<http://schema.org/articleBody>
" When Sheryl Gurrentz, 47, began hosting &amp;quot;hormonal happy hours&amp;quot; to research her coauthored book A Strange Period: Insights Into the Bizarre Experiences of Perimenopausal Women, she discovered just how wild women&amp;#039;s menstrual periods become during the years leading up to the big change. &amp;quot;One woman told me she&amp;#039;d had cycles that were 41, 55, then 18 days long \u2014 it sounded like a locker combination,&amp;quot; Gurrentz says. &amp;quot;Another was bleeding through a maxi pad plus a tampon. I myself was taking more home pregnancy tests during perimenopause than in my 20s. We assume our periods will taper off and stop, but it doesn&amp;#039;t work that way.&amp;quot; Nope. Until recently, information about perimenopausal periods was often more fiction than science, even among many health experts. Changes start sooner than was once believed, as early as your late 30s, and can last up to 10 years. Cycles can stretch to 80 days \u2014 a longer interval than was once known \u2014 or may be shorter than usual. Heavy bleeding and long periods are more common than many women expect \u2014 over 30% report very heavy periods. And at least one in four say their periods interfere with their lives, so they may put khaki skirts in storage, shun sex and social events, even call in sick to work. The march toward menopause is not a steady one for many. In one study, half the women said their cycles were so variable, they didn&amp;#039;t know what to expect, and no wonder: Estrogen and progesterone can be riding their own crazy roller coasters, and aging ovaries may or may not pop out an egg. The lining of your uterus may stay in place...or it may decide to rush for the exit. Wacky hormones also mean that the other no-fun signs of an impending period \u2014 PMS, bloating, tender breasts, fatigue \u2014 could come at any time, stick around longer, and feel worse than ever, even if they don&amp;#039;t herald an actual period&amp;#039;s arrival. But don&amp;#039;t just shrug off all the weirdness: Fibroids, polyps, and underlying health problems like a misbehaving thyroid or even precancers and cancers can set things awry. And there&amp;#039;s plenty your doctor can do to ease symptoms. &amp;quot;It&amp;#039;s important to track your cycle,&amp;quot; says Devorah Wieder, M.D., of the Cleveland Clinic. &amp;quot;And then it&amp;#039;s worth calling your doctor if you notice a change.&amp;quot; Here&amp;#039;s a rundown of what may be bugging you and why \u2014 plus ways to tame symptoms, from the simplest (over-the-counter pills) to the more involved (surgery). 1. &amp;quot;It never stops!&amp;quot; The average menstrual flow lasts four to six days, but during perimenopause, it can go on \u2014 and on. Some months you may not ovulate at all (often the case during these years), and your ovaries may not pump out predictable levels of estrogen and progesterone. This imbalance can cause the uterine lining to become too thick. Then, when you get your period, it can take forever for the lining to shed. \u2022 IT COULD ALSO MEAN you have uterine polyps \u2014 mushroom-like &amp;quot;skin tags&amp;quot; growing from the walls of your uterus \u2014 which can lengthen bleeding. \u2022 TELL YOUR DOCTOR IF you&amp;#039;ve had periods that last more than seven days \u2014 or several days longer than is normal for you. &amp;quot;If you usually have two-day periods and now you&amp;#039;re bleeding for six or seven days, that may signal there is something different going on,&amp;quot; says Julia Schlam Edelman, M.D., a clinical instructor at Harvard Medical School. &amp;quot;You might have precancerous changes to the lining of your uterus, which won&amp;#039;t show up on your regular Pap test.&amp;quot; 2. &amp;quot;It&amp;#039;s so heavy!&amp;quot; There&amp;#039;s a reason your drugstore&amp;#039;s feminine-products aisle is jammed with 20 different varieties of super maxi pads: Women commonly experience heavy bleeding during perimenopause. And if you&amp;#039;re overweight, heavy periods are even more likely \u2014 50% more so, in one study, and for extremely overweight women the chances of heavy bleeding doubled. \u2022 IT COULD ALSO MEAN you have a fibroid, a noncancerous tumor that starts in the muscle wall of the uterus (or you may have multiple fibroids, as is often the case). \u2022 TELL YOUR DOCTOR IF heavy periods interfere with your life or you&amp;#039;re feeling extra tired. You could be anemic as a result of excess blood loss. But simply taking iron may not correct the problem. It is important to learn the cause, since other, more serious conditions \u2014 precancers and cancers of the uterine lining \u2014 can cause heavy periods as well. 3. &amp;quot;I&amp;#039;m spotting!&amp;quot; Some women may bleed a little at mid-cycle, when they ovulate, notes Dr. Wieder. And hormone shifts often explain spotting between periods. \u2022 IT COULD ALSO MEAN you have a polyp, which may bleed between periods. Or, you could have a condition called adenomyosis, in which lining tissue lodges in the muscle wall of the uterus and blood may leak out between periods. Spotting can also signal an infection or precancerous changes in the lining of your uterus. \u2022 TELL YOUR DOCTOR IF you have any spotting. A regular gyno exam can pick up many of these causes, though you may need an endometrial biopsy. 4. &amp;quot;It&amp;#039;s baaa-ack!&amp;quot; (After five months!) You&amp;#039;re planning a menopause party when, out of the blue, you&amp;#039;re wrestling adhesive-backed pads into your panties again. &amp;quot;This usually means that your brain and your ovaries were actually still having a conversation and, finally, one reluctant egg responded,&amp;quot; explains Tara Allmen, M.D., a gynecologist at New York City&amp;#039;s Center for Menopause, Hormonal Disorders and Women&amp;#039;s Health. The time between periods does lengthen as your hormones lurch toward menopause \u2014 in one study of 120 women, the average cycle length was 80 days in the 12 months before their final period. \u2022 IT COULD ALSO MEAN an underactive or overactive thyroid gland. \u2022 TELL YOUR DOCTOR IF you do not bleed for 90 consecutive days and then get your period again. Building up several months&amp;#039; worth of lining in your uterus can put you at risk for precancerous changes called hyperplasia. WHATEVER MAY BE going on with your cycles, one piece of basic biology hasn&amp;#039;t changed: You can still get pregnant. Yes, it&amp;#039;s harder when you&amp;#039;re older, but more than 30% of pregnancies in women over 35 are unintended (maybe because many, especially in their 40s, skip birth control?). Consider yourself fertile until you&amp;#039;ve gone 12 consecutive months without a period. Then you are officially out of &amp;quot;peri&amp;quot; and into menopause. Next:  THE FACTS OF LIFE \u2014 BY THE NUMBERS 12.4 Average age of first period. It has dropped over the years \u2014 in the 1930s, it was 13.3 \u2014 but now is holding steady. 1953  Year that Molly Grows Up,the classic (and hilariously dated) educational film, was made...and shown to girls everywhere. 58%  Of pill users take them (at least in part) for cramps or other reasons besides birth control. 11,000  Number of tampons and pads a woman may use in her lifetime. (Ka-ching! That&amp;#039;s about $2,000.) 51  Average age at menopause. Every day, 6,000 American women pass this milestone.  MISERY RELIEF What to try first \u2014 and last. TREATMENT: NSAIDS (Ibuprofen [Advil], naproxen [Aleve], or a prescription anti-inflammatory like mefenamic acid [Ponstel] HELPS: Heavy bleeding, long periods. HOW IT WORKS: Corrects prostaglandin imbalance, which lessens bleeding. VITAL STATS: Lightens periods for about half of women; also eases cramps for 70%. DOWNSIDES: Increased risk of gastrointestinal bleeding. TREATMENT: LOW-DOSE PILLS/PATCH/RING HELPS: Heavy bleeding, long periods, PMS, breast tenderness. HOW IT WORKS: Prevents excess build-up of uterine lining \u2014 21-day pill regimens keep you on a regular cycle; continuous and extended regimens either stop your periods or let you have a period four times a year. VITAL STATS: Cuts menstrual-blood loss 40% to 50%. DOWNSIDES: Breakthrough bleeding with extended and continuous regimens (though this can get better if you stick with the treatment). TREATMENT: IUD (MIRENA) HELPS: Heavy bleeding. HOW IT WORKS: Thins the lining, and periods get lighter. VITAL STATS: Reduces blood loss up to 86% in three months \u2014 and up to 97% in 12 months. DOWNSIDES: Irregular bleeding (which usually gets better over time), breast tenderness, and other hormone-related side effects. TREATMENT: D&amp;amp;amp;C AND/OR HYSTEROSCOPY HELPS: Uterine polyps. HOW IT WORKS: Doctor removes polyps and lining tissue during a dilation and curettage; in a hysteroscopy, a thin, lighted tube is inserted into the uterus to aid the examination, and any polyps are snipped out. VITAL STATS: Polyp removal improves abnormal bleeding 75% to 100%. DOWNSIDES: Polyps may grow back. TREATMENT: ENDOMETRIAL ABLATION HELPS: Heavy bleeding, long periods. HOW IT WORKS: A layer of uterine lining is removed via radiofrequency waves, freezing, or other techniques. VITAL STATS: Controls bleeding for 60% to 80% of women. DOWNSIDES: You may need a repeat in a few years, depending on type; up to 28% of women ultimately opt for a hysterectomy. TREATMENT: HYSTERECTOMY HELPS: Heavy bleeding, long periods, large polyps, and other conditions. HOW IT WORKS: Removing the uterus means no more periods \u2014 or period problems. VITAL STATS: Research suggests many end up more satisfied than with less aggressive approaches. DOWNSIDES: Major surgery, though laparoscopic or vaginal procedures are less invasive and require shorter recovery. "^^<http://www.w3.org/2001/XMLSchema#string>
<http://www.goodhousekeeping.com/health/a18865/perimenopause-symptoms-treatment/?src=shelter_footer>