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Menopause & Perimenopause
Symptoms and Treatments for Women in Massachusetts
As you move into your 40s and 50s, you’re likely to notice the changes occurring to your body. Even as women enter the stage of life known as menopause, they may not know much about what to expect. Take a look at this overview to understand what menopause and perimenopause actually are, why menopause occurs, what symptoms you can expect and what you can do to alleviate them.
What Are Menopause and Perimenopause?
Menopause is the stage of life women reach when their ovaries cease to release eggs due to a drop in the production of estrogen, the primary female hormone. This in turn causes menstrual periods to stop. Once you go consecutive 12 months without a menstrual period, you’ve reached menopause.
American women reach menopause at an average age of 51. However, it can begin earlier if you smoke, have had a hysterectomy, have undergone chemotherapy or radiation treatments or if early menopause runs in your family.
Perimenopause is the transitional stage that precedes menopause. It typically begins sometime in a woman’s 40s, though some women start to experience it in their late 30s. Perimenopause usually lasts a few years, though for some women it can last as little as a few months or as long as 10 years.
During perimenopause, your estrogen levels fluctuate, causing hormonal imbalance. As a result, your menstrual cycles are likely to become uneven and somewhat unpredictable. While it’s possible to become pregnant during perimenopause, it’s rare.
During the later stages of perimenopause, women begin skipping periods as their estrogen levels decline dramatically. The most marked menopausal symptoms begin at this time, usually about 6 months before the woman’s periods finally stop completely. Once your periods stop, you are no longer able to get pregnant.
Menopause is a natural occurrence that comes with aging and isn’t considered a disease. However, it can be accompanied by some uncomfortable symptoms, and the reduction of estrogen that occurs during menopause is associated with some significant medical conditions, including osteoporosis and heart disease.
Symptoms of Perimenopause and Menopause
Some symptoms you may experience during perimenopause and menopause are quite obvious — you’re likely to notice when your periods stop, for instance. Others may be less noticeable, and you may not realize what you’re experiencing is actually a result of menopause. Among the most common symptoms are the following:
Irregular Periods
During perimenopause, you may find that your periods are less predictable than they’ve been for most of your life. As you transition from perimenopause to menopause, you may skip a period or two. The heaviness of your menstrual flow may also vary.
Hot Flashes
You may experience these as a sudden increase in body heat, especially in your face, for several minutes at a time. Hot flashes are often accompanied by sweating and followed by chills as your internal thermostat resets. They typically begin during perimenopause and last up to 5 years — though some women experience them throughout menopause. When hot flashes occur while sleeping, people refer to them as night sweats, and they can interrupt sleep.
Vaginal Atrophy
As estrogen levels drop, the vagina loses elasticity and moisture, and its walls start to thin. This drying of the vagina often makes sexual intercourse painful. You may become more prone to urinary tract infections, vaginal infections, urinary incontinence and itchiness around the vagina as a result.
Mood Swings
During perimenopause, many women begin to experience irritability and even depression. These mood changes may be exacerbated by sleep disturbances caused by hot flashes and night sweats. Women who have experienced severe PMS throughout their lives may be at greater risk of developing clinical depression during perimenopause and menopause. During the postmenopausal years, though, mood swings and depression can lift.
Weight Gain
The hormonal imbalance of menopause often leads to weight gain in many women, typically beginning in the late 40s and early 50s. Weight distribution also changes. Instead of weight clinging to the hips and thighs, women tend to gain weight around the abdomen/belly during menopause, leading them to lose their waistlines and develop an “apple” shape. This body shape puts women at risk for diabetes and heart disease, among other health issues.
Other symptoms that some women experience during perimenopause and menopause include:
- Increased PMS
- Changes in hair texture and volume
- Breast tenderness
- Headaches
- Heart palpitations
- Insomnia
- Decreased sex drive
- Difficulty concentrating
- Fatigue
- Dry skin and changes in skin texture
Health Risks Associated With Menopause
When estrogen declines during menopause, the risk of several health problems increases. Many of these health conditions carry no observable symptoms, so women in menopause may not even be aware that they’re at risk.
During menopause, the risk of heart disease increases due to the drop in estrogen. This is largely a result of the increase in LDL (or “bad”) cholesterol with a concomitant decrease in HDL (or “good”) cholesterol levels caused by the decline of estrogen.
In addition, women start to lose bone density as they age and lose estrogen. They may develop osteoporosis, with bones becoming thin and weak, without knowing. Their bones are more likely to break, with a particular risk for spine fractures and tooth decay due to bone loss in the jaw.
When To See a Doctor for Menopause Symptoms
Many women feel they should tolerate the perimenopausal and menopausal symptoms they experience. However, there’s no need to suffer if those symptoms are interfering with your daily life or your sense of well-being. Treatments are available to help you cope with everything from mood swings and hot flashes to discomfort with sexual intercourse.
Call your doctor if your symptoms are causing you enough discomfort to affect daily life. And definitely seek medical help if you experience blood clots during your period, excessively long or heavy periods, bleeding after sex or spotting when you don’t have your period. These symptoms may have causes that require medical attention.
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Help for Women in Massachusetts
Menopause Treatment Options
While hormone replacement therapy remains the top choice of treatment for most women experiencing menopausal symptoms, other options may also be of some help.
Estrogen and Hormone Replacement Therapy
Hormone replacement therapy delivers estrogen or a combination of estrogen and progestogen to boost your hormone levels after your body reduces its production of estrogen. (Estrogen alone is used for women who don’t have a uterus, typically as a result of a hysterectomy.)
This therapy normalizes your estrogen levels so you don’t experience symptoms caused by the hormonal imbalance of menopause. It reduces or does completely away with symptoms such as hot flashes and mood swings, and it can reduce the risk of osteoporosis.
Your doctor will prescribe estrogen in any of several forms. While most women prefer the ease of taking a pill, estrogen skin patches, gels and creams are also available.
Lifestyle Remedies
Various lifestyle changes can also help you decrease menopausal and perimenopausal symptoms. Try some of these options to see if they help you feel better:
- Exercising can help with weight gain, mood swings, sleep disturbances and even hot flashes.
- Practicing good sleep habits, including a regular sleep routine and relaxing activities before bedtime, can help with insomnia
- Avoiding spicy foods, caffeine, alcohol and hot drinks can help you minimize hot flashes
- Lowering the temperature in your home can help with night sweats
- Using over-the-counter vaginal moisturizers and lubricants can alleviate vaginal dryness
Other Medications
While hormone replacement therapy treats most of the major symptoms of menopause simultaneously, other pharmaceutical treatments target specific symptoms. Prescription and over-the-counter options include:
- Vaginal creams to minimize dryness and painful intercourse
- Vitamin D and calcium to decrease the risk of osteoporosis
- Antidepressants to regulate mood swings
- Neurontin (a prescription seizure medication) to treat hot flashes
- Supplements, including black cohosh and dong quai, to treat hot flashes — though they may not be effective and may have dangerous complications
- Clonidine (a prescription blood pressure medication) to treat hot flashes
- Testosterone to treat loss of sex drive and boost bone density
- Osphena (a non-hormonal prescription medication) to treat vaginal dryness
Many of these medications have side effects, so you should discuss them thoroughly with your doctor before trying them.
