Menopause is the term that has historically been used to describe the years of a woman’s life during which estrogen production decreases progressively until, one day, menstruation stops. Technically, menopause means that the ovaries are no longer producing estrogen and that a woman no longer menstruates. The average age for this event is 51. However, we now realize that there is quite a bit more to menopause than the cessation of having a period.
What Is Perimenopause?
Perimenopause is the period of time during which estrogen production fluctuates. Changes in the ovaries may begin sometime during a woman’s 30’s or 40’s and can last several years. As estrogen variances continue, the menstrual cycle may become shorter, or it may become longer. Flow may lighten up or it may become heavier, and this can change from month to month. Some months, there may be no period at all. While menstrual changes are a telltale sign of perimenopause, it is important to consult with your healthcare provider about abnormal bleeding.
My Period Is Fine, but I Don’t Feel “Right.” Could This Be Perimenopause?
One of the frustrating aspects of perimenopause is that hormone disruption can interrupt a variety of bodily functions. This part of a woman’s journey may include:
- Sleep disturbances. A woman’s sleep may become highly erratic during perimenopause. She may have difficulty falling asleep, or may “crash” at the end of the day only to become restless in the early morning hours. Night sweats may also develop, causing both restlessness and physical discomfort.
- Hot flashes. Instances of sudden heating of the face and upper body may increase as hormones seesaw wildly. These moments of “personal summer” may occur once or twice a month, or they may occur daily and may last a few seconds or several minutes.
- Changes to vaginal health. Decreased estrogen levels lead to thinning and drying of the vaginal mucosa. This can lead to painful intercourse, and it can also increase a woman’s risk for vaginal and urinary tract infections.
- Loss of libido may occur as estrogen and testosterone balance is thrown into a state of imbalance. Instances of moodiness, irritability, anxiety, and depression may also arise.
Does Perimenopause and Menopause Pose a Health Risk?
The primary symptoms of hormone changes in a woman’s body affect daily living, and thus the quality of life. The less estrogen a woman has, the greater risk she also has for bone loss, high cholesterol, and cardiovascular disease, including stroke and heart attack. A certain degree of risk can be mitigated with healthy eating and exercise habits. Hormone replacement therapy, or HRT, may also be something to consider.
What Is Hormone Replacement Therapy?
Hormone therapy, or HRT, is tailored to a woman’s need for estrogen as she approaches or completes menopause. Treatment may involve taking estrogen pills or administration via a topical solution, vaginal ring, or skin patch. Pellet therapy has also become a popular method of hormone replacement in recent years. The dosage and type of hormones that are prescribed are based on individual circumstances. Combination hormone therapy may include an appropriate dose of progestin, as well as estrogen, to decrease the risks associated with estrogen-only HRT.
Why Would I Want Hormone Replacement Therapy?
HRT has demonstrated clinical value in the reduction of perimenopause symptoms such as night sweats and hot flashes. Vaginal dryness can improve with local estrogen therapy in the form of a cream or vaginal ring. Treatment also has protective properties that preserve bone density, decreasing the risk of osteoporosis.
Recommendations for the Menopause Years
We are here to support you with personalized health care as you transition through this change of life. A few recommendations for women in perimenopause, and for post-menopausal women, include:
- Eat well. Balanced nutrition encourages cellular health and should also focus on building strong bones. Calcium and vitamin D are two nutrients that are vital to every woman.
- Research has shown that exercise such as walking and other weight-bearing activities equals better bone density. Aerobic activity that increases heart rate is beneficial for cardiovascular health as well as weight management. Exercise that promotes good balance is also advantageous as it reduces the risks of falls.
- Perimenopause and menopause are not changes to go through alone. Foster a relationship with your healthcare provider through routine exams and diagnostic testing at recommended intervals.