When Does Perimenopause Usually Start and End?
Perimenopause is the term for the months and years that lead to menopause. It begins with the first signs or symptoms of menopause. For some women, this is as early as their thirties. By their mid-forties, most women notice at least occasional signs that their estrogen is beginning to decline. Officially, perimenopause ends with the diagnosis of menopause, which is when you’ve had twelve consecutive months without a period. The day after you have not menstruated for one full year, you are considered postmenopausal. The day before your menopause day, you are premenopausal. The average women experiences menopause at the age of 51. The normal range is from 40 to 58 years old.
Perimenopausal and Menopausal IBS symptoms
An increase in gastrointestinal (GI) symptoms, including bowel discomfort, abdominal pain/discomfort, bloating, gas and alterations in bowel patterns, has been reported during premenses and menses menstrual cycle phases and the perimenopause period in women with and without irritable bowel syndrome (IBS). Dr. Margaret M. Heitkemper, Ph.D., of the Department of Biobehavioural Nursing and Health Systems at the University of Washington in Seattle, conducted a review of scientific literature about the possibility that fluctuations in ovarian hormones affect gastrointestinal symptoms in women with irritable bowel syndrome. During perimenopause (and menopause), the gastrointestinal tract slows down, which contributes to constipation, and constipation may cause hormonal imbalances.
Author Dawn M. Olsen, founder of the Menopause A to Z website, explains if a woman going through menopause is also dealing with stress, constipation and indigestion can worsen, especially if she overeats, eats certain foods or eats too quickly. Not drinking enough water may lead to dehydration and contribute to constipation. Constipation can be problematic, because daily bowel movements are essential to eliminate waste from the body and may be crucial for maintaining hormonal balance as women go through menopause.
It has been theorized that this increase in symptoms at the time of early menopause is due to the lessening of the levels of sex hormones that occurs at this time, in much the same way that women experience an increase in IBS symptoms in the days surrounding the onset of menstruation. There is a well-established relationship between these sex hormones and digestive symptoms, most likely due to the fact that receptor cells for these hormones are located throughout the digestive tract. Thus, the changing hormonal levels of menopause do have an effect on IBS, but what that effect is is not completely clear. The evidence to date currently provides only conflicting and incomplete evidence about the change in IBS symptoms during and after menopause.
Many women in menopause develop acid reflux or gastroesophageal reflux disease, known as GERD. This condition occurs when the lower part of the esophageal sphincter does not close properly, allowing stomach contents to reflux or leak back into the esophagus. One of the main symptoms of GERD is persistent heartburn caused by acid regurgitation; however, some women who have gastroesophageal reflux disease do not suffer from heartburn. Women may experience a burning or choking sensation in the throat, chest pain, trouble swallowing and morning hoarseness. Mary Infantino, RN, Ph.D., Director of the Graduate Nursing Program at Long Island University in New York conducted a study in 2008 on gastroesophageal reflux symptoms in perimenopausal and menopausal women. The research found that perimenopausal and menopausal women had higher percentages of GERD diagnoses than premenopausal women and that menopausal patients had significantly more upper gastrointestinal discomfort. Dr. Infantino’s research found that menopausal women were nearly three times more likely to have GERD symptoms, suggesting a hormonal link between menopause and gastroesophageal reflux disease.
To conclude, studies have shown that the drop in hormones after menopause results in reduced severity of IBS symptoms; after age 50, the severity of IBS symptoms in women and men is identical. Women in postmenopausal age groups have significantly less severity overall for IBS abdominal pain, bloating and have a higher quality of life scores compared to younger women with IBS. The theory that the drop in hormones from menopause directly correlates with improved IBS symptoms is further supported by studies finding that hormone replacement therapy in menopause is associated with an increases risk of IBS flares.