getting pregnant are less, which is true, but many women use that perimenopausal time and assume that it's not going to happen to them. When, in fact, women over the age of 45 have about a 55 percent sterility rate. But, because your periods are longer, because the ovulation cycle is longer, it's harder for you know to when you're fertile and when you are not. So, you kind of have this false sense of security. You missed a couple of months, 'oh, I must be going through menopause, therefore I can't be pregnant,' and that's exactly when the unplanned pregnancies occur."
On staying on the same birth control
"It kind of depends. We do kind of encourage some of the long-acting systems. For example, the IUDs and the implants, partly because they also seem to give you some benefit. For example, during the perimenopausal stage, many women can have very significant bleeding. They go from having normal cycles to very heavy bleeding and bleeding through their clothes and becoming anemic. With those it may be helpful to switch from your birth control and using something like the Mirena, because it helps you control the bleeding and gives you some protection from pregnancy at that time."
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Dr. Margery Gass
On hot flashes
"Some women have no hot flashes. They are the lucky few, maybe 20 percent. And the rest of women have a range of anything from getting a little warm to breaking out in a full sweat and turning red."
On any predictors of who will have symptoms
"There are none that I know of. Some women actually start to have a few right before they have a mences. Or they might have had a couple the night after their delivery, when they've had a baby, so that might indicate that they are someone who has a propensity to having hot flashes."
Dr. Theresa Rohr-Kirchgraber is a professor of medicine at the Indiana University School of Medicine. She is also the Executive Director of the National Center of Excellence in Women's Health at Eskenazi Hospital. Dr. Margery Gass, a gynecologist, is the Executive Director of The North American Menopause Society.