Menopause is the stage in a woman’s life where her fertility comes to a close. The diagnosis becomes official when you haven’t menstruated for 12 consecutive months.
Perimenopause is the time leading up to menopause that comes with all the nasty symptoms women complain about. While the exact timing is different for each individual, the symptoms generally start between ages 45-55 and last for several years.
Symptoms develop during perimenopause because reproductive hormone levels drop; these include estrogen, progesterone, follicle-stimulating hormone (FSH), testosterone, and luteinizing hormone (LH). That affects the reproductive organs and many other bodily systems.
Along with the hormone drop, women lose active ovarian follicles, the structures that produce and release eggs from the ovary walls. Periods and blood flow both become irregular until they drop off completely.
Dr. Hany H Ahmed is a board-certified OB/GYN in Houston, Texas. He and his staff understand that women can struggle with the symptoms of perimenopause and menopause, and they’re committed to providing symptom relief to help you get through the changes.
How do you know if you’re in menopause?
The real question is, “How do you know if you’re in perimenopause?” because that’s where the symptoms appear. Once you reach menopause, they quiet down. The earliest signs of perimenopause generally include:
- Fewer menstrual periods
- Lighter or heavier flow than normal
- Hot flashes, flushing, and night sweats
About 75% of perimenopausal women experience hot flashes and flushing, the symptoms most commonly associated with this time of life.
Additional common symptoms include:
- Anxiety, depression, and mood swings
- Sleep problems
- Urinary incontinence or increased urination
- Dry skin, eyes, and mouth
- Vaginal dryness
- Tender breasts
- Mental fog
- Metabolism changes, leading to weight gain
- Increased risk of osteoporosis (low bone density)
- Stiff or painful joints
- Hair thinning or loss
If you experience any combination of these symptoms, and you’re between 45-55, you can be fairly sure you’ve reached perimenopause. Some women go through an early version of this change, starting as early as the mid-30s. Seeing your OB/GYN regularly can help you stay on top of it.
Dealing with perimenopause
Dr. Ahmed helps address your symptoms in a number of ways. Which method he chooses is based largely on the severity of your symptoms and your priorities.
Hormone replacement therapy (HRT)
As estrogen levels fall, symptoms such as hot flashes, vaginal dryness, sleep disturbances, and an increased risk of osteoporosis develop. HRT is an FDA-approved treatment that restores hormone levels, relieving symptoms. It’s available in two types:
This type of HRT is prescribed for women who’ve had a hysterectomy and don’t have a uterus. It provides the most symptom relief.
2. Estrogen plus progestogen
Progestogen is added to the estrogen to protect against an increased risk of uterine (endometrial) cancer that can result from estrogen alone.
HRT can also be administered in two forms:
1. Systemic products
This method circulates through the bloodstream and reaches all parts of the body. It’s effective for hot flashes, night sweats, vaginal symptoms, and osteoporosis.
Systemic HRT, though, carries certain risks. These include associations (but not necessarily a cause-and-effect) with breast cancer, stroke, and venous blood clots, especially for women over 60. The doctor prescribes the lowest effective dose for the shortest amount of time.
2. Local (nonsystemic) products
This method involves applying the hormone to the vaginal tissues. It affects only a localized area of the body and treats only vaginal symptoms such as dryness and laxity.
If you’re not a good candidate for HRT, you have other options.
Medications, including low-dose antidepressants and anti-seizure medications, can be prescribed off-label to help with hot flashes. Antidepressants can also address mood swings, especially if you combine them with some form of psychotherapy.
Doctors also use bone-building medications, most commonly bisphosphonates, to increase bone density and decrease the risk of osteoporosis.
You can also help yourself by adapting your lifestyle to accommodate your symptoms.
For night sweats, wear light pajamas, use layered bedding, keep a fan by the bed, and keep a frozen cold pack under your pillow. All can improve symptoms.
For urinary incontinence, avoid food and drinks with high acid and/or caffeine content, since they irritate the bladder lining. Practicing Kegel exercises to strengthen your pelvic floor muscles can also be effective.
If you’re experiencing symptoms of perimenopause, the best thing you can do is to visit Dr. Ahmed’s office so he can evaluate those symptoms and test your hormone levels. Menopause doesn’t have to be uncomfortable.
To get started, call our office or book online with us today.