PERIMENOPAUSEAND IRREGULAR CYCLES
Perimenopause begins in a woman in as early as late thirties or anytime throughout the forties. It lasts for a variable length of time. Think of it as a transition period. Dr Steven R. Goldstein a Perimenopause Specialist in NYC, past President of the International Menopause Society and a Certified Menopause Practitioner says that irregular is what becomes regular during this phase of a woman’s life.
Dr Goldstein has patients at his office immediately when their cycle is off. While the majority of women may have great irregularity to their cycle, they may not be aware of it. The change is often subtle. Women do not always notice if their period is a few days late or a few days early, particularly if they are not worried about getting pregnant.
For example, a patient who we will call Marilyn, forty five, came in for an annual exam. Her complaint was that she was having horrible PMS. She said she never had a problem before, not even cramps in high school. She went on to say she now has about one week a month where she is symptom free, her breasts do not ache and she doesn’t want to scream and yell at those around her.
When asked if she noticed any changes in her menstrual cycle, she said she was a little irregular. Not being in a relationship, she didn’t care whether her period was early or late because she knew she wasn’t pregnant.
She had jotted down her dates, however. Her last six or seven periods were 22 days, 27 days, 37 days, 38 days, 19 days, 27 days, and 21 days apart. The point was though, that she had probably ovulated only twice in that interval. One may think, what is the problem? Why does it matter if she doesn’t ovulate each month if she isn’t trying to get pregnant?
Episodes of anovulation, periods when a woman doesn’t ovulate, are characterized by variable amounts of estrogen production without progesterone to balance it. This hormonal “imbalance” isn’t dangerous, but is the basis of a host of symptoms, such as the ones that Marilyn was experiencing, that appear to be totally unrelated to the menstrual cycle. Do note that unopposed estrogen for very long periods of time, which is unusual may predispose women to hyperplasia (precancer) and sometimes cancer.
Dr Steven R. Goldstein is a Perimenopause Doctor in NYC and co-author of the book “Could it be….Perimenopause?” Perimenopause is a stage of life with symptoms and realities of its own that responds to specialized healthcare strategies. Perimenopause begins about a decade before the actual onset of menopause. Yet, even though every woman will go through Perimenopause, it is one of the least understood, most misdiagnosed, and most confounding stages in a woman life. If what you read sounds like you, then maybe a consultation with Dr Steven R. Goldstein, a Perimenopause Specialist in NYC may be appropriate.