Medically Reviewed by Andrea Caamano, Director Medical Affairs, The HRT Club
Perimenopause, or menopausal transition, is the time leading up to natural menopause. This phase often begins with the onset of menstrual irregularities, with the body undergoing significant hormonal changes that can lead to a variety of physical and emotional symptoms. These varying symptoms can present complex clinical management situations for providers, often leading to a tumultuous diagnosis process.
Duration of Perimenopause
Perimenopause can last for varying times and depends on numerous factors, but the median duration is four years. It often begins in a woman’s 40s but it can begin as early as the late 30s. Traditionally, perimenopause has an early and late stage. During the early stage, the menstrual cycle may be regular but there may be the onset of symptoms such as wight gain, sleep disturbances and hot flashes. During the late stage, the menstrual cycle becomes irregular with some months having little to no bleeding and other months having very heavy bleeding. There may be months at a time where there is no bleeding at all.
Symptoms of Perimenopause
Not all women experience symptoms of perimenopause, but most women have minimal or moderate issues. Symptoms occur in varying degrees among 75 percent of women.
The most common symptoms of perimenopause include hot flashes, night sweats, and insomnia. Additionally, mood swings, anxiety, and depression are often heightened.
The following symptoms may occur:
- Hot flashes
- Night sweats
- Insomnia
- Chills
- Vaginal dryness
- Mood swings
- Anxiety
- Weight gain
- Thinning hair
- Dry skin
- Slowed metabolism
- Migraines
- Brain fog
The symptoms may fluctuate and change throughout perimenopause and can be triggered by other factors like stress. Tracking your symptoms, as well as symptom severity, can help you and your provider formulate a viable treatment plan.
Treatment Options for Perimenopause
There is no way of stopping perimenopause, it’s a natural part of life. However, your healthcare provider may recommend ways of easing symptoms. The following treatment options may be recommended:
- Antidepressants: Help with hot flashes, mood swings, and depression
- Hormone Replacement Therapy (HRT): HRT increases your estrogen and progesterone levels to aid in balancing your hormones
- Birth Control Pills: Used to stabilize hormone levels and relieve symptom.
- Vaginal Creams: Your provider can inform you of prescription and OTC options. Vaginal creams can help decrease pain during sex and relieve vaginal dryness
Talk To Your Provider About Hormone Replacement Therapy
Hormone Replacement Therapy, or HRT, can provide relief through perimenopause and well into menopause. HRT can play an integral role in helping regulate hormonal imbalances. Talk to your provider about whether HRT is right for you or find a new HRT prescriber.
