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Premenopause

Premenopause is considered to be the fertile period of the women when she regularly menstruating and it begins with menarche and ends with the onset of perimenopausal and subsequent menopausal symptoms like hot flashes, night sweats, irregular periods etc.
During the premenopause phase the most common symptom is those of premenstrual syndrome. There is another term in relation to menopause, perimenopause. Both premenopause and perimenopause can be very much confusing and also to add to the confusion the two phases in a woman within a particular span of time are overlapping in most of the cases. However there is a basic difference between the two phases; these are premenopause occur before perimenopause and perimenopause occur around the time one attain menopause.
It is difficult to identify the exact age group for premenopause; as per the definition it is the time interval between the first menstrual bleeding (menarche) and the first evident symptom of menopause like hot flashes, mood swings etc.
In most of the cases menarche starts in the teens and the first symptoms of impending menopause become evident during later part of 30’s. Hence the period of premenopause usually last between teens and late 30’s or early 40’s.
Symptoms
The symptoms of premenopause usually appear in women during menstrual cycle and are known as commonly as premenstrual syndrome (PMS). These symptoms appear every monthly cycle. The frequency as well the severity of the symptoms varies from woman to woman even in the same woman at different cycle.
Common presenting symptoms of premenopause include
1. ower abdominal (pelvic) cramps before or during the monthly menstrual bleeding
2. anxiety although stress is the most common cause but fluctuation in the level of estrogen during different  time of a single cycle may be another cause
3. mood swings during or immediately before the bleeding starts
4. depression associated with estrogen level fluctuation
5. increased irritability
6. tendency to eat excessively
7. nausea even vomiting due to change in hormonal levels
8. sense of bloating as body tends to retain water with alteration in the progesterone level
Other than the above mentioned common premenopausal symptoms some women tend to suffer from certain uncommon symptoms; these are muscle spasm especially in the calf muscles just before the menstrual bleeding, loss of self confidence, increased frequency of panic attacks, lightheadedness resulting into sudden blackout, uncoordinated body movements often identified as clumsiness etc.
The severity and the extent to which they can interfere with normal day to day life at home, schools, college or at workplace vary from woman to woman; some woman may not even notice the symptoms whereas in some these symptoms become quite bothersome.
Causes
Premenopause is the phase in a woman’s life when she experiences the effects of circulating hormones on her body functions for the first time.
In a woman’s body the balance between circulating hormones namely estrogen, progesterone and testosterone are essential for the normal functioning of the body. Normally the levels of these hormones change at different time of a single menstrual cycle, the fluctuation in the levels often become unpredictable especially just before the menstrual bleeding leading to the different symptoms of premenopause.
Other than alteration in the circulating hormone levels numbers of external factors are also known to play important role; these are
1. Stress: chronic exposure to physical or emotional stress like work pressure, family problems, financial problems etc
2. Diet: eating foods rich in artificial refined carbohydrates and lacking essential minerals and other micronutrients
3. Regular exposure to artificial hormones or toxic substances: cigarettes, ammonia, butanes etc are the common sources.
Treatment
Treatment options depend upon the severity of symptom; in some women no treatment is required while in some treatment is essential for maintaining normal day to day life.
The common treatment approaches include
1. Lifestyle adjustments: these include eating health balanced diet, avoiding stress by regular exercise, pursuing hobbies and in severe cases by seeking professional help
2. Alternative drug therapy: it includes consumption of both phytoestrogenic herbs like ginseng and non phytoestrogenic herbs like Macafem
3. Drugs: hormone replacement therapy is required in severe cases. Fluoxetine, SSRI is approved by the FDA for managing the premenstrual syndrome (PMS)

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