Periods during premenopause

Les règles pendant la préménopause : un parcours sinueux

Periods don't last a lifetime. They have an end, which is called menopause . This phenomenon marks the end of the period during which women are fertile and can conceive a child . But this does not happen suddenly. A transition phase precedes this definitive cessation of periods : this is premenopause . Frequent and significant changes in the menstrual cycle mark this pivotal stage. But what exactly is happening there? Premenopause and periods : discover the great hormonal upheaval responsible for the disruption and then disappearance of menstruation .

Premenopause and periods: what is the link?

Premenopause, as its name suggests, is the period before menopause. To understand premenopause, let's take a look at what menopause is.

What is menopause?

Menopause means the permanent cessation of periods in a menstruating person. It also refers to the moment when this phenomenon occurs in a woman's life. This event marks the end of the period known as “genital activity”, which begins at puberty with menarche . During this entire period, getting pregnant is possible with each menstrual cycle (except for health problems and special cases). It is this reproductive capacity that is extinguished at menopause.

Why menopause?

Physiologically, the menopausal phenomenon results from the cessation of ovarian function. Indeed, the ovaries play two essential roles in women of childbearing age. On the one hand, they ensure the growth within them of oocytes (female reproductive cells), their maturation into ovules (mature fertilizable oocytes), then the release of the latter during ovulation in the middle of the cycle. On the other hand, they secrete sex hormones responsible for regulating the menstrual cycle and the reproductive process – estrogen and progesterone. But with the natural aging of the body, this ovarian functioning deteriorates, and ends up being completely non-existent. Likewise, with age, the number of oocytes available in the ovaries, called ovarian reserve, diminishes. When this oocyte stock is completely exhausted, ovulation no longer takes place, the ovaries hardly produce any more progesterone and estrogen and menstruation ends, it is menopause. This generally occurs between the ages of 45 and 55, with an average around 50 years. It is said to be “confirmed” when the absence of periods has lasted for at least 12 consecutive months.

Premenopause: pre-menopause

Menopause very rarely happens overnight. It is preceded by this transition phase called premenopause. This lasts on average between 2 and 4 years. In some cases, it can be much shorter – a few months – or much longer – up to 8 years. Sometimes, it is not detected by the women who experience it, because it is free from clinical manifestations. But very often, it is accompanied by notable negative effects that can impact both physical and emotional well-being. It is during these premenopausal years that the functioning of the ovaries gradually changes: ovulation becomes unstable; progesterone and estrogen levels fluctuate widely and create hormonal imbalances; the menstrual cycle undergoes significant irregularities, including periods whose duration and intensity can vary considerably from one cycle to another.

How does premenopause impact the menstrual cycle?

Premenopause is characterized by the different effects of slowing down ovarian functioning and the gradual cessation of ovulation. These vary greatly from one woman to another: they are not all and always present.

  • The length of menstrual cycles fluctuates: sometimes they are short; sometimes they are long. In general, it is rather a shortening that is observed: the first phase of the cycle, the follicular phase, lasts less long, leading to shorter cycles, with menstruation occurring every 25 days rather than every 28 days.
  • Periods are irregular: they may skip one or more cycles, then return and continue normally over the next few months, until another temporary suspension occurs.
  • Ovulation is unpredictable and becomes rarer, since it is no longer systematic each month.
  • Hormonal variations are important. It is progesterone that decreases first. Its level then becomes lower than that of estrogen. This hyperestrogenism can cause the appearance or intensification of typical PMS symptoms: breast pain, abdominal swelling, mood swings , irritability, etc. Periods may become heavier, with blood clots; metrorrhagia may occur. Subsequently, estrogen levels drop drastically. This is often the cause of hot flashes, night sweats, sleep problems, vaginal dryness or even urinary leakage .

The onset of the last period puts an end to perimenopause. Some symptoms that appear during this period are transient and will stop after menopause, once a new hormonal balance is established – this is often the case with hot flashes for example; others will probably persist into postmenopause, such as intimate dryness or urinary incontinence.

Premenopause and periods: a classic problem as you approach fifty. The consequences of the gradual cessation of the functioning of the female reproductive system can be numerous and disabling: erratic periods, heavy menstrual flow, hot flashes, etc. However, it is important to remember that the menopausal transition is a natural stage in a woman's life. Despite the somewhat abusive use of the term “symptoms”, it is in no way an illness. There are also solutions to relieve the effects of (pre)menopause. Among these is the use of adequate intimate protection. Menstrual underwear is a perfect option for managing irregular menstrual duration and intensity, as well as small urinary leaks.

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Written by cd