Premenopause and menstruation: what changes occur. Premenopause – what is hidden under the prefix “pre”? Intermittent periods in premenopause

Content

In the life of any woman there comes a stage when reproductive function declines or menopause (menopause). The duration of this interval depends on the individual characteristics of the female body. The average duration of menopause is 15 months.

What is menopausal syndrome

The physiological period of cessation of menstrual and reproductive functions is often called menopausal syndrome. The reason for the development of this stage is the gradual decrease in the activity and amount of estrogens (sex hormones), which provoke the production of the pituitary hormone. The menopausal period is divided into 3 stages:

• Premenopause. Precedes the cessation of menstruation. How long does menopause last at this stage? As a rule, the duration of the stage is from 3 to 7 years.
• Actually menopause. The phase that occurs after the end of menstrual bleeding.
• Postmenopause. This time is determined by the complete cessation of ovarian function.

Many ladies often wonder how long the menopause lasts? It is impossible to answer this question precisely, since everything depends on the individual development of the organism. Although in a normal course, menopause passes within a year. The severity of the symptoms of menopausal syndrome depends on the characteristics of the female body. The main signs of the onset of menopause are:

• headache;
• sweating;
• pressure changes;
• apathy;
• cardiopalmus;
• vaginal dryness;
• burning and discomfort when urinating;
• itching in the vagina;
• frequent urge to urinate;
• sleep disturbance;
• decreased sex drive.

How long does menopause last in premenopausal women?

It is known that the premenopausal phase is the time preceding the onset of menopause, during which a woman’s production of sex hormones produced by the ovaries decreases. How long does menopause last during premenopause? The average duration of the period is from one year to 7 years. The stage begins after 45 years with a change in the intensity and duration of menstruation. The onset of menopause is a great stress for the adrenal glands, since they are responsible for the independent production of estrogen (without the ovaries). The premenopausal state is accompanied by:

• increased sweating;
• hot flashes;
• rare menstruation;
• rapid heartbeat;
• itching and dryness of the vagina;
• frequent urination.

How long does the menopause last?

The stage when the last menstruation occurs is called menopause. In this phase, the level of progesterone decreases to almost zero, and the ovaries stop producing estrogens. On average, menopause occurs at the age of 50, although some factors (smoking, alcoholism) contribute to its onset 3 or 4 years earlier. The menopausal period lasts from one to three years. As a rule, according to its duration and premenopause, women calculate how long menopause lasts. Changes during menopause can occur like this:

• weight increases;
• fat deposits appear in the waist area;
• frequent dizziness occurs;
• the cervix becomes inflamed;
• a disease such as osteoporosis appears.

How long does menopause last in postmenopause?

The final period, when the ovaries no longer work, but atrophic changes occur in the uterus, is called postmenopause. This stage can be determined and stated if menstruation has not been observed for a year. It will last until the end of life. During the postmenopausal period, the production of male hormones may increase; estrone predominates over estradiol, so there is a possible risk of developing tumors. Main symptoms:

• sleep disturbance;
• tides;
• mood swings;
• sweating;
• emotional swings.

How does menopause occur in women?

Changes in hormonal levels affect the physical and psychological state of a woman. Half of the female population experiences menopause easily, but the remaining 50% may experience pain and discomfort. At the same time, no one can accurately determine how long menopause lasts in women, since the occurrence of menopause is influenced by genetic factors, habits, and working conditions. But the symptoms are almost always the same:

• skin redness;
• hot flashes;
• decreased libido;
• profuse sweating;
• chills;
• headache;
• increased irritability;
• insomnia.

Changes in the menstrual cycle

The regularity of menstruation during menopause and how it progresses directly depends on the functioning of the female body, her health, environmental conditions, previous operations, etc. For each woman, this process proceeds differently. At first, the discharge is irregular, disruptions may occur, and then menstruation stops altogether. The delay period can reach several months. Menstruation during menopause can occur in several ways:

• The cessation is gradual. The discharge is scanty, the interval between cycles becomes longer. This condition can last from one to three years.
• Abrupt cessation of menstruation. It may be painless.
• Resumption of discharge after a long period. Gradually, the break will become longer and menstruation will completely stop.

How long do hot flashes last during menopause?

Many women tolerate menopausal syndrome easily, without experiencing any particular discomfort or pain. However, some representatives of the fairer sex do not feel well during menopause. The most common symptoms of the onset of menopause are considered to be hot flashes, which cause serious physical and psychological discomfort to a woman. Hot flashes are a momentary feeling of warmth, accompanied by heat and sweating. The cause of their occurrence is the dilation of blood vessels near the surface of the skin.

The duration and intensity of hot flashes in different women depends on individual characteristics. Some may experience them only for one year, others do not feel any discomfort at all, and others have to put up with them for many years. The duration of such phenomena can be from one to 2 minutes, in rare cases up to an hour. Gradually, the severity of such ailments decreases.

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Hello, dear readers of the blog site.
The topic of premenopause, menopause, menopause, and the decline of a woman’s fertility after 45-50 years is quite unpleasant for many. We don't know how to live after 45 years.

Many roads in society are closed to a woman at this age. We see around older unfulfilled women who have problems in the family, with children, with health, with money, with profession and work. Observing this, young women do not know where to grow old, where to go, what is the essence of older age.

Therefore, many women “cling” to menstruation, become pregnant and give birth after 40-45 years, as if going to the “second round”. If only not these terrible words - “menopause” and “menopause”.

Everything in the world is cyclical. The periods of the day, the year, and life are natural. And in a woman’s psyche all its stages are always present. Girl, Girl, Woman and Old Woman, like the four phases of the Moon, are within us at any age. It is important to know them, to master their qualities.

The ability to bear children disappears with age. A woman can see the first signs of decreased fertility quite early. This could be, for example, if she has a lot of stress, had abortions, if she took hormonal contraceptives, has poor health, etc.

Natural Family Planning and Fertility Detection Methods make it possible to prevent early ovarian failure. A woman, knowing her fertile and barren days, feels much calmer; she has complete information about herself. This means he can avoid abortions, fear, and harm from contraception. Therefore, the age of premenopause may occur much later.

Fertility in premenopause.

Premenopause is a period of decline in fertility. Signs of fertility decline can occur at any age. It's always individual. But at the age of approximately 38-40-45 years, as a rule, a decrease in ovarian function begins.

Premenopause is the period from the beginning of the attenuation of ovarian function to the complete cessation of menstruation. It is characterized by a sharp decrease in the ability to conceive and a change in the nature of menstruation.

Menopause is the last independent menstruation in a woman's life.
Postmenopause is the time from the last menstruation (menopause) until the almost complete cessation of ovarian function.

The cessation of menstruation at the age of 40-45 years is usually regarded as early menopause; over 55 years old - late menopause. The age of 38-39 years is accepted as the lower limit of early premenopause. If a woman begins to experience these symptoms before the age of 38, it is considered ovarian wasting syndrome.

The menstrual cycle is controlled by female sex hormones - estrogens and progesterone, which prepare the uterine mucosa for pregnancy.

But not only the endometrium of the uterus is sensitive to estrogens and progesterone. These are the brain, liver, intestines, heart, musculoskeletal and urinary systems and some other tissues. The organs contain receptors sensitive to female hormones.

That is why, when the level of female hormones decreases, the so-called “menopausal syndrome” develops, characterized by dysfunction of various organs.

The balance between estrogens - female hormones, the synthesis of which in the body decreases, and androgens - male hormones produced by the adrenal glands is disrupted.

Premenopause, developmental mechanisms.

In conditions of deficiency of ovarian hormones, compensatory and adaptive mechanisms develop.
The adrenal glands begin to produce an increased amount of androgens - male sex hormones, which turn into estrogens in the subcutaneous fat.

Violation of autonomic regulation by the hypothalamus provokes increased sweating, dizziness, nausea and hot flashes. These reactions are vascular in nature.

An increase in prolactin synthesis by the pituitary gland often accompanies menopausal syndrome. Because of this, the secretion of estrogen by the ovaries is suppressed even more. In addition, prolactin enhances proliferative processes in the mammary glands and uterus. As a result, the risk of uterine fibroids and mastopathy increases significantly.

Neurotic reactions (increased irritability, nervousness, tearfulness, sleep disturbance, suicidal thoughts) occur against the background of pathology of internal organs and due to a woman’s emotional experiences about her age and condition.

Signs of perimenopause.

• Heavy bleeding during menstruation, discharge of blood clots.
• Menstruation lasts several days longer than usual.
• Minor bleeding between periods.
• A slight discharge of blood after sexual intercourse.
• Reducing the length of time between menstruation.
• The main sign of the onset of perimenopause is a decrease in fertility.
• Decreased number of ovulations, shortening of the luteal phase of the cycle (these are signs of insufficiency of the luteal phase of the cycle).

• Luteinization of unovulated follicle syndrome (LUF syndrome) is possible.
• Resistance of the ovaries to the effects of FSH, an increase in its production by the pituitary gland. This stimulation of the ovaries leads to the maturation of several follicles simultaneously, none of which reaches full maturity. As a result, high levels of estrogen in the blood, changes in cervical secretions and the condition of the cervix.
• When estrogen levels drop due to the destruction of ripening follicles, heavy irregular bleeding occurs.

I wrote about unovulated follicle syndrome (LUF syndrome) in a separate video course on menstrual cycles. There I also covered the issue of luteal phase insufficiency, because these are the first “bells” that indicate a decline in fertility. Moreover, we are not talking only about premenopausal age, this is possible at any time.

Signs of perimenopause can occur at any age. If you read the literature, get acquainted with these topics, and see a decrease in ovarian function, then you should think about changing your lifestyle and reducing stress. Maybe you should take care of your health.

Monitoring signs of fertility and keeping charts of the menstrual cycle during premenopause will help you avoid unplanned pregnancy, see signs of disease, and feel free in marital relationships. :)

And now - a movie from the video course - Fertility in premenopause. Lesson 1 - Hormonal background of a premenopausal woman.

Sincerely, Elena Volzhenina.

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comments 84

I didn't have any premenopause. Menopause began unexpectedly, the symptoms were severe: hyperhidrosis, lack of libido, apathy, weakness. I took cyclim and drank herbs to reduce the severity of the symptoms. Great help. But you need to start looking after your health in general: eat right, take vitamins and exercise. This approach helps me

Elena, hello!

I'm almost 42 years old. There were no pregnancies, no abortions. Menstrual cycle from 10 years. I haven’t taken OK since I was 28 years old. At the age of 37, the first hormonal imbalance occurred: within six months, myoma grew and against this background, fibrocystic mastopathy sharply worsened. As I now understand, these were the first signs of entering a new phase of my life. But then I was in complete confusion and was thinking about something completely different - the doctors were pressing: give birth urgently or have surgery, and then give birth right away. I was not ready for either one. In the end, I decided to do nothing and observe the fibroids. I took indinol and epigallate. Nobody encouraged me to see an endocrinologist then. Three years later, I finally decided to undergo abdominal surgery to remove the fibroids, since it began to grow, and they also discovered an increased blood supply to the node. Everything went well, the cycle was restored immediately. The doctor said that in a year you can plan a pregnancy. I refused hormones and prescribed all the same dietary supplements above. But she didn’t send me for hormonal tests. Yes, since the appearance of fibroids, the cycle has become shortened and meager. There was a moment before the operation when he disappeared for two months (by the way, all hormonal disruptions occurred in the middle of summer). About a year ago, I began to notice increased sweating, although I had never suffered from it before. Periodically I wake up in the morning in a sweat. Now in the heat it haunts me constantly. Fatigue set in next. That’s when I became concerned about my hormones. On the recommendation of a gynecologist-endocrinologist, I took tests and it turned out: AMH is 0.13, macroprolactin is off scale 1652, the rest seem to be normal. In general, I'm all upset. And I want to know how I can help my body to get through this period as smoothly as possible. I don’t plan to have children, I understand that if it happens suddenly, it will be a miracle. I’m definitely not going to experiment with my body in this regard (I decided this before the operation, until it became clear that I would be saving the organ). I don’t accept HRT, I watch how my older friend prolongs her womanhood in this way and I am amazed at her courage. But it’s still terribly offensive (I even cried today), people only remember at the age of 50 that menopause happens in the world, but I’m barely over forty and here’s hello. Although, of course, we need to be grateful that this is all. Help me how not to fall into bargaining and depression, but to accept my condition and find reasons for joy. Thank you in advance!

Hello. Please tell me. I’m 42 years old, my periods disappeared a year ago, I haven’t had them for two months, an ultrasound shows that my ovaries are fading. My doctor prescribed duphaston, I took it for 5 months. During this period, menstruation was restored, but an ovarian cyst appeared, I had a laparoscopy with hysteroscopy RDV. After it, there was discharge for 14 days, and then for a month and a week there was no discharge; according to histology, it was a cyst of the corpus luteum, the endometrium of the early phase of secretion. I don't feel very well. The doctor tells me to take Lindinet 20 for my periods, but they don’t. Tell me, should I call the duphaston month again? Should I drink Lindinet? Thanks in advance.

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Good afternoon! I found your blog by accident, watched the video and people’s reviews, and decided to ask you for help. Please tell me what tests should be done initially. I am 44 years old, my periods have always been with an interval of 27-28 days. But this month for some reason 2 times, my chest hurt, severe itching of the skin on my back, which periodically worsened over the course of 2 years. I have suspicions about a hormonal disorder. Last year I had a frozen pregnancy and an arbitrary miscarriage. Thank God everything went without surgery, my period was on time, I didn’t have to go for curettage
Ie. The thing is that I want a child with my husband, I don’t have much time anyway, but I know at this age I can still give birth, abroad for sure. Recommend where I should start the examination?, thank you very much. It’s just that my husband is young and I wanted to give birth for him again. I have a 25-year-old son. Thanks for the answer

Good afternoon. I am 47 years old, in October (2017) my periods did not come, then they came in November and came every month according to the usual pattern, in April they did not come again, they came in May, very scanty. I went to the gynecologist and had all the tests done, FSH 8.9 LH 7.6, the doctor said that the hormones were normal so far, they did an ultrasound and found no abnormalities. But lately my condition has not been very good, I have been sweating, increased heart rate, and irritability. The doctor said that although the hormones are normal, this is premenopause, or rather the beginning of it, and prescribed claira and vitamins. My question is whether it is advisable to take a hormonal drug to support the body.

Elena, hello! I have a question about birth control during menopause. I am 50 years old, ultrasound showed signs of menopause (no menstruation for 5 months, ovaries decreased to 1.7 x 1.4 x 1.3 m-echo thickness 2 mm, dry mucous membranes), the gynecologist said that I don’t have to use protection. How do you think? I found in the literature that it is necessary to protect yourself for a few more (!) years.

Fsg-50 and lg-40 at 38 years old - is this a death sentence? My period is not a month and a half. Yesterday I had an ultrasound. ENDOMETRIUM-11 named after, 4 Hollywood in the left ovary, on the right there is a cyst. What can you do to get your period started?

Hello! I am 42 years old. At 37 and 39 years old, cesarean section. Two children. In May 2016, my first period after childbirth, also my last. I breastfed my youngest for 2 years. There were no cycle disruptions before the birth. And, suddenly, early menopause. The gynecologist recommends hormones. He says otherwise there are high risks of premature aging. I do not know what to do. And why did menopause begin immediately after childbirth and breastfeeding?

Hello. I am 50 years old. I had my last period 2 years ago. The last 3 periods came at intervals of 4 months. But the doctor said that he did not see signs of menopause, since the ultrasound did not increase the size. But when was the last time I visited the doctor again on the issue absence of menstruation for 4 months, the doctor said by ultrasound that the size of the uterus has already decreased and this is a picture of menopause. She said she thinks she will have her period one more time so that everything will clear up there. But I haven’t had a period for 2 years. But now I have I started my period. What could this be? Before this, I had severe allergies and problems with urinary incontinence when sneezing. I would also like to add that 6 months ago I took prednisolone tablets for 5 days. Thanks in advance.

good day, Elena! I am 51 years old and, as I understand it, I am in the pre-menopause period. There were 2 pregnancies that ended in childbirth, there were no abortions. My cycle my whole life was every 26-28 days, like clockwork. 2 years ago the first changes in the cycle began - acceleration, the cycle became shorter after 21-23 days, but the periods were normal in number and duration of 3-5 days, as always. But a year ago - another change occurred - the period of time between menstruation has lengthened significantly - 36-40 days, and it happens that before menstruation there is a brown spot for several days or after menstruation as well. Before the penultimate period there was already a gap of 58 days, but the period passed normally, and before the last one there was also a gap of 58 days, but here a very strange situation had already occurred - the smudge was brown for almost a week, then 3 days passed with normal periods, then again a smudge for a week , then it seemed like everything stopped for a few days and again the spotting, but quite abundant, like a scanty period - in general it has already lasted 3 weeks. Help me understand what is happening to me, is this normal for the premenopausal period?

good day, Elena!
I’m 58. I was amazed when I read your article about Duphaston.
Help me, please, since the onset of menopause, for 4 years already, the body temperature has not risen above 35.5, sometimes even 34 and 33.5, hands and feet are cold in winter and summer. the whole body suffers from this. I feel terribly weak and bad. + insomnia, tears and nervous breakdowns. Tablets like Klimadinon do not give results. I understand that this is due to the thermogenic effect of progesterone, but how can I correct it? The local doctor said, “at your age, this happens, it’s okay!” What to do??
Thank you.

Good day, Elena. I am 49 years old, three CS ended with 3 children. The fallopian tubes were ligated. The first disruptions in the cycle began in the summer of 15, when there was an unplanned trip to the sea and there were no periods in July. In August everything returned and until the fall of 2016 it was on schedule. In the fall, very scanty discharge began. No odor and no pain. This lasted until June 16, 17. Although in May there was no discharge at all. And now, on June 16 and for 4 days, discharge began with small and rare clots. I undergo a medical examination with a gynecologist and mammologist once a year. Question: Am I in menopause? Thank you.

good day, Elena!
I am 41 years old, I have 2 children, and I already know for sure that I am (for like a year) premenopausal, as indicated by all the symptoms and AMH. Over the past 2 years, I have seen dramatic aging every day. My gynecologist said that I can take a hormonal drug that will prolong my periods, which are no longer systematic. Do you think this should be done? Thank you in advance for your response!

Elena, hello! This is the situation: I am 42.5 years old. Exactly a year ago in December I had menstruation twice (the second time it was very scanty), then there was a 40-day delay. Since January, everything has been going smoothly, although a couple of times I had heavy menstruation, and scanty menstruation in the summer. Previous menstruation was 40 days late, I was tested for hormones, FSH and LH were normal, low estradiol - 17.9. The doctor prescribed me to drink duphaston for a month (from days 14 to 26), then she told me to drink femoston. I read Noya - they drink it after 6 months. after my last menstruation, I haven’t gone through menopause yet... I called another doctor, she advised me to drink Logest right away (I took it for many years before the DHS surgery, which was 3 years ago). Today is the 45th day, spotting has begun, the endometrium is 7 mm according to ultrasound. What do you advise? I’m torn about whether to drink Duphaston or not, whether to drink Logest or look for phytoestrogens...

Hello! I am 47 years old. The last two years have been “bells and whistles” about age: the pressure has changed from working 90/60 to 110/70, the cycle is “jumping”, the nerves are “exploding” for no reason, the orthopedist recommends seeing a gynecologist-endocrnologist due to the wave-like loss of bone tissue... On the advice of one of the gynecologists, I started taking Menopace Plus, and my body reacted with inflammatory, painful pimples on my shoulder. I stopped drinking and they went away. I made an appointment with a gynecologist-endocrinologist. What tests should I come to the initial appointment with so that something can be understood about my condition? I read that FGS is needed, on what day of the cycle should I take it? Please tell me. (The reception is paid, it’s very far to travel, I don’t want to waste time and money)

Elena, good evening! I am 47 years old, 2 pregnancies resulted in two children, one operation to remove a polyp, nothing else happened. After the 2nd pregnancy, there was heavy bleeding. I visited a gynecologist, they found a polyp, and they cut it out as the cause of the bleeding. It didn't get any better. I take tranexamic acid + vitamin E 1000 mg every month. That’s how I save myself! I’m waiting for menopause, because heavy periods ruin my life. I live in an embrace with sorbifer durules))) For 5 months now, the cycle has been jumping by 2 weeks, before it was like clockwork. I recently read about the complex, there were only vitamins like B6 B... IT RESTORES THE CYCLE.. Then I called an ambulance because I had palpitations, dizziness, etc. I immediately left him and everything became normal.... Since the cycle began to jump, is this premenopause? What should I do, do nothing?))) wait for menopause? or run to the doctor?

Good afternoon I am 31 years old. Yesterday I went to the doctor and found out the results of my tests, AMH 0.40, and she said that with such indicators they wouldn’t even accept IVF. I'm naturally in shock. I had never given birth, I didn’t take hormonal pills and I always felt good, my periods came regularly. My husband and I have been trying to get pregnant for a year and it hasn’t worked out, so we went to the doctor to check my and his health. Tell me where to start??? I started looking for information on the Internet and found your article, tell me how to start monitoring fertility? My husband and I really want a child. Thank you!

Hello, Elena! I am 49. My periods are regular. The cycle began to fluctuate a little, 26-28 days. Today, on day 16, bleeding began. Not plentiful. This has never happened before. The day before, the right ovary pulled a little, as if tingling. I was at the sea, roasting in the sun. However, as always before. There was some discharge with an unpleasant odor. I made an appointment with the doctor for Saturday. Tomorrow I go to work, but I’m all in a panic. Help with advice! Sincerely, Elena.

good day, Elena! I can find out your opinion on the following situation: I am now 41 years old, I gave birth to my second child at 38 years old, and my first at 21 years old. Until the age of 35, the cycle was 22-24 days (IUD was used as contraception), then oral contraceptives and the cycle was established at 28 days, after discontinuation of contraceptives and examination at 38 years, pregnancy occurred immediately, childbirth was normal without complications. After giving birth, menstruation began 1 year 7 months later, with continued breastfeeding, the cycle was immediately established at 28 days. But now, that is. after 1 year after the start of menstruation, for the second time the cycle is 20 days. Last month, on the first day of unexpectedly onset of menstruation, I had an ultrasound scan - the conclusion was: “peristant follicles, a consultation with a gynecologist is necessary,” the next day I went to an appointment - the doctor said that everything was normal according to the ultrasound.

Elena, good afternoon. I am 36 years old, I do not have children yet and I am not married. On June 9, 2016 I had my last period; it didn’t come in July and I visited the doctor in early August. FSH 96.9 LH 50.3 Prolactin 10.9 estradiol 44.9 progesterone 5.1 testosterone 1.3. I was diagnosed with SIA and prescribed climanorm for 4 months. The doctor said that with such indicators, it is possible to get pregnant only with a donor egg. Help me please! Maybe there is still some percentage of people who can get pregnant on their own without a donor cell. I hope that my ovaries can still recover, but I don’t know how to help them.

Good day, Elena. I am 45 years old. I gave birth to my second child at 40. In the early stages there was a threat of miscarriage - they prescribed Duphaston, I drank for a long time and in large quantities. I breastfed for a long time, about 2 years. When my period came after childbirth, I first smeared it until the 10th day. Then the scribbling gradually became chaotic. My periods became very heavy. My last period ended with bleeding. They did a cleaning and the diagnosis was glandular fibrous polyps. Orgametril or busereln injections were prescribed as treatment. I am very wary of hormonal drugs. But no doctor can advise anything more. Maybe you should take wild yam and it will improve your hormonal balance?

Hello, I did an ultrasound of the ovaries, the dimensions of the right ovary are 18x10x9 mm, the left ovary is 26x15x13 mm, the volume is 0.85 mm.cubic and the volume is 2.56 mm.cub., respectively. Please tell me is this the norm or deviations?

Elena, many thanks for the very useful information! I am 51 years old. And I began to experience the first signs of approaching menopause. Suddenly, slight bleeding began in the middle of the cycle. The cycle has gone wrong. This continues for 2 months. The examination did not reveal anything special. (Follicular cyst, cystic changes in the left ovary). Polycystic ovary syndrome accompanies me throughout my life. But this did not particularly affect my condition - the only thing was that menstruation lasted a week and was abundant. I started taking Wild Yam (NSP) (on the recommendation of the NSP consultant, my gynecologist recommended progesterone) from days 5 to 25 of the cycle, 3 capsules per day with food. My question: what if after 25 days menstruation does not occur? How then should you take Wild Yam? What if bleeding starts again on day 14? How to take Wild Yam in this case, if after bleeding the endometrium again looks like after menstruation? A slight nagging pain in the lower abdomen (or right or left), which I feel only during the day (they calm down at night). Is this normal during the onset of menopause? Thanks in advance for your answer.

Hello! I am 49 years old. Since the beginning of this year, signs of premenopause have been present. You say - watch to see if there is ovulation. How can you trace it? I do ovulation tests - they show a weakly positive result on any day of the cycle. Sometimes in the middle of the cycle I feel pain in the lower abdomen, which I take for ovulation. What other ways are there to determine ovulation? Thanks in advance.

good day, Elena. I have the following problems: at the age of 38 I was diagnosed with ovarian failure syndrome. months did not go regularly. the shortest interval is 16 days, the longest is 65, JAZZ was prescribed, I took it for half a year. and refused, my legs began to hurt badly. irritability. Now it's the last month. were on February 26th. I went for an ultrasound. The left testicle has shrunk. The right one has ovulated. I'm waiting for months. The doctor prescribed normomens.vit.E. and if they go to Klair. What do you think, is the treatment prescribed adequately?

I am 43 years old. The pressure of PA fears and everyone offering to it has risen sharply. The examination was completed completely. Everything was normal. FG 6.12 according to ultrasound was also normal everywhere. Menstruation preserved. Attributed to Klair. I drink 6 packs, hot flashes go away and my blood pressure also goes away. But neurosis and anxiety won’t let me in. I take hydrozypam 0.2 at night. In the morning I take valerian. Tell me whether I should continue taking the drug or whether I need something else. Thanks for the early response.

Hello! I am 47 years old. Three years ago I started having heavy menstruation with clots, and I was put on the hormonal Mirena IUD. Now “catastrophes” don’t happen, but somehow everything is irregular and it’s just smeared, then menstruation occurs. My chest hurts all the time. Hair is falling out a lot and growing in the wrong places. I took tests: thyroid-stimulating hormone -4.1, free thyroxine 0.911, dehydroepiandrosterone sulfate 299.1, free testosterone 3.188. And all this against the backdrop of nervous breakdowns, irritability and thoughts about why I live and what to do. I started to pass it on because it turned out that this is the only pleasure. Is this perimenopause? What should I take to be calm and in general. Thank you.

Hello, Elena. Please tell me. I am 41 years old. My periods have always been regular. In January 2016 arrived as expected. But now 2 months have passed, and they are not there. I’m very worried, I don’t know what it is, has the menopause already begun? Lately I have been having headaches and high blood pressure very often. In February I had the flu. I was very nervous this winter (problems with my son). I visited the doctor. She prescribed me to take duphaston and vitamin E. No tests were taken. Tell me what's wrong with me?

Hello. I would like to know if I have perimenopause or not. I just turned 38 years old. My periods were regular until August 2015. Then we went in September. From September to December they were regular. Since January 2016, no periods. Passed FSH tests - 27.4; LG-18.82; Estradiol-34.8; Prolactin-150. Ultrasound: there are signs of chronic endocervicitis. Small cystic lesions of the right ovary, cyst of the left ovary, adenomyosis (minor changes). I also have type 1 diabetes. The doctor said that if FSH is high, it means you are in menopause. He prescribed what to do in order to schedule an HRT appointment. What to do? Reading the symptoms of menopause, everything fits. I’m nervous, I’m tired, I want to sleep, sometimes my spine and knees hurt, I broke out into sweat once for several days (not anymore), it seems to me that a light mustache has appeared above my lip. My child turned 4 years old.

Hello, Elena! I am 44 years old in May, my child is 6 years old. She had a long history of infertility, the main reason being polycystic ovary syndrome. 7 years ago, an ovarian fibroma was removed. She gave birth to a child via cesarean section, a year after laparoscopy. The last six months have been extremely irregular periods. According to the test results, FSH 55.8, LH 29.83, estradiol<37, пролактин 195. У меня пременопауза? Заранее спасибо за комментарий. С уважением, Валерия.

Hello, I’m 53 years old. Until June I had my periods regularly. Then
Bleeding started and they did a curettage. The fibroids are not very large. I did an ultrasound and did all the tests. The hyperplasia seemed to have gone away. I drank wild yam. There were no periods as such for two months, but some kind of mucus and blood came. In December, heavy periods with clots began, two weeks, then again mucus with blood. Five years ago I had myoma removed. My blood pressure was jumping and my condition was bad. I was in the hospital, they gave injections and that’s it, only the blood became thick. What should I do: remove the fibroids or wait for menopause, the doctor says that my age is such that menopause should come. And everything will go away on its own. Thank you!

Hello, Elena! I am 49 years old. Last month there was a delay of 10 days and my period lasted only 1 day. My chest hurt. When it was time for menstruation to arrive, it turned out that the cervix was in a position similar to ovulation, so I was already prepared that menstruation would come late. This month the middle of the cycle has already passed (day 19) but there is still no ovulation (discharge is dry and the cervix is ​​closed, temperature is 36.5). Could this be perimenopause? For some reason I became very irritable. Is it from perimenopause? I’m getting on my nerves... I’m afraid I’ll completely lose my mind (I’ve decided to lose weight and am counting calories) and give up everything. I don’t know what the reason is and how I can restore emotional balance. Thanks in advance for your answer. And thanks for your site!!!

Hello. I have a question for you. I’m almost 44 (I’ll be 44 on February 20) and my period has been late for 11 days. Pregnancy is excluded, since I have not been sexually active for a year. before that everything was fine. The menstrual cycle was 25-28 days, regular, without any complications. What could it be? I am already worried because I am still planning to have children.

Hello. I have multiple large nodular uterine fibroids. 41 years old. Menstruation was abundant, but lately there have been delays. Previously, the cycle was regular. I had my period in July and then in September. That's all. There is another delay in October. What could it be. Thank you

Elena, hello! I am 47 years old, I gave birth 5 years ago, my third. Breastfed for 2 years. Now it looks like perimenopause has begun. Menstruation (or bleeding) is regular, but very heavy. An ultrasound showed the thickness of the endometrium on day 7 of the cycle was 12 mm. On day 5-1 of a 27-day cycle, FSH is 15, estrogen is 5, and other hormones are normal. According to my observations, there has been no ovulation for the last 2 months. Well, FKB category 2. The doctor diagnoses premenopausal hyperpolymenorrhea and endometrial hyperplasia and sends for hysteroscopy. I can’t take hormones because I’m prone to thrombosis. Plus, over the past year, I began to quickly gain weight, which I cannot get rid of. The doctor prescribes Mastodinon, Estravel, Selzinc, Toxidont May, Gemafemin. After two weeks of taking it, my breasts hurt terribly; it looked like I was ovulating. I haven't gone for a hysteroscopy yet. Did I understand correctly that it is necessary to compensate estrogen with progesterone? The treatment is prescribed for 3 months, but I do not feel a positive effect on the body. Is hysteroscopy necessary in this case?

Elena, thank you so much for your knowledge and kindness! God bless you!
Elena, if possible, comment on my situation, please.
I am 38 years old and have been unable to get pregnant for about 2 years (first pregnancy). Husband is a sailor 1 month/1 month. A regular normal menstrual cycle is 26-28 days.
We contacted a reproductive specialist. She liked the result of the ultrasound (on the 1st day of the cycle): the ovaries were working normally. Then another examination was carried out, I don’t remember the name: both tubes were passable, the others were also fine, but there was a polyp in the uterine cavity. It was immediately removed.
Hormones: LH 9.3, FSH 20.2. The rest are fine. The conclusion was drawn: Premenopause. I found information that LH and FSH are also stress hormones. A few days before the hormone test, I worked out, the day before I went to a Russian bathhouse, and drank black coffee before the test. In the next cycle I retook according to the rules. As a result: LG 4.7, FSH 9.1. I’ve already been taking DHEAx150mg for the second month, so the analysis will already be biased (as the fertility specialist told me). She also said that overwork is nonsense and these hormones in fairly young women under no circumstances fluctuate like that. Is it so??
Thanks a lot!!

Hello, Elena. I'm 29 and already going through menopause. My periods started when I was 13 and were immediately irregular, 3-5 times a year. Naturally, I can’t even get pregnant. Is it really possible to give up on me already? I went to doctors. I took contraceptives, hormonal pills and even clostilbegit 2-3 times. Do I have a chance of becoming a mother?...

good day, Elena! Please tell me, is it possible to talk about premenopause at 33 years old, if the following symptoms are present: over the last 3 months there has been a reduction in menstrual days from 7 to 5, a reduction in the amount of blood, decreased libido, frequent urge to urinate, sometimes discomfort during sex, I suspect which is due to dryness of the vaginal mucosa. What should I do and what examination should I start first? Thanks for your reply.

Hello, Elena!!! I found your site by accident when I was looking for information about duphaston. Starting today I started keeping a calendar. I am 44 years old. I really want to get pregnant. I went for a consultation with a doctor, there was a spotting. She said my cervix was soft, sent me for an ultrasound, and prescribed duphaston. I drank it for 6 days, and when I stopped, my period came (at the same time, I think I extended the cycle by several days). It was very bad. When my period came, on the second day there was unbearable pain in both ovaries, I even called an ambulance. Now my period is over, and my chest hurts terribly, like before my period. Honestly, I’m panicking that I’ve thrown off my entire hormonal balance. I don’t want to go to this doctor anymore, but I’m going through the tests she prescribed. I would like to take a consultation with you. Is it better to collect all the tests first? Again, it’s scary to procrastinate, because realizing that time is not working for me, age... Help!?

Elena, hello. The signs of premenopause that you described are identical to my condition. I am 50 years old. When to expect an increase in the time between periods. I've been menstruating for a year now. The cycle was reduced to 21 days. Previously it was 28 regularly. And the duration remained the same as 6-7 days. There are multiple fibroids: one of the nodes is up to 2.5 cm. I compensate for the decrease in hemoglobin by taking Sorbifer for several days. The premenopausal condition is definitely not hereditary. For my mother, it all ended at 45 years old. The gynecologist at the clinic says that everything is individual. And someday it will all end. And when? There is not even any irregularity!

Good day, Elena. I am 45 years old, my last period was 9 months. ago, then (after 10 days) - bleeding, which was stopped with injections. At 43 I gave birth, I finished feeding the baby 10 days ago (I fed the baby 1-2 times a day for the last six months). After weaning, I immediately started drinking menopause, as I suffered from insomnia and hot flashes. But I have a strong sexual attraction from it, so I stopped drinking it three days ago. Result: today I fell asleep only at 5 am. I drink motherwort. I take a walk before bed with my child. Until half past nine in the evening. And I can't sleep! During the day I go sleepy, tired, I fall asleep when I can and for how long I can. Please advise how I can improve my sleep.

Elena, good afternoon. I just started studying your method because we really want a child. I have two children, already adults, I turned 45 in August. I have been wanting to get pregnant since I was 41, I have a new husband, we are happy, but we have no children together. I managed to get pregnant once, but ZB was 42. I went to see a doctor because hot flashes began to torment me, my breasts were very painful. She advised me to get pregnant while on withdrawal. I took Lindinet-30 for three months, my periods went smoothly, but after discontinuation they stopped coming completely. G said that if it doesn’t work out over the summer, then only IVF or donor UC. I just rule it out. It’s already October, and it’s already month. still no. I feel normal, the hot flashes became less as soon as I started taking cyclodinone, I’ve been taking it for 3 months, there are practically none. But the ovaries began to tingle periodically, first one way or the other, what does this mean? In July I went for an ultrasound, the ovaries are not empty, there are 4-5 eggs in them, but I understand that this is very little, I reassure myself that at least they are not empty. The uzistka said that in such a situation it is impossible to get pregnant. Please advise me something. I'm just like a squeezed lemon already. I really don't want any cleaning. I still hope for a miracle, I really believe it. How can I get my periods back and do I need to get them back? I'm afraid of breakthrough bleeding. Thank you in advance. Thank you for your back-breaking work in the area of ​​fertility.

good day, Elena! Please tell me. I am 42 years old. I have been trying to get pregnant for a long time. On an ultrasound they said that I had ovarian failure - a small number of follicles. Adenomyosis 0-1 st. When measuring basal temperature almost all the time it stays at 36.6-36.8. Occasionally there are jumps to 37.1 at 18 dc and by the 25th dc it decreases. The cycle is about 30 days. Menstruation lasts no more than 4 days. Previously it was until 7. All my life I had irregular menstruation, it started at the age of 16, it was provoked by Norkolut, in my opinion. Please advise what research I need to do? Which doctor should I contact? I really want a baby.

Elena, thank you for your work!
Please explain my situation if possible.
I am 47 years old. Until about 38-39 years of age, periods were scanty, infrequent (with breaks of up to three months), and irregular. By the age of 40, for some reason, I began to approach the norm. The breaks between menstruation have decreased during this time and now the cycle is 28-30 days, of average abundance, practically the norm. I donated blood for hormones, everything is normal, except for FSH, which is 11.3 (according to the laboratory - the upper limit of normal). What could this mean? Is this premenopause peculiar?
Lately there has been a lot of stress (for the last 5-6 years, due to problems with mother and daughter). I am married, my relationship with my husband is wonderful and active). I started to sleep little, I can’t sleep more than 6 hours, I can cry at any moment. What to track? what to observe in this case?

Elena, thanks for the useful information. Recently I began to be interested in the topic of premenopause, and you found everything in an accessible, understandable language and acceptable schemes for supporting the body. I am 46 years old, my uterus was removed a year ago (multiple fibroids), the cervix was left, and Nabothian cysts were removed. There was a history of adenomeosis and heavy bleeding, so surgery. Some semblance of menstruation has stopped, there is a slight spotting during sexual intercourse. I began to feel dry mucous membranes. The skin also began to lose elasticity, and all this was somehow drastic)) Now I have been prescribed to drink Klimaninon for 1 year. Histology is normal. I was surprised that they didn’t ask me to test for hormones. As I understand it, you need to take progesterone-like drugs in parallel with phytoestrogens? Is there anything else that can be done? Thank you in advance!

I agree - thank you so much for the information about premenopause!
I also have a question for you, Elena.
I am 46 years old, several periods (since March of this year) have become heavier and longer. The usual cycle is 28-3 days. I went to a gynecologist, did an ultrasound - on the 10th day, the uterus was -5 cm, the contour was smooth. Myomatous nodes are located - 8x10 mm and 15x15 mm interstitially, 16x15 mm deforms the walls of the uterus. The thickness of the M-echo is 12 mm, the contour is not smooth, the endometrium is not homogeneous, with hypoechoic inclusions. The cervix is ​​without features. Ovaries are normal.
UAC and TAM are normal.
In case of heavy menstruation, the gynecologist advised me to drink tincture of water pepper, and if the bleeding does not stop for more than 5 days, go to the hospital.
I have a question: how many cycles can I take hemostatic agents? How can I assess whether there is too much gestation or is this more or less normal during my premenopause? When is it necessary to do a repeat ultrasound? Which day is better? I would be very grateful for your answer.

• Svetlana, simply removing the symptom, heavy menstrual-like bleeding, is unreasonable. Because their reason is the predominance of estrogen, the lack of progesterone. Less frequent ovulations and a decrease in the synthesis of estrogen in the ovaries lead to the fact that a low level of estrogen, but acting for a long time, leads to the so-called relative hyperestrogenism. That is, there are few of them, but their effect is long-lasting, without compensation with progesterone. Read in my lessons how estrogen works and how progesterone works. Estrogens cause the division of endometrial cells, an increase in the thickness of the endometrium, and progesterone causes the filling of these cells with secretions. And then the cycle is completed, menstruation comes. But in the absence of progesterone, constant, unnoticeable cell division occurs. This is the cause of fibroids, endometrial polyps, bleeding, etc.
  To compensate for such conditions, progesterone-like herbs are needed on a constant basis. For example, I like wild yam (NSP). It must be taken constantly, one capsule at night. If the symptoms of hyperestrogenism are severe, then take 2-3 capsules a day for several months, and then switch to 1 capsule. If necessary, over time, if there are symptoms of a decrease in estrogen (dry mucous membranes, etc.), then you can add estrogen-like herbs, for example, sage - just drink it periodically as tea.
  One way or another, you need to keep self-observation cards and select herbs for yourself, and maybe good homeopathy, in order to keep the entire system in balance. Otherwise - curettage, hospitals, and other delights of life. It is very important to deeply understand what is happening. If you have any questions, ask.

Elena! First of all - Many thanks to you for publishing your experience and knowledge!
And the question is: is there a way to reduce the abundance of menstruation in premenopause? I see it directly during menstruation, when the discharge is very heavy.
Thank you!

A woman’s body is an almost perfect system. Everything is going according to schedule here. But even such a system, thought out to the smallest detail, undergoes some changes over time. And this is a normal process. Having crossed the fourth decade of life, most women begin to notice disruptions in their health. Such changes are characteristic of premenopause, which is characterized by a decline in the activity of processes in the female body aimed at reproductive function.

What is perimenopause?

Premenopause or the menopausal transition - a time period that precedes the onset of menopause (age-related loss of reproductive function), accompanied by hormonal changes and a gradual increase in fluctuations in the duration of menstrual cycles. During this period, gradual age-related changes begin in the female reproductive system, caused by the depletion of the ovaries, which lead to the extinction of its functions.

For most women, the symptoms of premenopause become apparent at the age of 40-50, but there are clinical cases where the transition period begins at the age of 30 or even less. Several years before the onset of menopause, the amount of estrogen produced by the ovaries slowly decreases, and approximately 24 months before menopause itself, its level drops very sharply, which necessarily affects the menstrual cycle and causes the first signs of menopause.

Menopause itself (climatic period) in women is also called menopause - hence the name “premenopause”. There is also postmenopause– a period when menstruation has completely stopped and a woman can no longer have children.

There is also a concept perimenopause(from the Greek “perimenopause” - around menopause) is a period that covers several years before menopause (premenopause) and 1-2 years after it (postmenopause), i.e. the time when symptoms caused by hormonal changes during menopause are expressed.

How long does premenopause last?

It will not be possible to answer the question unequivocally, because everything depends on the individual characteristics of the female body, and the hereditary factor also plays a significant role. But the average figure obtained by studying a large number of patient records of gynecological offices is 4 years. Again, this is only the average period of time from the beginning of perimenopause to its end and, therefore, the beginning of menopause. There are cases when the transition period lasted 6 months or even 10 years.

According to the American organization with the original name "North American Menopause Society", perimenopause (i.e. menopause + postmenopause) can last from four to eight years. But the Canadian organization “Center for Research on the Menstrual Cycle and Ovulation” talks about 6-10 years of duration of this period before menopause and another 12 months after the last menstruation.

Premenopausal symptoms

Signs of the imminent onset of menopause are quite varied. Among the main ones, both experts and women themselves note:

• Increased breast sensitivity. Palpation may be painful
• More acute phase of premenstrual syndrome (PMS)
• Decreased sex drive
• Increased fatigue
• Menstrual irregularities
• Minor urinary incontinence when coughing or sneezing
• Frequent urination
• Sudden changes in psycho-emotional state
• The onset of hot flashes - sudden sensations of intense heat that last from 30 seconds to 10 minutes and may be accompanied by shaking, sweating and redness of the skin
• Sleep disorders
• Discomfort during sexual intercourse due to insufficient amount of vaginal secretion

When is it definitely time to see a doctor?

It is necessary to dwell separately on changes in the menstrual cycle, because they are the most important sign of the onset of perimenopause. It often happens that women attribute the irregularity of their cycle to the previous menopause, but often the causes of abnormal changes in the nature and cyclicity of menstrual bleeding indicate other problems.

If a woman notices the following symptoms, then consultation with a gynecologist should be mandatory:

• Excessively copious discharge that consists of blood clots
• Bleeding increased in duration by 3 or more days
• Bloody discharge mid-cycle
• Bloody discharge after sexual intercourse
• The period between periods has become shorter

Among the most widespread causes of pathological changes in the menstrual cycle, which are not related to the onset of perimenopause, are:

• Use of hormonal oral contraceptives (birth control pills)
• Hormonal imbalances in the body
• Development of inflammatory processes
• Onset of pregnancy
• Blood diseases
• Oncological diseases

Diagnosis of premenopause

In the vast majority of cases, the specialist diagnoses the onset of the transition period based on the symptoms voiced by the woman. However, it is recommended that when the first signs of premenopause appear, you take a venous blood test to determine the level of hormones in the body. But it is important to keep in mind that during this period a woman’s hormonal background can be extremely unstable, therefore, in order to obtain reliable test results, it is necessary to repeat blood sampling several times within two months and compare the results obtained.

Premenopause and pregnancy – are they compatible?

Although reproductive function during this period is significantly reduced, the possibility of conception is still preserved. Therefore, if pregnancy is undesirable, you should continue to use your usual methods of contraception or choose a new one. Gynecologists often prescribe hormonal contraceptives to their patients during this period. In addition to being highly effective, such drugs have a beneficial effect on the overall health of both the general health and women's health in particular. This is achieved by compensating for missing hormones in a woman’s body.

How to ease the symptoms of perimenopause?

You need to understand that all changes in the body during this period are natural, so they do not require treatment. But if the general condition turns out to be such that it is difficult to lead a normal life, then you can resort to the help of symptomatic treatment drugs. That is, for example, if a woman is in constant nervous tension, then it is necessary to take sedatives, if she often suffers from headaches - standard painkillers. Hormonal therapy can also be prescribed, but only by a specialist. You cannot self-medicate; starting to take a particular drug should only be done after consulting a competent specialist.

It implies a certain period of time during which a woman’s reproductive function slowly declines. The final stage of this process is menopause. The basis of this physiological process is the loss of the ovaries’ ability to form new eggs.

The onset of premenopause is most typical for women between the ages of 45 and 50 years. In gynecological practice, cases of the onset of premenopause are quite often observed in the range from 32 to 40 years.

Signs of the onset of perimenopause

The appearance of at least 1 of the following signs in a woman of the specified age category may indicate the beginning of the premenopausal period.

The main symptoms of suppressed menstrual function include:

• the presence of blood clots in menstrual flow;
• persistent sleep disturbance, up to insomnia;
• feeling of heat, increased sweating, redness of the facial skin;
• decreased libido;
• causeless weight gain;
• increased blood cholesterol levels;
• sudden mood swings;
• frequent urge to urinate;
• the appearance of discomfort during intimacy;
• a significant increase in symptoms characteristic of the premenstrual period.

Perimenopause and menstruation

The average duration of this period varies from 3 to 10 years. Throughout the entire specified time, a woman may notice significant or minor irregularities in the menstrual cycle. Changes are observed in the intensity of menstruation, its volume and time interval of onset. A variant of the norm for the premenopausal period can be called scanty and short menstruation. Long and heavy periods during premenopause should be a strong argument for a woman to go to an antenatal clinic.

Scanty discharge

Reduced in volume and even scanty periods during the premenopausal period can be regarded as a variant of the absolute norm, which does not require special attention to oneself. A reason to seek medical advice may be a prolonged absence of menstrual flow.

Long course

Prolonged menstruation during premenopause may indicate the development of one or another pathology of the reproductive system. Particular concern should be caused by the appearance of such signs as the duration of menstruation for more than 1 week, the presence of blood clots in menstrual flow, the presence of bloody discharge after intimacy, and the duration of the menstrual cycle less than 20 days.

Women who experience long periods during premenopause should undergo a detailed examination aimed at identifying the cause of this condition.

Delayed menstruation

If a woman experiences a delay in menstruation during premenopause, then we can talk about her body’s maximum readiness for the transition to menopause, or the complete cessation of menstrual function. The duration of the delay is individual for each woman. The result of this process is the complete disappearance of menstruation.

Heavy menstruation

Any increase in the volume of menstrual flow during premenopause is a deviation from the physiological norm. The most likely cause of this disorder is hormonal imbalance that occurs against the background of restructuring of the female body. Changes in the ratio of sex hormones lead to hypertrophy (proliferation) of the mucous membrane of the uterine cavity, causing bleeding. Other, no less likely causes of heavy menstruation during premenopause include:

• Benign tumors of the uterus (fibroids).
• Polyps in the uterine cavity. Polyps of the uterine cavity that appear during premenopause must be removed as soon as possible, since against the background of hormonal changes the situation risks developing into a malignant tumor of the uterus itself or its cervix.
• Endocrine disorders in a woman’s body, caused by the appearance of multiple ovarian cysts (polycystic). In this case, heavy periods may be preceded by their complete absence.
• Overgrowth of the lining of the uterus (endometriosis).
• Onset of pregnancy. In this case, the appearance of heavy bleeding may indicate a high risk of miscarriage.
• Violation of blood coagulation function.
• Use of oral hormonal contraceptives. An increase in the volume of menstrual flow may be observed when using a non-hormonal intrauterine device;
• Thyroid gland dysfunction.

It is important to remember that, regardless of the cause, heavy periods in premenopause should be regarded as pathological bleeding requiring immediate medical intervention. Delaying the process can result in the development of massive uterine bleeding, even death.

Diagnostics

The initial diagnosis of premenopause is made through an analysis of the complaints presented, as well as on the basis of laboratory analysis data on the level of sex hormones. When prolonged or heavy menstrual flow appears, a woman needs constant medical monitoring of her condition, as well as undergoing special diagnostic procedures. Long and heavy menstruation during premenopause requires such diagnostic measures as:

• Clinical blood test to determine the presence of an inflammatory process in the body.
• Coagulogram. This study is one of the most important, since heavy menstruation is often caused by a violation of the blood clotting function.
• Ultrasound examination of the pelvic organs for organic pathology.
• Cytological examination of a previously taken smear from the cervix. This study is carried out to exclude malignant pathology.
• Blood chemistry.
• To confirm the diagnosis, diagnostic curettage and hysteroscopy may be performed.

Treatment

If a premenopausal woman is bothered by heavy or prolonged menstruation, then the issue of treatment in this case should be approached comprehensively based on the cause of the disturbance. Drug therapy during premenopause may include taking the following groups of medications:

• hormonal drugs (oral contraceptives);
• transvaginal administration of estrogens;
• sedatives and antidepressants.

To prevent the development of malignant neoplasms of the body and cervix, premenopausal women can be prescribed the drug Duphaston, which is by its nature a synthetic analogue.

During premenopause, a woman should pay special attention to her body. If the course of this period is not accompanied by a number of severe complications, then you can use the list of the following tips:

• The daily diet should contain only natural products. You should completely exclude foods high in carbohydrates and fats. To maintain your body, it is best to consume fresh vegetables, fruits, natural juices and whole grains.
• Daily moderate physical activity through walking, gymnastics or cycling has a beneficial effect on the body of a premenopausal woman.
• Sleep duration should be at least 8 hours a day.
• Yoga classes can significantly ease the course of this period, as they also help strengthen the entire body and relax the nervous system.

It has several stages, which differ from each other in the events that occur and specific manifestations. The initial phase of this period is called premenopause. Normally, it occurs in women after 45 years of age.

If they appear earlier in a woman, doctors diagnose early menopause. Some manifestations of this stage are similar to the symptoms of certain diseases. Therefore, every woman needs to know what premenopause is, how it is diagnosed and how intense symptoms are treated.

The natural physiological stage in the life of a mature woman, during which the natural decline of reproductive function occurs, is called the menopause.

What surprises await along the way.

It consists of the following stages:

1. Premenopause - the stage starts with the first manifestations of specific symptoms and ends with the last independent menstruation. The main event of this stage is ovarian dysfunction. Forty-five years of age for a woman corresponds to the accepted norm for the onset of premenopause.
2. Menopause is the last period in a woman's life. The gynecologist states that a woman has reached menopause, when after menstruation she has not had her period for a whole year. The norm is the onset of menopause at 50 years of age.
3. Postmenopause - at this stage, a woman does not have periods. The ovaries have already completed their work and are beginning to atrophy. They decrease in size.

Thus, reproductive function in women does not stop overnight, but takes a long time. The menopausal period for all representatives of the fair sex has individual characteristics.

We can only answer the question with certainty: how long does menopause last? All ladies have exactly 12 months. It is impossible to answer unequivocally how long premenopause and postmenopause last. It's different for every woman. So, premenopause lasts for women from 2 to 10 years. Postmenopause will continue for the rest of a woman's life.

What happens during perimenopause

Many ladies want a short answer to a common question: what is perimenopause? This is the beginning of age-related restructuring of the female body, when reproductive function ceases, and metabolic processes and organ activity occur against the background of low levels of sex hormones.

At the stage of menopause, the ovaries stop working, which synthesize the main part of the sex hormones - estrogens and progesterone. A small part of these hormones is synthesized by the adrenal cortex and adipose tissue. Sex hormones not only affect the organs of the reproductive system, but take part in almost all metabolic processes occurring in the female body.

Therefore, it decreases gradually so that the body can adapt to the new state and rebuild its work. The hormonal function of the ovaries is controlled by the hypothalamus and occurs under the influence of the pituitary hormones: follicle-stimulating hormone (FSH) and luteinizing hormone (LH).

During perimenopause in women, the ovaries gradually begin to fall asleep and synthesize fewer sex hormones. The pituitary gland responds to a reduced level of the main female hormone estrogen in the blood by producing large amounts of FSH. A hormonal imbalance occurs in the body, which provokes menopausal symptoms.

What symptoms indicate perimenopause?

When perimenopause occurs, symptoms are the first to signal this.

Therefore, it is important for all women to know what manifestations are possible at this stage of the menopause.

The first manifestations of premenopause

Women experience the following symptoms:

1. .
   They concern all cycle parameters. It may become longer or shorter. Delays occur more frequently. First for a few days, then weeks and months. The amount of discharge changes. They can become abundant, but more often they become scanty. Ovulation does not occur every cycle, but it still happens. Therefore, premenopausal women should take precautions to prevent an unplanned pregnancy.
2. accompanied by increased sweating.
   During high tide, the lady's face, neck and chest turn red due to a sudden rush of blood. The duration of the attack varies from half a minute to 3 minutes. After this, the woman feels chills and weakness. During an attack, the lady breaks out in profuse cold sweat. Tides can occur both during the day and at night. Some people have 3-4 mild attacks during the day, others can have up to 50 of them.
3. Sleep disorders.
   The woman has sleep disturbances due to decreased estrogen levels. Another reason for interrupting night rest is hot flashes. A sweaty lady has to get up to take a shower, change clothes and change bed linen. Frequent hot flashes at night cause insomnia. The lady doesn't get enough sleep and doesn't feel well.

Expert opinion

Alisa Vladimirovna

Gynecologist, associate professor, leading specialist in the field of obstetrics, work experience 9 years.

The hallmark of the first stage of menopause is hot flashes. This is a specific symptom that the woman has not encountered before and it worries her. Women, as a rule, attribute delays in menstruation and sleep disturbances to fatigue or the consequences of stress.

Other symptoms of the first stage of menopause

Menopause is a natural state of the body.

Hormonal imbalances provoke the following manifestations:

1. Unstable psycho-emotional state. The lady’s mood begins to change sharply, from euphoria to a depressed state. Depression may develop. The woman becomes nervous, irritable, sometimes tearfulness appears, and sometimes unjustified aggression.
2. Memory deteriorates. It is more difficult for a lady to concentrate attention and learn new information.
3. Rapid fatigue and constant fatigue appear. Because of this, performance decreases.
4. Libido - sexual desire - decreases.
5. There may be frequent headaches, which sometimes have the nature of a migraine.
6. Blood pressure jumps.
7. General weakness and dizziness.
8. The skin becomes dry and wrinkles appear on it.
9. Hair and nails become dull. Hair falls out profusely and gray hair appears. Nail plates flake and break easily.
10. An insufficient amount of lubrication is produced, and therefore, during sexual intercourse, a woman experiences discomfort or pain.

As you can see, the symptoms are identical to the manifestations of many dangerous diseases: thyroid diseases, diabetes, cardiovascular diseases, and the development of neoplasms, both benign and malignant.

Against the background of hormonal changes, the immune system is weakened and many diseases can develop. Therefore, when the listed symptoms appear, you should visit a gynecologist.

What does diagnostics include?

To date, there is no uniform method for diagnosing premenopause. If one or more of the symptoms described above are detected, a woman should contact a gynecologist to determine whether they indicate the onset of menopause or are manifestations of pregnancy or the onset of the disease.

What happens to the body.

Diagnostics will include:

1. The doctor will collect information about the course of menstrual cycles and disturbing symptoms.
2. Conduct a gynecological examination...
3. Perform a colposcopy procedure, which allows you to examine the condition of the cervix.
4. Palpates the mammary glands to identify possible lumps.
5. He will refer you for an ultrasound of the pelvic organs to detect emerging pathologies.
6. Will give directions for blood tests for hormones and tumor markers.

In order to study the changing hormonal levels during premenopause, it is necessary to take blood tests several times. Based on the results of blood tests, studies and examination, the doctor will be able to determine premenopause and prescribe treatment for symptoms. If a woman does nothing, the symptom does not go away on its own, but becomes even brighter and can lead to the development of complications.

Menopause is not a disease, but a stage of life, therefore, it is not treated. Treatment of menopausal symptoms is carried out to reduce the intensity of their manifestations or completely disappear.

How to treat symptoms of premenopause

During perimenopause, symptoms are treated in several ways:

1. Prescribe vitamin complexes specially designed for women in this period.
   They contain not only vitamins and microelements, but also plants that contain substances identical to sex hormones. Such plants include: black cohosh, sage, red clover, soybeans and others. The complexes help prolong the hormonal function of the ovaries by improving blood supply to the pelvic area. In addition, they are able to speed up many chemical processes important for women's health, which slow down due to the reduced amount of estrogen. The following drugs are popular: Menopace, Ledis formula menopause, Dopelherz Menopause.
2. Herbal medicines and homeopathic remedies are prescribed when menopausal symptoms do not bother the woman much.
   Herbal medicines consist of phytoestrogens, and homeopathic medicines, in addition to phytoestrogens, include snake and bee venom. The following have proven themselves well: Estrovel, Klimakt-Hel, Remens, Klimadinon and Klimaktoplan.
3. prescribed for severe premenopause.
   Effective combination drugs: Cyclo-Proginova, Divina, Klimen and Klimonorm.

All medications and their doses should be prescribed only by a doctor. You cannot adjust the dosage or stop taking the drug yourself, so as not to worsen the situation.

Bottom line

Perimenopause is a natural period in a woman’s life during which ovarian dysfunction begins before the completion of their work.

For all female representatives it takes a different amount of time, but has the same symptoms and treatment is carried out in three ways, which are chosen depending on the intensity of the manifestations. We wish you good health!

What do you know about premenopause?