THEin perimenopause or premenopause is a natural transition and represents a period of transition to menopause. In this phase, Ovias progressively reduce the production of sex hormonessuch as estrogen, progesterone and androgens, and this generates irregularity of menstrual cycleswhich can even be absent, and numerous other symptoms that can create inconvenience to the woman. How to manage them at best? We asked the Dr. Tiziana CasalenaGynecologist of Humanitas Medical Care of Varese.
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Perimpause: the symptoms
This phase varies from person to person: in some cases it can already start around 40 years, in others it can occur later. Ends with menopause, or the moment when a year has passed since the last menstruation spontaneous, which occurs, on average, between 48 and 52 years. “There perimenopause, can last several years And it can involve anovulator cycles, that is, without ovulation, with consequent alteration in the production of estrogen and progesterone. Menstruation become irregularsometimes amenorrhea occurs for 2-3 consecutive months, followed by a recovery in the cycle. Menstrual bleeding and the woman can experience different symptoms related to hormonal fluctuations, such as Wampate of heat, joint pain and rigidity, insomnia, mood swings, irritability, drop in sexual desiredifficulty of concentration, mental confusion, known as Brain Fog. A can also occur weight gain, in particular at the abdominal level»Explains Dr. Casalena.
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Perimpause: what are the symptoms and how to keep them under control
Hormonal fluctuations: what consequences
«Ovias leave to ovulate, but ovulation stops and only estrogen are produced, without progesterone. This relative hyperestrogenism has as consequences: swollen breasts, mastodynia, or breast pain, swelling and water retention. Too many estrogens can also lead to headaches and nausea. Hormonal fluctuations also create alterations in thermoregulation, which manifests itself with hot flashes that often alternate with a sensation of cold. A lack of estrogen, however, can have consequences on urogenital healthwith the occurrence of the vaginal dryness. Furthermore, In the bladder there is an area, called bladder trine, which is an estrogen dependent. The lack of estrogen, therefore, creates the feeling of having to urinate more frequently. If the symptoms of the premenopause are particularly heavy to manage, it can be evaluated with the gynecologist to take the contraceptive pill », continues the expert.
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Perimopause and contraceptive pill: risks and benefits
«Take the contraceptive pill, however, It may have some contraindications. Among the most common: the increase in the risk of venous thrombosisespecially in women who smoke or who have a genetic predisposition on this condition. In addition, it can increase the risk of stroke and heart attack, especially in women with hypertension or other cardiovascular diseases. It should not also be taken in case of metabolic diseases. But if the patient’s anamnesis allows it, The contraceptive pill can ferry it towards menopause and thus find them a hormonal balance. Alternatively, phytoestrogens can be taken, “advises Dr. Casalena.
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The importance of prevention
«In this phase it is important to continue preventing. It is therefore recommended that the woman undergoes to An annual gynecological examination with Pap Test or HPV Test and a transvaginal ultrasound To evaluate the possible presence of fibroids or polyps. Mammary ultrasound is also needed annually who, after 45, goes associated with mammography. The latter should be started from 40 years or even from 35 if there is an important familiarity, that is, if the mother or grandmother or maternal aunt have received a diagnosis of breast cancer. It is also good to also perform some blood tests to evaluate: blood sugar, lipid profile, thyroid function, vitamin D and hormonal structure if necessary. It is also good periodically measure blood pressuresince the risk of hypertension increases due to the lower elasticity of the arteries for estrogen deficiency. It is also important keep weight and body composition under controlfundamental to reduce the risk of type 2 diabetes and metabolic syndrome. One must not leave one too Oculistic, dermatological and cardiological visit. Because prevention saves life, “concludes Dr. Casalena.
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