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perimenopause

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Medically reviewed by: Stephanie Gordon, MD
Board Certified in Urogynecology
The Women's Center
Conyers, Ga.

For many women, the transition to menopause often begins in their early 40s. Called "perimenopause," or the "menopause transition," this life stage is defined by physical, emotional and psychological changes. You will know you've reached menopause when you haven't had a menstrual period for 12 consecutive months.

But in the meantime, you may start to experience many of the symptoms women associate with menopause. As your body's hormone levels decrease, you may notice these changes:

  • Menstrual periods that are heavier or lighter, shorter or longer than you're used to
  • One or more missed menstrual periods followed by a regular period
  • Hot flashes, irritability, decreased sex drive and problems sleeping
  • You're inching closer to middle age and are wiser for it, but sometimes you may wonder where the years have gone. While this turning point can be cause for celebration, it can also lead to anxiety and depression for some women. Talk to your health care professional if negative feelings about this life stage become overwhelming. You might find that simply establishing a healthy diet and exercise program—and sticking to it—will lift your spirits. If not, there are effective treatments for depression and anxiety.
  • Your metabolism continues to slow during the transition to menopause and your weight gradually shifts from your hips and thighs to your abdomen, shoulders and chest. If you don't have a regular aerobic exercise and strength training program, it's never too late to start.

Talk with your health care professional about putting together a plan that takes into account your age, health status, daily schedule and goals. You'll improve your health, have more energy and look your best if you maintain a healthy weight and keep your muscles well-toned.

Exercise and strength training will help your bones, too. Because your body produces less estrogen as you near menopause, you're at increased risk for bone loss, which can lead to the bone-thinning disease osteoporosis. In addition to exercising, make sure you are getting enough calcium in your daily diet. Your health care professional can advise you if you need supplements or medications for your calcium needs.

Be sure to eat a lot of fresh fruits and vegetables and cut down on junk foods to help keep you healthy and fit. If you drink alcohol, limit consumption to no more than one drink per day, and if you smoke, try to quit. If you're feeling stressed, find ways to relax and take time for yourself. Talk to your health care professional for guidance.

What's Normal and What's Not?
As you go through your 40s, your risk for certain diseases, such as osteoporosis, heart disease, hypertension and diabetes, increases. Some health conditions occur more often in certain families, and you may be nearing the age at which a parent developed a disease or disorder. That doesn't mean that you will develop the same problem, but it's more important than ever to have regular medical checkups and basic screening tests, including a pelvic exam, mammogram, cholesterol test and possibly others, with the advice of your health care professional.

Don't forget to keep your family medical history up to date. Your health care professional should have a copy, and you should keep one in a safe place. This important document should include your personal medical history, illnesses of relatives and the age at which family members were diagnosed with medical problems.

If you don't have one, check out the "My Family Health Portrait," created by the U.S. Surgeon General's office in the U.S. Department of Health and Human Services. It will help you organize your family tree and identify common diseases that may run in your family.

Your skin may be showing the signs of aging, especially if you've spent a lot time in the sun without sunscreen. Some women experience changes in skin color or pigmentation, which result in brownish "age spots" or "liver spots." Moles and facial wrinkles may be more plentiful now. Check in with a dermatologist if you notice any skin changes or growths. Always wear sun protection to help reduce your risk of skin cancer and to prevent further damage to your aging skin.

You may also notice that your vision is changing. You may need corrective lenses or glasses to sharpen your vision. Many people in their 40s find they need bifocals for reading and distance vision. And, your sense of smell may be less keen in your mid-40s.

It's always a good idea to ask your health care professional about any physical or emotional changes you may be experiencing. Some are typical to this life stage, while others may need more serious consideration. Use these Questions to Ask Your Health Care Professional as guide for your conversation.

For more information on preventive health in your 40s, check out these Preventive Health Screenings You Need.