What is Perimenopause?
Perimenopause refers to the years before menopause, when the ovaries gradually begins to produce less estrogen. During this time, a woman begins to experience fluctuations in her menstrual cycle, estrogen levels fluctuate, which can cause heavy, irregular periods and cramping.
READ ALSO: Menopause and Perimenopause
These changes in the menstrual cycle are not a cause for concern for some women and can be managed using at-home remedies and over-the-counter medication.
However if severe pain occurs in the abdomen, especially if it’s sudden, chronic, unexplainable, or continues after menstruation, a person should see their doctor.
The female body is said to reach menopause when there have experienced 12 consecutive months without menstruation. This indicates the end of their reproductive years.
Most people enter into this transitional period at some point in their 40s, though some reach it in their 30s or even 50s. It is common for individuals to experience perimenopause symptoms for between 4 and 8 years.
In the early years of perimenopause, a woman will typically experience some changes in the timing or heaviness of her period. In the later stages, a woman will start missing at least two menstrual cycles in a row. During perimenopause, reproductive hormones such as estrogen and progesterone, produced by the ovaries begin to fluctuate.
READ ALSO: Foods That May Delay Menopause
Although estrogen and progesterone levels drop during menopause, levels may be higher or lower than usual for lengths of time during perimenopause.
In the case of testosterone in the female body, most studies proves that circulating levels of this hormone are more related to age than to menopause.
Many women’s testosterone levels begin to fall during her 30s, plummeting to half their initial levels by the time she reaches menopause.
Causes Ovary Pain During Perimenopause
Most women who menstruate will experience abdominal cramping and pain around the womb or uterus and the ovaries.
Menstrual cramps is caused by uterine muscles contracting to help the uterus shed its lining each month. Prostaglandins are released when the uterine lining cells break down at the beginning of the menstruation cycle.
These lipids cause blood vessels in the uterus to tighten or get smaller, causing its outer muscular layer to constrict too. This tightening causes a cramping sensation.
During perimenopause, a woman may experience longer and heavier menstrual bleeding and more severe cramping during menstruation.
The basic reasons for these changes are fluctuations in estrogen and lowering progesterone levels.
Symptoms of perimenopause
Some women may not experience any physical symptoms of perimenopause apart from more irregular menstruation. Usually, the symptoms associated with changes in hormones relate to the functions they serve in the body.
For high estrogen levels, symptoms may include:
- breast tenderness
- heavier than normal bleeding
For low levels of estrogen, symptoms may include:
- vaginal dryness
- night sweats
- unexplained exhaustion
- reduced thickening of the uterus lining, resulting in less regular shedding and menstruation
- osteoporosis or loss of bone density and integrity
Ovulation and menstruation are associated with progesterone. Thus, during perimenopause, women tend to experience lower levels of this hormone.
Low levels of progesterone can cause:
- irregular menstruation
- heavier menstruation
- longer menstruation
There are several ways to help treat painful cramping at home. Some of the most popular and effective recommendations include:
- placing a heated bag, heating pad, or hot water bottle on the abdomen for 20 minutes or until it cools
- taking a warm bath or shower
- practicing deep breathing
- exercising gently with activities such as walking, swimming, or yoga
- drinking lots of water to prevent dehydration which can intensify pain and muscle cramping
- massaging the abdomen gently
If at-home remedies do not relieve the pain enough, many OTC medications are available to help reduce abdominal pain and cramping.
- non-steroidal anti-inflammatory medications or NSAIDS
- non-narcotic analgesic or pain-relieving medications
- medications with acetylsalicylic acid, such as Asprin
- analgesic transdermal pads or gels with camphor, menthol, capsaicin, or methyl salicylate
For women with severe cramping, a doctor may prescribe a low-dose birth control pill, patch, ring, or IUD to help regulate periods and make them less heavy.
In rare cases, women with very severe pain related to menstruation or perimenopausal may be given prescription grade pain medications temporarily.
Dietary and lifestyle changes can also help to manage or reduce perimenopause symptoms. A person can try the following:
- staying hydrated to reduce overall inflammation and pain
- eating a healthful, balanced diet rich in a wide variety of nutrients
- eating plenty of high-fiber foods, such as whole beans, nuts, grains, cereals, vegetables, and fruits to ease digestion and help the body digest and eliminate waste estrogen and prostaglandins
- eating foods and drinks low in fat or limiting overall fat intake, especially saturated or trans-fats
- trying to limit intake of refined wheats and sugars
- choosing lean proteins, such as fish, skinless chicken, and plant proteins instead of red meats
- avoiding fried, packaged, processed, and preserved foods
- exercising regularly
- limiting stress when possible
Some alternative therapies may also help reduce perimenopausal and menopausal symptoms, including:
Supplements can possibly cause adverse side effects, so people should always talk with a doctor before using them. Herbal and vitamin supplements that may be useful in treating pain, inflammation, and cramping include:
- vitamin E
- vitamin D
- Omega-3 fatty
- black cohosh
- red clover
- dehydroepiandrosterone (DHEA)
- dong quai
- wild yam
- evening primrose oil
What else can cause pain during perimenopause?
A woman may experience pain around the ovaries during perimenopause for several reasons that are not directly related to menstruation. These include:
- ovarian or uterine cysts
- non-cancerous ovarian or uterine growths that press on the pelvic organs
- polycystic ovary syndrome (PCOS)
- pelvic infections