Whether it is puberty, pregnancy or menopause, hormonal changes will occur in all women at certain stages of their lives. As women age, menopause becomes a natural occurrence.
“Perimenopause marks the interval in which a woman’s body begins its transition into menopause and can usually last anywhere from 10 months to 10 years,” says Barry Jacobson, M.D., chairman of the Department of Obstetrics and Gynecology at Delaware County Memorial Hospital.
Even though perimenopause is a precursor to menopause, many of the symptoms are the same.
“Some signs that perimenopause is approaching can include irregular and unpredictable periods, hot flashes, headaches, mood swings, fatigue, anxiety, diminished libido, vaginal dryness and weight gain,” says Joel Noumoff, M.D., chairman of the Department of Obstetrics/Gynecology and chief of the Division of Gynecologic Oncology at Crozer-Chester Medical Center. “These symptoms can start as much as 10 to 15 years before menopause and can start as early as age 35. Women experience these symptoms due to their body’s fluctuating and gradually decreasing hormone levels.”
Menopause, which is the gradual process of hormonal changes at which a woman’s menstrual period stops, occurs in most women around age 50. A woman is experiencing menopause when her period stops for 12 months in a row. Any bleeding after six months without a period should be reported to your health care provider.
“The big difference between perimenopause and actual menopause is the absence of a menstrual period,” Jacobson says. “Because an often irregular period occurs, a woman can conceive in the perimenopausal time. However, as women age, there is a smaller chance of becoming pregnant.”
Fortunately, many of the symptoms associated with perimenopause and menopause are temporary and can be treated. In addition to the often used prescription drugs, such as hormone replacement therapy, there are certain home remedies that can be used to treat menopausal symptoms.
According to the Mayo Clinic, exercising and eating healthy may reduce some symptoms. Wearing layered clothing can help with hot flashes; and a vaginal lubricant is recommended for decreasing vaginal discomforts. Also, getting plenty of rest, practicing relaxation techniques, such as deep breathing; and avoiding caffeine may also help.
“There are some medical treatments that can help to alleviate some of the symptoms of perimenopause and actual menopause,” Jacobson says. “Estrogen therapy remains, by far, the most effective option for relieving menopausal hot flashes. Other than that, over-the-counter phytoestrogens, which are plant compounds that act as estrogen, such as Remifemin, Promensil and Estroven, can help to treat mild symptoms.”
Even though it may be help to alleviate some menopausal or perimenopausal symptoms, hormone replacement therapy (HRT) also has risks.
“The risks vary depending on the age at which the therapy is initiated, the preexisting risk factors for each woman, and the length of time that the therapy is continued,” says Rebecca Choitz, CNM, director of Midwifery Services for Crozer-Keystone Health System and a member of the Midwives of Delaware County. “Women who choose to use HRT should use the lowest effective dose for the shortest time possible and should have regular medical supervision.”
Recent studies have shown that the risks of HRT may outweigh the benefits. Women should talk with their OB/GYN or midwife about their medical history and whether or not HRT is right for them.
“Having a positive attitude can make a difference in how a women experiences menopause,” Noumoff adds. “Because it is simply a phase in a woman’s life, the hot flashes, moodiness, irregular periods and other discomforts do eventually come to an end.”
For more information or to schedule an appointment with a Crozer-Keystone physician or midwife, call 1-800-CK-HEALTH (1-800-254-3258) or visit www.crozer.org.