Perimenopause + Fertility = 2014 Proactive Planning

By Ellen Dolgen

Contrary to popular opinion, you won’t just wake up one 2014 morning in menopause.

So when does menopause start? you ask. Your body actually begins “the change” 6-10 years before you reach menopause. This early menopausal transitional time is known as perimenopause. You are not in menopause until you’ve missed 12 consecutive periods.  The average age for the start of menopause is 51.

Unfortunately, during pre-menopause and perimenopause, one of the first things to take a hit is your fertility.

By age 30, about 95 percent women have only 12 percent of their original number of ovarian follicular cells, which are those which can develop into eggs, according to research from the University of Edinburgh. By age 40, only 3 percent of women’s egg-producing cells remain. However, the research also shows that most females have about 600,000 cells before birth. So even if you lose 97 percent of them by the time you blow out your birthday cake’s 40 candles, you still have 18,000 cells to celebrate!

Meanwhile, during perimenopause, you will probably find that your menstrual cycle is more unpredictable than ever, making it increasingly difficult for sperm to meet the eggs that you do have. In fact, according to Mayo Clinic, menstrual cycles that vary in length by seven or more days are a telltale signs of perimenopause.

Even if your menstrual cycle is regular, however, it doesn’t mean you are necessarily ovulating regularly, says Dr. David B. Smotrich, M.D., a Diplomate of the American Board of Obstetrics and Gynecology specializing in Reproductive Endocrinology and Fertility. So put those ovulation sticks to good use! Per cycle, a 30-year-old has a 20 percent chance of getting pregnant, but by the time she hits 40, her odds drop to only 5 percent, according to the American Society for Reproductive Medicine.

Still, it’s important to remember that all women experiencing menopause (and their baby makers) are unique, Dr. Smotrich says. In fact, as difficult as conceiving might seem to be, if you do not want to become pregnant in 2014, it’s still vital to use contraception during perimenopause, according to a recent review in the Canadian Medical Association Journal. (Check out the best birth control options during perimenopause.)

If you are approaching 30 this New Year and have plans of getting pregnant in the future, Dr. Smotrich recommends having some baseline fertility tests performed for your big 3-0. Follow up with yearly tests until age 35, semi-annual tests (pair them with your trips to the Victoria’s Secret semi-annual sales!) until 39, and quarterly tests after that to monitor your fertility, he says. Some simple blood tests to consider: a Follicle-Stimulating Hormone (FSH) Test, which measures levels of hormones that control your menstrual cycle and production of eggs; a 25-Hydroxy Vitamin D Test, which determines your body’s levels of calcidiol, deficiencies of which can predispose your baby to health complications; an Estradiol Test, which measures a form of estrogen that is integral to conception and pregnancy, and an Anti-Mullerian Hormone (AMH) Test, which estimates the number of eggs in the ovaries.

If your numbers—and years—aren’t working in your favor this New Year, don’t panic. Fertility treatments exist to help give women the babies of their dreams. For instance, during in vitro fertilization, eggs are harvested from a woman’s ovaries, combined with sperm in a lab, and implanted in a woman’s uterus for the greatest chance of conception. In women ages 35 and younger that have up to six cycles of in vitro fertilization therapy, the live-birth rate ranges from 65 to 86 percent. The rate for women ages 40 and up ranges from 23 to 42 percent, according to an analysis of more than 6,000 patients published in The New England Journal of Medicine. According to Dr. Smotrich, the procedure usually costs about $10,000 per cycle.

However, since the risk of birth complications increases with the mother’s age, Dr. Smotrich recommends that, before trying to become pregnant, women older than 35 talk with their doctor about having their baby monitored during gestation for chromosomal conditions including Down Syndrome. A good 2014 offense is the best 2014 defense.

When it comes to fertility, ignorance is anything but bliss! But if we keep tabs on our biological clocks, we can help make sure that when our lives are ready for a baby, so are our bodies!

Suffering in silence is OUT! Reaching out is IN!

Ellen Dolgen is outspoken women’s health and wellness advocate, menopause awareness expert, author, and speaker.

After struggling through the silence that surrounds menopause, Ellen resolved to help women reach out and end the confusion, embarrassment, and less-than-lovely symptoms that come with “the change.” Her passion to be a “sister” to all women fueled Ellen’s book, Shmirshky: the pursuit of hormone happiness. As a result of her women’s wellness journey, and in response to the overwhelming thirst of her ever-expanding audience for empowering information, Ellen’s weekly blog, Menopause Mondays^TM was born.

Menopause Mondays^TM allows Ellen an expansive platform from which she broadens her discussion of menopause, women’s health, and life as a menopausal woman. Her weekly newsletter provides a one-stop shop for the latest menopause and women’s health news and research, allowing women the access and know-how needed to take charge of their health and happiness. In addition to Ellen’s ever-growing social media presence, EllenDolgen.com has fast become “the place” on the web for informative and entertaining women’s menopause and wellness engagement. Ellen is #1 on Dr. Oz Sharecare.com Top 10 Social HealthMakers on Menopause. In 2012 and 2013 EllenDolgen.com/Menopause Mondays was named first on the list of the “Best Menopause Blogs” by Healthline. Ellen is also a regular contributor to over a dozen leading women’s health blogs. Her motto is: Suffering in silence is OUT! Reaching out is IN!

Ellen has founded a women’s health and wellness program that provides corporate education events for businesses, healthcare institutions, and other organizations. She produces and facilitates Menopause Mondays Parties^TM for organizations across the country. In addition, she works with pharmaceutical companies in helping them understand and address women’s health needs. Ellen co-chaired a social media roundtable for Novo Nordisk in 2012. In 2013, Ellen was a key spokesperson for GLAM^TM (Great Life After Menopause) a non-branded campaign sponsored by Novo Nordisk.

She serves on the Community Advisory Board of Scripps Memorial Hospital La Jolla and has chaired and served on various boards and committees for Fresh Start Women’s Foundation, San Diego Hospice, Brandeis University, Planned Parenthood of the Pacific Southwest, NARAL, the Phoenix Heart Ball, Juvenile Diabetes Research Foundation, Weizmann Institute of Science, Angel Charity for Children, Brewster Auxiliary, and Handmaker Home for the Aging. Ellen’s lifelong commitment to philanthropy through board representation, fundraising, and event organization continues with her founding of Menopause Mondays, which assists in promoting women’s health and wellbeing around the world.

Ellen has appeared on the “TODAY Show,” The Katie Show,” “NBC Nightly News”, the “Rachael Ray Show,” “The Doctors,” Oprah Radio, Playboy Radio, NPR’s “Tell Me More,” Doctor Radio, and dozens of regional and national media outlets. In 2011 she appeared in a production of “The Vagina Monologues.” Ellen was one of the first regular contributors to debut on The Huffington Post’s, Huff/Post50, which targets 116 million Americans over the age of 50.

Ellen is the founder and president of Menopause Mondays and is a principal of Dolgen Ventures along with her husband, David. She lives in Coronado, California, and has two adult children, Sarah and Jack.

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