How Is Perimenopause Treated
There isnt any treatment to stop perimenopause. Perimenopause is a natural part of life. The cure for perimenopause occurs when your periods stop and you enter menopause.
But your healthcare provider may recommend over-the-counter or prescription perimenopause treatment to help ease symptoms. Your provider may recommend:
- Antidepressants: These medications help with mood swings or depression.
- Birth control pills. These medications stabilize your hormone levels and typically relieve symptoms.
- Estrogen therapy: This treatment stabilizes estrogen levels. You may take estrogen therapy as a cream, gel, patch or swallowable pill.
- Gabapentin : This medicine is a seizure medication that also relieves hot flashes for some women.
- Vaginal creams: Your provider can tell you about prescription and over-the-counter options. Treatment can decrease pain related to sex and relieve vaginal dryness.
Cause Of The Menopause
A number of hormones are responsible for initiating your menstrual cycle each month. These are controlled by other hormones which are released from the pituitary gland in the brain. When a woman reaches a certain age, your pituitary hormones begin to decline, which in turn means that the ovaries stop producing their sex hormones as efficiently this means ovulation will stop. As ovulation stops, so do your periods.
However, this process often happens very gradually and hormone fluctuations along the way are common this means the irregular periods and other symptoms as described below are often a part of the experience.
What Is Perimenopause Or The Transition To Menopause
Perimenopause , or the menopausal transition, is the time leading up to your last period. Perimenopause means around menopause.
Perimenopause is a long transition to menopause, or the time when your periods stop permanently and you can no longer get pregnant. As your body transitions to menopause, your hormone levels may change randomly, causing menopause symptoms unexpectedly. During this transition, your ovaries make different amounts of the hormones estrogen and progesterone than usual.
Irregular periods happen during this time because you may not ovulate every month. Your periods may be longer or shorter than usual. You might skip a few months or have unusually long or short menstrual cycles. Your period may be heavier or lighter than before. Many women also have hot flashes and other menopause symptoms during this transition.
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Its Best Not To Ignore Any Changes That Cause You Distress
You may cringe at the thought of talking to your gynecologist about sex. But rest assured, there is no reason to feel awkward. If youâre dealing with these changes and are very much unhappy with them, talk to your doctor. Right now, this may be a conversation that needs to take place via telehealth due to the pandemic. If you feel dismissed, then Dr. Rowen encourages you to consider switching to another provider if at all possible. Go find someone who will listen to you and take your problems seriously, Dr. Rowen says. Together, you can come up with a treatment plan that may help you have a more fulfilling sex life, even after menopause.
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When Does Menopause Start
Though menopause is defined as starting one year after the end of a person last period, they may begin experiencing symptoms earlier.
According to the North American Menopause Society, the average age for a woman to reach menopause in the United States is 51 years. However, this age range varies. Menopause may happen early when a woman is in her forties or later when she is in her late 50s.
The onset of menopause can also follow surgery that reduces ovarian function or hormones, such as a hysterectomy, where a surgeon removes the uterus, or surgery or other treatments for cancer. In these circumstances, symptoms may begin rapidly as an adverse effect of these procedures.
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Of The Reproductive Journey
We usually diagnose menopause in hindsight, after that full year of absent periods. Ive found that most women know theyve reached menopause when they get there.
Even if your irregular periods turn out to be something else, youll face menopause eventually. Talk with your ob-gyn about what youre experiencing. Together we can work through this part of your health journey.
The views expressed in this article are those of Dr. Eisenberg and do not reflect the views of the National Institutes of Health, the Department of Health and Human Services, or the United States government.
Copyright 2021 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.
This information is designed as an educational aid for the public. It offers current information and opinions related to women’s health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOGs complete disclaimer.
Dr. Esther Eisenberg
What Do You Need To Know About The Menopause
The menopause is the natural process women go through as they reach a certain age and signals the point when a womans monthly periods have come to an end.
Although reaching the menopause technically means you have had your last ever period, we often use this phrase to describe the lead up to your periods stopping. Periods rarely just stop suddenly, many women experience irregular periods for some time. This might include heavier, more painful periods or lighter, less frequent ones these patterns can go on for a number of years. Every woman is different but you are generally considered to be fully through the menopause after not having a period for at least two years.
Alongside the often irregular periods, many women often experience a whole number of symptoms in the lead up to the menopause as oestrogen begins to drop, this can be anything from hot flushes to joint pain.
On this page I give a quick overview of what the menopause involves and specifically the effects it can have on the menstrual cycle. Visit A.Vogel Talks Menopause for more in-depth information and video blogs from our menopause expert Eileen.
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Hair Loss During Menopausal Transition
Hair loss during the menopausal transition can be just as dramatic as menopausal hair loss. The two are both related to the same changes in hormone levels. The menopausal transition is the time leading up to menopause and can last several years. During the menopausal transition, fluctuating hormones can cause some of the same symptoms typically associated with menopause.
Calcium And Vitamin D
A combination of calcium and vitamin D can reduce the risk of osteoporosis, the bone loss associated with menopause. The best sources are from calcium-rich and vitamin D-fortified foods.
Doctors are currently reconsidering the use of calcium and vitamin D supplements. The U.S. Preventive Services Task Force advises that healthy postmenopausal women don’t need to take these supplements. According to the USPSTF, taking daily low-dose amounts of vitamin D supplements , with or without calcium supplements , does not prevent fractures. For higher doses, the USPSTF says there is not enough evidence to make a recommendation. In addition to possible lack of benefit, these supplements are associated with certain risks, like kidney stones.
However, calcium and vitamin D are important nutrients. Supplements may be appropriate for certain people including those who do not get enough vitamin D through sunlight exposure and those who do not consume enough calcium in their diet. They are also helpful for people who have been diagnosed with osteoporosis. Talk with your doctor about whether or not you should take supplements.
The National Osteoporosis Foundation recommends:
Vitamin D is necessary for the absorption of calcium in the stomach and gastrointestinal tract and is the essential companion to calcium in maintaining strong bones.
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Will Being Super Healthy Help Delay Menopause
Although maintaining good overall health is important for a variety of reasons, it wont necessarily translate to later menopause, says Streicher. I have women who tell me, I have a healthy diet, Im thin, I work out all the time, and I look young. Im sure Im not going to go through menopause early, and when I do, I wont have hot flashes and other symptoms. I wish I could say that was true, but its not, she says.
Body weight might matter, though. We do know that the extremes of weight, in someone who is very obese or someone with very low body weight, may impact the onset of menopause, but for the majority of women in the middle it doesnt seem to have a big impact, says Streicher.
Menopause And Complementary Therapies
Some women can benefit from using complementary therapies for menopause. But it is important to remember that natural herb and plant medications can have unpleasant side effects in some women, just like prescribed medications. A registered naturopath may provide long-term guidance and balance through the menopausal years.Herbal therapies can often be taken in conjunction with hormone therapy. It is important to let both your doctor and naturopath know exactly what each has prescribed, and to consult your doctor before taking any herbal treatments or dietary supplements for menopause. Some natural therapies can affect or interact with other medications you may be taking.
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Menopause And Hair Loss: Whats The Connection
When entering the years of menopausal transition, it is a good idea to check the bodys hormone levels. This can help explain symptoms such as hair loss.
When a person experiences hair loss and other symptoms of menopause, it is predominantly due to hormonal changes. With age, the ovaries begin to decrease the amount of sex hormones that are normally produced. As the body responds to the fluctuations in hormones, numerous physical changes occur. Menopausal hair loss is directly related to the decreased production of estrogen and progesterone.
As these hormone levels drop, hair may begin to grow more slowly and become thinner. Over time, the decrease in estrogen and progesterone causes an increase in the activity of male hormones that the body makes. Androgens cause the hair follicles on the head to shrink, which leads to hair loss. These are the same hormones that are responsible for increased facial hair growth in menopausal people.
Among other factors that contribute to hair loss are lack of nutrients, stress, and illness. A health care provider may suggest tests for basic blood count, thyroid function, or hormone levels to identify the cause of hair loss.
What Other Factors Influence When Perimenopause Starts Or When A Woman Reaches Menopause
New research published online on April 12 in Menopause, the journal of NAMS, looked at the various factors that may affect the age when natural menopause occurs.
They found that there are factors that do seem predictive of when a woman will approach menopause, such as higher estradiol and follicle-stimulating hormone levels, which weve known for a while,” says Streicher. Irregular menstrual bleeding and hot flashes were also indicators of earlier menopause, she adds.
One new finding uncovered in the research was around alcohol consumption. The authors observed that participants tended to increase their alcohol consumption when approaching menopause, making it a potential clue that the change was coming.
That makes sense, says Streicher. This can be a time of added stress for women, and we know that any stressful situation can cause someone to drink more, she says.
Although this study didnt find a strong association with smoking, other research has indicated that smoking is related to early onset of menopause, says Streicher.
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Menopause And Birth Control: When Is It Time To Quit
Menopause can be a distressing, confusing time for many women. Its a natural part of life, but the timeline may vary between individuals with a uterus. You may have several questions about what this process entails, which is totally normal! The following article will provide some insight, particularly in terms of how to manage birth control use as you approach menopause.
What Are The Stages
The process happens slowly over three stages:
Perimenopause. Your cycles will become irregular, but they havenât stopped. Most women hit this stage around age 47. Even though you might notice symptoms like hot flashes, you can still get pregnant.
Menopause. This is when youâll have your final menstrual period. You wonât know for sure itâs happened until youâve gone a year without one. Hot flashes, vaginal dryness, sleep problems, and other symptoms are common in this stage.
Postmenopause. This begins when you hit the year mark from your final period. Once that happens, youâll be referred to as postmenopausal for the rest of your life. Keep in mind that after more than 1 year of no menstrual periods due to menopause, vaginal bleeding isn’t normal, so tell your doctor if you have any ASAP.
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How Can I Treat The Symptoms
There are a bunch of ways.
Lifestyle changes. A healthy diet and regular exercise program will help manage your symptoms and boost your health. This is a great time to finally kick any old, unhealthy habits like smoking or drinking too much alcohol. To help with hot flashes, dress lightly and in layers. Avoid triggers like caffeine and spicy foods. And if you stay sexually active, that may help preserve your vaginal lining.
Prescription medication for hot flashes. If you still have your uterus, your doctor might prescribe treatment with estrogen and progesterone. This is called combination hormone therapy or hormone replacement therapy . It helps with hot flashes and night sweats, and it may help prevent osteoporosis. If you donât have a uterus, you might get estrogen alone.
Hormone therapy isnât for everyone. Donât take it if you’ve ever had breast cancer, uterine or “endometrial” cancer, blood clots, liver disease, or a stroke. Also don’t take it if you might be pregnant or you have undiagnosed vaginal bleeding.
If you can’t or don’t want to take hormones, other medications can ease symptoms. They include antidepressants, antiseizure drugs, or blood pressure medications to help with hot flashes and mood swings.
Prescription and OTC medication for vaginal dryness and sleep problems. You can try topical estrogen, lubricants, and non-estrogen prescriptions for dryness and painful sex. OTC or prescription sleep aids can help if you have trouble falling asleep.
How Long Does The Transition To Menopause Last
Perimenopause, the transition to menopause, can last between two and eight years before your periods stop permanently. For most women, this transition to menopause lasts about four years. You will know you have reached menopause only after it has been a full year since your last period. This means you have not had any bleeding, including spotting, for 12 months in a row.
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What Age Is Considered Early For Menopause
If you reach menopause before age 40, that is considered premature menopause, says Faubion. This occurs in about 1 to 2 percent of women, she says.
Experiencing menopause at 40 to 45 years of age is called early menopause, and that occurs in about 5 to 7 percent of the population, so its safe to say that at least 7 percent of women are going to go through menopause early or prematurely, says Faubion. Menopause at age 46 or older is considered normal, she says.
When To See A Doctor
At the onset of perimenopause, a person may wish to schedule regular doctor visits for preventive healthcare.
Around perimenopause, doctors may recommend certain health screenings that sometimes include a colonoscopy, mammogram, and blood tests.
An individual should not hesitate to seek a doctors care and advice to deal with disruptive menopausal symptoms. If vaginal bleeding occurs after menopause, a person should also seek medical attention.
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Why Does Menopause Cause Irregular Periods
Your periods are regulated by the hormones oestrogen and progesterone. These hormones drive the menstruation process and as you reach menopause, levels begin to decline. Often this is not a steady or gradual descent, but an erratic oscillation. This means that your periods will also begin to fluctuate, sometimes coming more frequently than usual, sometimes less so.
Other factors can also trigger irregular periods. These range from increased stress or changes in diet to underlying health issues such as diabetes. If you suspect that your irregular periods are caused by an underlying health condition, it is important to seek medical advice to help with this.
When Does Perimenopause Start
The average age of menopause is 51, and perimenopause symptoms typically begin about four years before your final period. Most women start to notice perimenopause symptoms in their 40s. But perimenopause can happen a little earlier or later, too. The best predictor of when your final period will be is the age at which your mother entered menopause .
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What Are The Symptoms Of Perimenopause
During perimenopause, most women have menopause-like symptoms. You might have:
The decrease in estrogen also can lead to bone thinning or changing cholesterol levels. During perimenopause, your risk for osteopenia and heart disease increases. Continue to have regular checkups with your healthcare provider to keep an eye on your health. Your provider may recommend lifestyle changes or treatment options to lower your health risks.
Menopause Symptoms At Age 45
Around the age of 45 many women enter pre-menopause and start to notice the first signs that menopause is coming. For some women, the symptoms are mild and short-lasting. For others, menopause symptoms can be disruptive and long-lasting.
Some of the earliest signs of menopause may include:
Changes to your period
Period changes are usually the first signs of menopause. For example, your period may start to happen every six to eight weeks. Or you may miss a couple months before it comes back again. You may also have a heavier flow or a lighter flow from time to time.
That said, its important to know you can still get pregnant during perimenopause. So, continue to use birth control in the lead up to menopause as you normally would. Also, if youve missed your period and youre not sure whether perimenopause has started, consider taking a pregnancy test as a first step.
As your hormone levels change, you may find yourself more irritable, anxious, sad or forgetful than usual. Your sex drive can also decrease or increase.
These changes are very typical as your body approaches menopause. So, be kind to yourself, practice self-care and ask for help if youre having trouble.
You may find it difficult to get to sleep, or you may wake up in the middle of the night. Sleep trouble can contribute to a constant feeling of tiredness, which can make you moodier.
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