Perimenopause and Menopause
Thanks to evolving and well-documented research, we now know that women can begin to experience the effects of the menopause-related changes as early as their 30s.
A woman officially enters menopause when she has not had a period for a full year. The average age of menopause in the U.S. is 52, which means that half of women enter menopause before the age of 52, and half at older than 52. Perimenopause can begin up to eight years before menopause. Given the variation of ages at which menopause begins, perimenopause follows suit with women seeing changes anywhere from their late 30s to mid-40s.
Causes/Symptoms
Although menopause is associated with a drop in estrogen, perimenopause is characterized by drops in progesterone, leading to signs of estrogen overload rather than deficiency. During this phase, some women notice a number of changes, including:
- Trouble sleeping
- Exaggerated PMS (increased breast tenderness, water retention)
- Nervous system irritability
- Fatigue and hot flashes
- Hot flashes
- Night sweats
- Vaginal dryness
- Insomnia
- Lighter or skipping menses
- Depression and anxiety
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Self-care Treatment
Amidst our hectic lives, the things we may have let slide – workouts, nutritious meal-planning, a good night’s sleep – can exacerbate hormonal changes. Women should start by getting educated about what is going on with their bodies and then determining what they want to do about symptoms or changes that concern them. Of course, this begins with the basics – eating right, not smoking, exercise sleep, and balancing work and fun. The changes we make around these areas can have a dramatic impact on well-being regardless of hormone fluctuations.
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Hormone Therapy and Bio-identicals
These days most women and their doctors view hormone therapy as a last resort for perimenopausal and menopausal symptoms. The prevailing belief at this point is that hormone therapy is still useful but should be administered in the lowest dose possible for the shortest amount of time. Experts encourage women to weigh their risks of hormone therapy with their doctors on an individual basis.
Bio-identical hormones are available in both FDA pharmaceutical form (e.g., estradiol) and in a number of non-regulated forms. Although the FDA and many physicians warn against non-regulated, alternative bio-identicals like estriol, the FDA-approved estradiol, particularly when used as a patch, is the treatment of choice for most practitioners.
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More Health Information
Health Library | Learn more about perimenopause and menopause
Health Library | Exams and test
Health Library | What happens in perimenopause and menopause
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