What is menopause? Menopause is a stage in a women’s life when she stops having her regular menstrual cycles and it is the end of her reproductive era and it usually happens between 40 to 50 years of age. If it happens before 45 years of age, after the age of 40, then it is called as early menopause. It can happen before 40 years, then it is called as premature menopause. So menopausal women, 3 things will happen, one is they will stop menstruating for consecutive 12 months at a stretch, second is the level of the estradiol. Ovaries will reduce the secretion of estradiol or it stops the release of eggs. So this is called as menopause. Coming to perimenopause, is gradual process where the levels of estrogen is gradually reducing so the women is experiencing the perimenopausal phase. So the average duration of this perimenopausal phase is 4 to 5 years. In some women it may be only few months. It may start as early as 40 years and continue for 8 to 10 years before the menopause. But in some women it can start as early as 30 years, by the age of 30 the level of estradiol would have started reducing and when it comes down drastically or abruptly the level of estradiol reduces so the women will start experiencing menopasusal symptoms. So during perimenopausal period women would start menstruating. It may be irregular. It may be irregular. She is still having estradiol hormones and ovulating occasionally. So she can still get pregnant. Unlike menopause, the lady can get pregnant while in perimenopause period. So what is post menopause? That is after the cessation of the menstrual cycles, when the estradiol levels are completely reduced and there is no more release of eggs. This phase is called as post menopausal period. Here the woman is experiencing lot of symptoms because of the low level of estradiol. So she develops symptoms such as hot flushes, chills, night sweats, headache, she puts on weight, there are mood swings and also faces health risk such as osteoporosis and cardiac problems. How to diagnose menopause and perimenopausal phase. By history she has not got her periods for consecutive 12 months. By symptoms she has already got all the symptoms of hot flushes, night sweat, etc. By lab we can always assess the level of FSH and estradiol. In perimenopausal women unlike in menopause she may be having her menstrual cycle. The cycle may be very irregular, very heavy or it can be very scanty. She is still ovulating and can get pregnant but because the levels of estradiol is lowering gradually and slowly she is experiencing the menopausal symptoms and at the same time when the estradiol, they are assessed or the FSH levels when they are assessed there can be variations. How to cope up with these problems? All the women she has to change her lifestyle, needs regular exercise, has to eat healthy food, avoid junk food, avoid smoking, avoid alcohol. She should get good sleep at night and get herself spiritually enlightened and relax herself and take care and consult the doctor as early as possible whenever she has some uncomfortable feeling or she goes through some bony problems, some aches and pains and palpations she has to make sure that other condition is only because of menopausal symptoms and not because of cardiac problems or any other health issues she should have regular check-up atleast once in 6 months and keep herself fit.

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