Perimenopause Q&A

What is perimenopause?

Perimenopause is the transitional phase before menopause when a woman’s body begins to undergo changes as it nears the end of reproductive years. It typically starts in the 40s but can begin in the 30s or even earlier. This phase can last anywhere from a few months to over a decade.

What are some symptoms I should be aware of?

Symptoms can vary widely but commonly include:

• Irregular periods
• Hot flashes and night sweats
• Mood swings and irritability
• Sleep disturbances
• Joint pain
• Vaginal dryness
• Decreased libido
• Fatigue
• Weight gain, especially around the abdomen
• Thinning hair and dry skin
• Breast tenderness
• Memory problems and difficulty concentrating

What causes perimenopause?

Perimenopause is caused by fluctuating hormone levels. These hormonal changes can lead to the symptoms associated with perimenopause.

How is it diagnosed?

At Xena Health, we provide diagnosis through:

• A detailed medical history and discussion of symptoms
• Evaluation of menstrual cycle patterns
• Blood tests to measure hormone levels, including estrogen, progesterone, and follicle-stimulating hormone (FSH)
• Physical examination

What are my treatment options?

Treatment options at Xena Health are tailored to manage symptoms and improve quality of life:

• Hormone Therapy: hormone replacement therapy (HRT) is the gold standard for treatment and can help manage the majority of symptoms to include hot flashes, night sweats, joint pain, mood and libido.  Low-dose birth control pills can help for women that are still ovulating and can help with irregular periods.
• Vaginal Estrogen: Creams, tablets, or rings that deliver estrogen directly to the vaginal area can help relieve vaginal dryness and discomfort during intercourse.
• Non-Hormonal Medications: some women experience relief with antidepressants, estrogen receptor modulators, and gabapentinoids can help manage hot flashes and mood swings.
• Lifestyle Changes: Regular exercise, a balanced diet, maintaining a healthy weight, avoiding triggers and quitting smoking can help alleviate symptoms. 
• Alternative Therapies: Acupuncture, yoga, and herbal supplements like black cohosh and phytoestrogens may provide symptom relief for some women, although scientific evidence varies.
• Counseling and Support: Therapy or support groups can help manage mood swings, anxiety, and depression.  Cognitive behavioral therapy has shown some efficacy for symptom relief.  

How can I manage symptoms at home?

Managing symptoms at home includes:

• Maintaining a regular exercise routine
• Eating a healthy diet rich in fruits, vegetables, and whole grains
• Practicing stress-reduction techniques like meditation, yoga, or deep-breathing exercises
• Keeping cool at night to manage night sweats
• Using lubricants with intercourse to alleviate vaginal dryness
• Ensuring good sleep hygiene by maintaining a regular sleep schedule and creating a restful environment

When should I seek medical advice for perimenopause?

Seek medical advice from Xena Health if you:

• Experience disruptive symptoms that affect your quality of life
• Have irregular or heavy bleeding
• Experience symptoms of depression or anxiety 
• Need personalized advice on hormone therapy or other treatments.

Visit our Blog on Navigating Perimenopause for more insightful information.