Normal Menstrual Cycle - Perimenopausal Menstrual Cycle

Perimenopause, which means "around menopause," refers to the 2 to 8 years of changing hormone levels and related symptoms that lead up to menopause. The most common sign of perimenopause is longer, often irregular menstrual cycles that are caused by hormonal ups and downs.

Most women start perimenopause between ages 39 and 51.⁸ Some women begin to notice menstrual changes and premenstrual syndrome (PMS) symptoms in their late 30s when hormones begin to fluctuate and fertility naturally declines. Other women don't notice perimenopausal changes until their late 40s.

Perimenopause is a time of unpredictability. Menstrual and hormone-related symptoms are different for every woman. Some notice few or no changes. And others have severe symptoms that disrupt their sleep and daily lives. As during the teen years, irregular cycles can lead to heavy menstrual bleeding. Other common symptoms include mild to severe hot flashes, insomnia, cloudy thinking, headaches, heart palpitations, mood swings, irritability, depression, and anxiety. Some of these symptoms can also be related to aging and other life changes. See your doctor to discuss your symptoms, whether you want symptom treatment, and which therapies you can consider.

See a doctor for menstrual bleeding that lasts longer than 7 days or for cycles that are shorter than 21 days or longer than 35 days. For more information, see the topics Dysfunctional Uterine Bleeding and Menopause and Perimenopause.

WebMD Medical Reference from Healthwise

Last Updated: March 27, 2009

This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.

Normal Menstrual Cycle Topics

Bladder Control Problems?
Have a Life Less Interrupted

Important Safety Information | Prescribing Information

ENABLEX is a prescription medicine used in adults to treat the following symptoms due to a condition called overactive bladder:

· having a strong need to go to the bathroom right away (also called "urgency")
· leaks or wetting accidents (also called "urinary incontinence")
· having to go to the bathroom too often (also called "urinary frequency")

IMPORTANT SAFETY INFORMATION

You should not take once-daily ENABLEX if you have certain types of stomach problems, glaucoma, or have trouble emptying your bladder. Side effects of ENBLEX include blurred vision, and more commonly dry mouth, constipation, indigestion, and abdominal pain. Use caution when doing certain activities until you know how ENBALEX affects you.

As You Journey through Menopause, Vivelle-Dot Is By Your Side

VIVELLE-DOT (estradiol transdermal system) IS AVAILABLE BY PRESCRPTION ONLY.

INDICATION

Vivelle-Dot is used after menopause to: reduce moderate to severe hot flashes; treat moderate to severe dryness, itching and burning in or around the vagina; help reduce your chances of getting osteoporosis (thin weak bones); and treat certain conditions in which a young woman's ovaries do not produce enough estrogens naturally. Vivelle-Dot 0.025 mg/day is only used to prevent osteoporosis from menopause. If you use Vivelle-Dot only to treat your dryness, itching, and burning in and around your vagina or if you use Vivelle-Dot only to prevent osteoporosis from menopause, talk with your healthcare professional about whether a different treatment or medicine without estrogens might be better for you.

IMPORTANT SAFETY INFORMATION

Estrogens increase the chances of getting cancer of the uterus (womb). Report any unusual vaginal bleeding right away while you are taking estrogens. Vaginal bleeding after menopause may be a warning sign of cancer of the uterus (womb).

Do not use estrogens with or without progestins to prevent heart disease, heart attacks, or strokes. Using estrogens with or without progestins may increase your chances of getting heart attacks, strokes, breast cancer, and blood clots. Using estrogens with progestins may increase your risk of dementia (decline in memory and thinking skills).

Vivelle-Dot should not be used if you have unusual vaginal bleeding; currently have or have had certain cancers, including cancer of the breast or uterus; had a stroke or heart attack in the recent past (for example, in the past year); currently have or have had blood clots; currently have or have had liver problems; or think you may be, or know that you are, pregnant.

The most common side effects that may occur with Vivelle-Dot are headache, breast tenderness, and back pain.

You and your healthcare professional should talk regularly about whether you still need treatment with Vivelle-Dot.

You are encouraged to report negative side effects of prescription drugs to the FDA. Visit www.fda.gov/medwatch or call 1-800-FDA-1088.

Please see Full Prescribing Information for Vivelle-Dot.

Prescribing Information