PERIMENOPAUSE

by Dr. Krystal Murphy

Perimenopause and Menopause are natural events. However, the body undergoes some major changes during this time. Menopause is the time in a woman’s life when she naturally stops having menstrual cycles. This signals the end of her reproductive years. The time leading up to menopause is called perimenopause. These changes may cause some bothersome symptoms, although many women only have a few symptoms.

Many women wonder what causes the body to undergo such a drastic change. During childbearing years, monthly changes in estrogen and progesterone control the menstrual cycle. These hormones are created by the ovaries. As a woman ages, the ovaries make less estrogen. The decrease in estrogen causes perimenopausal symptoms, typically starting with a change in the menstrual cycle. Cycle length and heaviness may vary from the norm. Some women have shorter cycles or skip them altogether. Although these cycle changes are normal as menopause approaches, these symptoms should still be discussed with a healthcare provider because abnormal vaginal bleeding could indicate a problem. Call a provider to discuss bleeding between menstrual cycles, bleeding after intercourse, intermittent spotting, heavy or prolonged vaginal bleeding or bleeding after menopause. It is important to note that even if a woman no longer has a uterus, but still has ovaries, she may show signs and symptoms of perimenopause.

Some women suffer from more bothersome signs and symptoms of perimenopause. Some women have hot flashes and night sweats. A hot flash is a sudden feeling of overwhelming heat that rushes to the upper body and face. It can cause the skin to turn red or may cause sweating. While some hot flashes only last a few seconds, others may last several minutes. Hot flashes may cause sleep disturbances in perimenopausal women.

Other women may suffer from recurrent vaginal and urinary tract infections. As estrogen levels in the body decrease, vaginal tissue gets thinner and dryer. This may cause recurrent vaginal infections or pain with intercourse. Hormonal changes in the body also affect the urethra. The urethra can become dry and irritated. Some women have urinary frequency or recurrent urinary tract infections because of these changes.

To relieve these symptoms, many women see a gynecologist for treatment of perimenopause. Some providers recommend hormone therapy. Hormone therapy helps treat bothersome symptoms like hot flashes, vaginal dryness or pain with intercourse. Some hormone therapy helps prevent hip and spine fractures, as well as reduces the risk of some cancers. Your provider will discuss these benefits, but also the risks associated with hormone therapy. These risks include possible cancer risks, slightly increased risk for heart attack and possible risk of stroke, deep vein thrombosis (DVT) or other blood clot formation.

Other treatment options are available to treat perimenopausal symptoms. Certain medications, like antidepressants and blood pressure medications, can be used to reduce hot flashes and sleep disturbances. Vaginal moisturizers and water based lubricants are over-the-counter products that can help improve vaginal dryness and pain with intercourse.

Estrogen produced by a woman’s ovaries helps prevent bone loss, heart attacks and stroke. When these estrogen levels decrease, the risk for bone loss, heart attacks and stroke increases. Taking Vitamin D and Calcium supplementation is important to prevent bone loss and maintain bone health. Healthy lifestyle choices, like healthy eating and exercise, reduce heart attack and stroke risk. Routine annual exams give you a chance to sit down with your provider and discuss any changes or problems you may be facing. If you are showing signs of perimenopause or have questions about treatment for hormone changes, call ProCare Women’s Clinic at (432) 640-2491 to schedule an appointment.

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