Perimenopause and Menopause

What is menopause?

Menopause is marked by the lack of menstruation for 12 months in a row. The average age for this to happen is 52 years old, although many women reach menopause in their 40s or later in their 50s.  It is rarely an abrupt change and women can experience perimenopause for up to 8-10 years before they are truly menopausal.

Symptoms of perimenopause can include:

• Irregular menstrual cycles. Cycles may come at shorter or longer intervals. The flow can vary as well.
• Hot flashes and night sweats
• Vaginal dryness and pain during sexual intercourse
• Mood swings
• Fatigue
• Poor sleep
• Weight gain which may be more age than perimenopause related
• Women can experience all or none of these symptoms during perimenopause.

Symptoms of menopause can include:

• The classic symptom is no menses for 12 months
• Menopause symptoms can include some or all of the symptoms listed for perimenopause. Mood swings though, may decrease after menopause.
• Some women notice “ brain fog” and a decreased ability to recall words. There can be several reasons for this, some of which relate to menopause.

Causes of menopause

Menopause is usually the natural result of aging and declined production of estrogen and progesterone by the ovaries, but other causes can include:

• Hysterectomy with removal of both ovaries
• Removal of the ovaries without hysterectomy
• Chemotherapy and/or radiation for cancer treatment
• Ovarian insufficiency, known as premature menopause, which usually occurs at over 40 years of age

The absence of menstruation for an entire year confirms menopause. Hormone levels are not helpful except in rare cases.

Treatment options for menopause

With guidance from a care provider, the following treatment options can help ease uncomfortable menopause symptoms:

• Hormone therapy, which could include medication that contains female hormones
• A new treatment which is non hormonal and works to regulate the brain’s temperature control center
• Contraceptive pills can be used in perimenopause for select individuals
• Some antidepressive medications can be helpful. They work on the temperature control center.
• Medication commonly used for chronic pain is a nonhormonal option
• Cognitive behavior therapy
• Mental health and emotional wellness support
• An incontinence medication can be but isn’t commonly used
• An antihypertensive can be but isn’t commonly used

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