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Perimenopause symptoms & treatment, what you really want to know

We can help you understand perimenopause symptoms & treatments available

What is perimenopause and what causes it?

Perimenopause is the period leading up to menopause, when a woman has not had a period for 12 consecutive months. It can last up to 10 years. The ovaries decrease production of estrogen and progesterone in preparation to stop ovulating. The closer a woman gets to menopause the more rapid the decline in hormone levels. These hormone fluctuations cause the symptoms women associate with “the change.”

During this time periods may become heavier, lighter, less frequent, or more frequent and women CAN still become pregnant during this perimenopausal period. The average age of menopause is 51, a few years earlier for smokers.

What are the symptoms?

We have hormone receptors throughout our bodies and hormone changes can cause symptoms in nearly every part of our bodies. Recognizing these symptoms and understanding their significance is critical to learning how to treat them.

  • Hot flashes/night sweats – up to 75% of women will have hot flashes. They are caused by fluctuations in hormone levels and can greatly affect every aspect of a woman’s life including sleep, work, and mood.
  • Urinary/vaginal symptoms – collectively called the Genitourinary Syndrome of Menopause and caused by decreasing estrogen levels, vaginal and urinary symptoms can affect overall health and wellbeing and can have a serious impact on a woman’s sexual functioning. Common symptoms include vaginal dryness, pain, irritation, painful intercourse, problems with urination, and frequent or recurrent urinary or vaginal infections.
  • Other common symptoms of menopause include
    • Brain fog/difficulty thinking or concentrating
    • Weight gain or difficulty losing weight
    • Sleep problems
    • Mood swings or new or worsening depression or anxiety
    • Decreased libido
    • Dry skin/eyes
    • Thinning hair
    • Joint pain
    • Headaches
    • Breast soreness

There is an interactive guide on The Hormone Health Network where you can learn more about menopause symptoms. Just visit

Hormone treatments

Hormones are the most effective treatment for menopause symptoms. Estrogen, progesterone, or a combination of the two can safely be used in women without increased risks. Before beginning any treatment you need to discuss your personal history and risk factors with your provider. There is a lot of information available and a google search may leave you thoroughly confused and maybe even scared. Remember though that all medications, treatments, and even herbal supplements carry risks and benefits. You need a knowledgeable provider who can thoroughly assess your personal factors and discuss risks and benefits openly with you so that you can make a good decision about your treatment. There are bioidentical hormone options, chemically identical to the hormones naturally produced in your body. There are patches, creams, pills, and combination products. Some formulations decrease certain risks and some are more effective for certain symptoms. The bottom line is, like every other medication you may be prescribed, whether hormones are safe should be an individualized decision.

Non-hormonal treatments

While hormones are the most effective treatment for menopause symptoms some women may not be able to take hormones and there are other treatments available.

Some of these include

  • SSRIs – selective serotonin reuptake inhibitors like Prozac, paxil, or Lexapro
  • SNRIs – serotonin-norepinephrine reuptake inhibitors like venlafaxine or desvenlafaxine
  • Gabapentin
  • Clonidine

There are also some supplements, that while there isn’t a lot of research to support their use, many women have reported have provided them some relief from menopause symptoms. You can learn more about them at

Lifestyle factors

There are also some changes you can make in your lifestyle to help ease some of the symptoms you may experience during the perimenopausal period

  • Try to exercise 30 minutes 5 times a week
  • Maintain a healthy weight
  • Decrease your alcohol consumption
  • Manage stress
  • Stop smoking
  • Avoid caffeine and spicy foods as this can worsen hot flashes
  • Counseling for mood problems

Where to get more information/find support

North American Menopause Society has a lot of great information

My Restored Balance – comprehensive telehealth treatment programs for menopause symptoms and weight loss

Red Hot Mamas – lots of education and links to resources

Red Hot Mamas support group and discussion community

Hormone Health Network

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