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Starting the Second Chapter

How Women Can Make Middle Age a Fresh Start.

Most women are familiar with menopause. But less well-known is perimenopause, the time between a woman’s reproductive years and the onset of menopause. Marked by hormonal changes, it can last anywhere from a matter of months to ten years, with an average length of four years.

While perimenopause usually starts in a woman’s late 40s, it can begin in the 30s as well. Even though fertility is in decline during this time, a woman can still become pregnant.

The symptoms of perimenopause are mostly the result of decreases in two hormones, estrogen and progesterone. While symptoms vary widely from one woman to the next, they commonly include hot flashes, difficulty sleeping, dryness, tenderness, irritability, mood swings, headaches and menstrual irregularity.

In addition to these obvious symptoms, other less noticeable changes may be happening that can have a greater long-term effect. Women may lose both muscle tone and bone mass, especially if they don’t exercise regularly. Often HDL or “good” cholesterol decreases, while LDL or “bad” cholesterol increases, increasing the risk of heart disease.

That’s the bad news. The good news is that perimenopause and menopause are a natural phase in a woman’s life, and your body is designed to deal with this period. However, there are steps you can take to diminish the negative effects and maintain your health.

Foremost among these is establishing a healthy lifestyle. If you’re not already active, begin a regular exercise program, and make sure that weight-bearing exercise is a part of that routine. Yoga is often seen as a healthy way to reduce stress and stay fit. Fine tune your diet, being especially mindful of heart-healthy foods.

If you smoke, this is an excellent time to quit. Continue regular mammograms and blood tests that can provide early detection for heart disease or diabetes. You may wish to ask your doctor about hormone therapy. Steps like these can turn perimenopause from a stressful time to the beginning of a vigorous, healthy second half of your life.


Christopher S. Grady, MD
Attending Physician, OB/GYN

A native of the Louisville area, Dr. Grady received his undergraduate degree from Translyvania University, then graduated from the University of Louisville Medical School, followed by an OB/GYN residency at the Medical College of Georgia. He provides care for women of all ages, including general and high-risk obstetrics and a wide range of gynecological care. He has three boys and is a member of the Southern Indiana Chamber of Commerce and Northside Christian Church