What can I expect with perimenopause and menopause, and what treatments are out there to make it better?

Menopause, is by definition, no menstrual periods for an entire year.  The median age of menopause in the U.S. is 51.  Perimenopause, is the time leading up to menopause where our ovaries start to slow hormone production, and that transition is, on average, about 5 years in length.  In addition to periods becoming irregular both in timing and amount of flow, common menopausal and perimenopausal symptoms include hot flashes, night sweats and difficulty sleeping, mood changes, brain fog, skin changes, and vaginal tissue changes that can lead to painful sex. 

The good news is there are treatment options available! 

Although not well studied Black cohosh, soy, and ginger are herbal supplements that can be helpful with the hot flashes and then there are prescription medications that are either hormonal or non-hormonal that can help with the menopausal symptoms.  In broad strokes, the estrogen containing products are best at managing the hot flashes and night sweats.  A word of caution, though, just because a hormone containing cream, pill or pellet comes from a medi-spa or is termed “bio-identical” does not mean that the product does not carry the same (or greater!) risks inherent to any hormonal pharmaceutical product.  Those risks include a slightly increased risk of stroke, blood clots forming in the legs and/or going to the lungs, heart disease, and a small increased risk breast cancer.  But there are some really great benefits to hormone replacement estrogen, such as improved bone health and decreased risk of colon cancer.  The non-hormonal prescriptions are often used for treatment of hot flashes but may not be primarily marketed for that use like certain antidepressants, seizure medicines, and blood pressure medicines.  There are, however, two FDA approved products specifically for the treatment of hot flashes that are hormone free (Brisdelle and Veozah).  For the vaginal and sexual changes due to menopause, there are hormonal and non-hormonal products targeted to help with that too.  (More on that later.) 

As always, ask your doctor what the best options are for you in light of your unique medical and family history.

Be encouraged!  Be empowered!