Menopause marks the end of a woman’s menstrual cycles and fertility and is considered to have occurred after a woman has not had a period for one year. It can happen during a woman’s 40s or 50s; the average age for the onset of menopause is 51. Following the onset of menopause, the risk of chronic diseases, such osteoporosis and heart disease, increases.
Perimenopause, the period of time when a woman’s body is making the transition to menopause, can take a few months up to a decade. The uneven rise and fall of hormones during perimenopause can cause a variety of symptoms:
- Irregular periods
- Hot flashes
- Sleep problems
- Vaginal and bladder problems
- Decreasing fertility
- Changes in sexual function
- Loss of bone
- Changing cholesterol levels
Although many women are able to tolerate the symptoms of perimenopause, for some, the symptoms can be severe and disruptive to daily life, usually in the two to three years immediately preceding menopause. A number of treatment options exist, including:
- Hormone Replacement Therapy is the most effective treatment option for women with moderate to severe symptoms. A low-dose treatment of either estrogen alone or estrogen and progestin (a synthetic form of progesterone), depending on the patient’s history, can be taken safely for up to five years. Hormones are available as a pill form, gel, cream or patch. For symptoms isolated to the vagina, a vaginal cream or ring are also available.
- Certain Low-dose Anti-depressants have been shown to decrease menopausal hot flashes and may be helpful for women for whom estrogen therapy is not recommended.
- Gabapentin (brand name: Neurontin) is approved to treat seizures, but has also been found to help reduce hot flashes and may be useful for women who also have migraines and those for whom estrogen therapy is not recommended.
- Osteoporosis treatment options include calcium and Vitamin D and prescription medications. Learn more about osteoporosis.
- Urinary incontinence treatments can range from lifestyle changes up to surgical procedures. Learn more about urinary incontinence.
- Treatments for Heavy Bleeding can include endometrial ablation or hysterectomy.
If you experience symptoms that are severe or disrupt your well-being or concern you, talk to us about possible treatment options.
New York Times Magazine: Women Have Been Misled About Menopause, February 2023
New York Times Magazine: 5 Things to Know About Menopause and Hormone Therapy, February 2023