Victorians called them "women of a certain age" when referring to perimenopausal women. Now a days, we know a little more about the perimenopausal years, but we don't always use the polite terminology of the Victorians when we talk about perimenopausal women. Instead we talk about "dragon ladies," to use one of the politer terms. Or we medicalize these years and treat them as a pathology.
So what is perimenopause? It consists of the 10 or so years - often filled with such familiar and infamous signs as hot flashes, night sweats, forgetfulness, memory problems, insomnia, and mood swings - preceding actual menopause. By medical definition menopause occurs when a woman has not had a period for a year, which is also when all the hormonal commotion and signs come to an end.
Hot flashes and night sweats are the best known and often the earliest signs of perimenopause. Though some doctors check various hormone levels to "diagnose" perimenopause, hormone levels are too unstable at this time to present a clear picture of what's happening. A thorough doctor will give a lot of consideration to a woman's history and symptoms. It is best to keep in mind that perimenopause is a natural part of a woman's life; any woman who lives to "a certain age" will pass through perimenopause, a term that literally means "the years surrounding menopause."
Not every perimenopausal woman has symptoms, but an estimated 65% - and probably more - do. On average, perimenopausal symptoms begin in the late 40's. I have seen, in my practice, a number of women who began having symptoms as early as their mid to late 30's. The average age of menopause (no periods for a year) is 51. But, for a woman who began the transition in her 30's, menopause will occur proportionately earlier.
Perimenopause, as I mentioned earlier, is a natural part of every woman's life, whether or not she experiences signs or symptoms. It becomes problematic when "vasomotor" symptoms (hot flashes and night sweats), osteoporosis, insomnia, memory problems, or depression occur. This topic's scope is limited to the depression part. For other symptoms, please see your family doctor or gynecologist.
Depression is marked by changes in sleep pattern (sleeping too much or too little), changes in eating habits, loss of energy, difficulty with concentrating, and the inability to enjoy life. Women who have suffered from postpartum or premenstrual depressions are more likely to have depressive symptoms during perimenopause. Also women who have a tendency toward depression and have suffered depressions in the past are more at risk for depression during this time.
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