Understanding Perimenopause
Perimenopause, often referred to as the menopausal transition, is a natural phase in a woman's life marking the end of her reproductive years. This period is characterized by hormonal fluctuations leading up to menopause: the point when menstrual cycles cease permanently. Understanding perimenopause is crucial, as it encompasses a range of physical discomfort and emotional changes that can significantly impact a woman's quality of life.
Common Symptoms of Perimenopause
Most women experience a number of perimenopause symptoms as their body transitions out of fertility and into menopause. Some symptoms of perimenopause that you may experience include hot flashes, breast tenderness, worsening PMS, low libido, vaginal dryness, fatigue, mood swings, sleep disturbances, and urinary leakage and urgency.
Symptoms experienced during perimenopause are diverse and can vary in intensity. It's important to note that while these symptoms are common, their presence and severity vary among individuals.
Though many women find these symptoms distressing, there’s no reason to worry. These are common, natural bodily responses to decreasing estrogen, and they are very treatable. Don’t worry that you won’t ever again have your same quality of life - you can!
Common symptoms include:
Irregular Periods: Menstrual cycles may become unpredictable, with variations in flow and frequency. This can be related to hormonal changes or other causes. It is important to find out the underlying cause of this type of irregular bleeding to determine the best treatment plan.
Hot Flashes / Night Sweats: Sudden feelings of heat, often accompanied by sweating, can occur during the day or night. These symptoms can be mild and rare or significantly affect a woman’s day or night, which in turn negatively affects her ability to take care of daily work, activities, and family. Depending on individual symptoms and medical history, there are multiple options to help with these symptoms.
Sleep Disturbances: Difficulty falling or staying asleep, often due to night sweats, leading to fatigue. Sleep is a complicated problem that has many contributing factors. Aging, hormonal changes, and night sweats can add to this. Treatment will depend upon the underlying causes.
Mood Changes: Increased irritability, anxiety, or risk of depression may be experienced. Depression is more common in women and abrupt changes in hormones can cause worsening symptoms, which in turn can cause irritability. Treatment may include lifestyle changes, exercise, and medication.
Vaginal Dryness and Discomfort: Decreased estrogen levels can lead to vaginal dryness, making intercourse uncomfortable. When estrogen declines, the cells lining the walls of the vagina change and thin out. This may cause decreased lubrication and sometimes even painful intercourse. Over the counter lubricants, hyaluronate gels, replacement of estrogen in the vagina, and/or laser vaginal therapy can significantly improve this.
Decreased Libido: A reduction in sexual desire is common during this transition.
Urinary Issues: Increased frequency or urgency of urination and a higher risk of urinary tract infections.
Cognitive Changes: Difficulty concentrating and memory lapses, often referred to as "brain fog." Hormone changes, especially abrupt ones, can cause this to be pronounced. Hormonal treatment options may improve this.
Physical Changes: Weight gain, particularly around the abdomen, and changes in hair and skin texture.
Diagnosis of Perimenopause
Diagnosing perimenopause primarily involves evaluating symptoms and menstrual history. A doctor or Healthcare providers such as ours at NoreHealth will conduct blood tests to measure hormone levels, though these are not always necessary. A comprehensive assessment helps in distinguishing perimenopause from other conditions that may cause similar symptoms.
Treatment for Perimenopause & Support Therapies
Managing perimenopausal symptoms often requires a multifaceted approach tailored to the individual's specific experiences and health profile.
Perimenopausal symptoms such as hot flashes, vaginal dryness, sexual dysfunction, and others can be alleviated using one or a combination of therapies offered at our various Nore Women’s Health locations. Our compassionate providers are dedicated to supporting women as they navigate the exciting and sometimes challenging journey of perimenopause.
Lifestyle Changes. Believe it or not, perimenopause can lead to you being in the best shape of your life, because diet and exercise help alleviate many perimenopausal symptoms. Your Nore provider will create a diet and exercise plan that fits into your lifestyle, helping you look and feel better all around. Adopting healthy lifestyle habits can alleviate some perimenopausal symptoms:
- Diet: Consuming a balanced diet rich in fruits, vegetables, whole grains, and lean proteins supports overall health. Limiting caffeine and alcohol intake may reduce hot flashes.
- Exercise: Regular physical activity helps maintain a healthy weight, improves mood, and promotes better sleep.
- Stress Management: Mind-body practices and techniques such as yoga, meditation, and mindfulness have been shown to reduce stress, improve mood, and help with sleep issues. Regular practice of these mind-body activities can also promote overall mental and emotional well-being during perimenopause.
Hormone Therapy: HRT or BHRT
Hormone replacement therapy (HRT) involves supplementing estrogen, and sometimes progesterone, to alleviate symptoms caused by hormonal fluctuations. It may not be suitable for everyone
- Systemic Hormone Therapy: Estrogen can be administered in various forms, including pills, patches, gels, or sprays, to address multiple symptoms like hot flashes and night sweats. For women with an intact uterus, progesterone is added to reduce the risk of endometrial cancer.
- Vaginal Estrogen: Low-dose estrogen preparations in the form of creams, tablets, or rings can effectively treat vaginal dryness and urinary symptoms with minimal systemic absorption.
Bioidentical Hormone Therapy. Perimenopause symptoms are caused by lower hormone levels than you’re used to. Bioidentical hormones are compounds that are chemically identical to the hormones produced by the human body. Bioidentical Hormone Therapy replaces those missing hormones with natural, plant-derived substitutes, helping to alleviate symptoms like low libido, lack of energy, irritability, and anxiety/depression. Bioidentical hormone therapy (BHT) is available in both FDA-approved forms and compounded versions from specialized pharmacies.
Learn more about Nore's Bio-identical Hormone Therapy.
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Read MoreNon-Hormonal Medications
For those who cannot or choose not to use hormone therapy, other medications may provide relief:
- Antidepressants: Certain selective serotonin reuptake inhibitors (SSRIs) and serotonin-norepinephrine reuptake inhibitors (SNRIs) can reduce hot flashes and improve mood.
- Gabapentin: Originally used to treat seizures, gabapentin has been found to alleviate hot flashes, particularly those occurring at night.
- Fezolinetant: A newer, hormone-free medication that works by blocking a pathway in the brain responsible for regulating body temperature, thereby reducing hot flashes.
Vitamin Therapy
Vitamins and perimenopause supplements can help ease some perimenopause symptoms as well as enhance your overall health.
If you decide to try Vitamin therapy, Nore’s expert providers will first perform a comprehensive Micronutrient Test to identify any nutritional deficiencies. Then, they’ll recommend Vitamin IV Therapy, Vitamin Injections, and/or Vitamin Supplements tailored to your specific needs.
Specific vitamins and minerals can help address common symptoms and support overall well-being:
- Calcium and Vitamin D: Bone density more rapidly during perimenopause, resulting in bone loss and increasing the risk of osteoporosis. Calcium and vitamin D play essential roles in bone health. Women in perimenopause are often advised to increase their intake of both, either through diet or supplements, to support bone density and strength.
- B Vitamins: B vitamins, including B6 and B12, can support energy levels and reduce fatigue, which is common during perimenopause. They also play a role in supporting mental clarity and mood stability.
- Vitamin E: Some studies suggest that vitamin E may help alleviate hot flashes in perimenopausal women. This vitamin has antioxidant properties, which can help protect cells from oxidative stress, an important factor in aging and general health.
- Magnesium: Magnesium can assist with muscle relaxation, improve sleep, and reduce stress, making it beneficial for women experiencing sleep disturbances or anxiety during perimenopause.
- Omega-3 Fatty Acids: Found in fish oil and flaxseed, omega-3 fatty acids have anti-inflammatory properties and can support cardiovascular health. They may also aid in reducing mood swings and enhancing cognitive health.
Vaginal Rejuvenation
Vaginal rejuvenation refers to various medical treatments designed to improve vaginal health and function, particularly for women experiencing symptoms like dryness, discomfort during intercourse, or urinary incontinence due to hormonal changes in perimenopause. Vaginal rejuvenation treatments can include both non-invasive and minimally invasive options:
- Laser and Radiofrequency Treatments: Technologies like CO2 lasers and radiofrequency devices are used to stimulate collagen production in the vaginal tissues. This process helps to increase elasticity, improve lubrication, and may help relieve urinary symptoms. These treatments are generally done in-office with minimal downtime and can be effective in reducing discomfort and restoring function.
- Platelet-Rich Plasma (PRP) Therapy: PRP involves drawing a small amount of the patient's blood, processing it to concentrate the platelets, and then injecting it into the vaginal tissues. Platelets release growth factors that stimulate tissue repair and regeneration, which may help with lubrication and reduce discomfort.
- Estrogen Creams or Rings: Topical estrogen cream treatments are another option for addressing vaginal dryness and atrophy. These are not technically rejuvenation procedures, but they help maintain tissue health and hydration by directly supplying estrogen to the vaginal area with minimal systemic absorption.
NoreHealth’s non-surgical vaginal rejuvenation therapies can provide much- needed relief for common vaginal perimenopause symptoms like dryness, pain, loss of tone or sensation, and overactive bladder. These symptoms may affect not only your quality of life but a sense of self, as well. There’s no reason to suffer when simple, non-surgical vaginal health therapies are available!
Each vaginal rejuvenation option has unique benefits, and the choice depends on the individual's specific symptoms and preferences. Consultation with one of our qualified healthcare providers will help you determine the most appropriate treatment and to discuss potential risks, benefits, and costs.
Herbal Supplements
Some herbs, such as black cohosh, red clover, and evening primrose oil, are traditionally used to manage menopausal symptoms. While some women report symptom relief, clinical evidence on their effectiveness is mixed, and potential side effects or interactions should be discussed with a healthcare provider.
Questions About Perimenopause
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NORTHMEADOW MEDICAL CENTER
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