5 Surprising Symptoms of Perimenopause

Hot flashes, loss of sex drive, and irritability are all common signs of perimenopause -- the five- to 10-year period during which your estrogen levels fluctuate and egg production becomes erratic until your menstrual cycle stops completely. Menopause begins one year after your last period. The average woman enters menopause at age 52, so you can start developing symptoms anywhere from your early 40s to your late 50s.

Signs menopause is in full swing

Many women overlook other perimenopause symptoms, says JoAnn Pinkerton, MD, ob-gyn professor and director of the Midlife Health Division at the University of Virginia. If any of these are familiar, you may be in perimenopause:

1. Your period stops for 3 to 6 months, then starts again. Some women may think they're pregnant, and when they turn out not to be, write it off as nothing in particular, but sporadic menstruation is a surefire sign that your ovaries have started producing eggs on an erratic basis. "Another signal is flooding," Pinkerton says. "You start to become irregular, may have a spotty period, and then go through times of very heavy periods."
2. Breast tenderness intensifies. Because your period is erratic, you may not link tender breasts to perimenopause.
3. Migraines worsen. Some women get bad headaches before or after their periods. During perimenopause, migraine headaches can get worse. "If you go to your doctor complaining of headaches, she may think it's more serious than a side effect due to hormonal changes," Pinkerton says. Make sure your doctor knows about all your perimenopause symptoms.
4. Anxiety increases. If you already suffer from anxiety, you may start to have panic attacks during which you feel fear disproportionate to the circumstances. Symptoms include difficulty breathing, a racing heart, dizziness, and sweating.
5. Mental illness becomes more acute. This is especially true of women who suffer from depression or bipolar disorder.

Ways to beat menopause symptoms

Because you've lost the predictability of your periods and symptoms, it's important to keep a menstrual calendar, Pinkerton advises. "Note when you have a period and come up with shorthand for a headache, breast tenderness, heavy flow," she says. This is especially key because the symptoms you experience may not be the same from cycle to cycle. Just because you have heavy flow or an especially bad migraine one month doesn't mean you'll have the same symptoms with your next period.

If your perimenopause symptoms get really bad, discuss solutions with your doctor, including whether hormone replacement therapy is a good option for you.

Wyeth’s Menopause Hormones Increase Risk of Lung Cancer Deaths

Wyeth’s hormone replacement therapy, a menopause treatment whose use has declined after being linked to heart attack, stroke and breast cancer, increases the risk of death from lung tumors, a study found.

After five years on Wyeth’s Prempro, a combination of the hormones estrogen and progestin, 67 women died from non-small cell lung cancer, compared with 39 on placebo, the research showed. Results of the trial, which examined women age 50 to 79 and included current and former smokers, were presented today at the American Society of Clinical Oncology meeting in Orlando.

Sales of the pills plunged in 2002 after a U.S. study linked the therapy to breast cancer and cardiovascular risks. As many as 6 million women took the menopause treatments before the study curbed use. The products generated $1.1 billion last year, down from more than $2 billion in 2001.

“This is a new finding that tells us women who smoke shouldn’t take estrogen and progestin for menopause symptoms,” said Rowan Chlebowski, the study author and a researcher at Los Angeles Biomedical Research Institute at Harbor-UCLA Medical Center, in an interview.

Tobacco use causes almost 80 percent of lung cancer deaths in women, according to the Atlanta-based U.S. Centers for Disease Control and Prevention. More lung cancer cases were also diagnosed in women on hormones, though the difference wasn’t statistically significant, today’s study found.

‘See the Logic’

“I can see the logic of that kind of recommendation,” for women smokers to avoid hormone pills, said Joseph Camardo, head of medical affairs at Madison, New Jersey-based Wyeth, in an interview. “I would absolutely advise women not to smoke.” Camardo said he had not seen the data.

About 200,000 Americans are diagnosed with lung cancer each year, and 160,000 die from it, more than any other tumor, according to the CDC.

About 85 to 90 percent of lung malignancies are of a variety called non-small cell, the type in today’s study, according to the American Cancer Society, an advocacy group.

The trial analyzed lung cancer diagnosis and death among 16,608 patients who participated in the Women’s Health Initiative, the same U.S. research project that identified other risks of hormone therapy seven years ago.

Among current and former smokers studied in the research, there were 56 deaths for women treated with hormones and 34 deaths with placebo. Among non-smokers, there were 9 deaths for women on hormones and 5 deaths for patients taking a placebo.

Menopause Symptoms

Reduced estrogen levels during menopause cause the part of the brain responsible for temperature control to malfunction. Hot flashes strike suddenly and can be accompanied by rapid heart beat, nausea, dizziness, headaches, muscle weakness and fatigue.

Patients today take lower doses of Wyeth’s hormones to reduce their risk of breast cancer and heart attacks. Prempro combines two hormones, estrogen and progestin, to curb the risk of uterine cancer that is linked to taking estrogen alone. Premarin, an estrogen-only pill, is given to women who have had hysterectomies, surgery removing the uterus.

Prescribing information on the label for Wyeth’s hormones details risks identified by earlier research from the WHI study, including breast cancer and heart attacks. No warnings about lung cancer are currently included.

More than 5,000 lawsuits have been filed against Wyeth, alleging its hormones caused cancer.

New York-based Pfizer Inc., the world’s largest drugmaker, said in January it would buy Wyeth for about $65 billion.