During Perimenopause And Menopause Talk To Your Healthcare Provider If:
You begin to bleed between periods, especially if you have a history of polycystic ovary syndrome , are higher weight, have a family history of uterine cancer, or have taken estrogen-only hormone therapy or certain medications to prevent breast cancer .
You experience any spotting or bleeding after reaching full menopause
You experience bleeding during penetrative sex
How Can Your Doctor Help
If your symptoms are becoming unbearable and self-help tips and herbal remedies havent helped, it might be time to pay a visit to your doctor.
Traditionally doctors would recommend HRT for the menopause. HRT involves the introduction of medication that provides synthetic forms of the sex hormone oestrogen and progesterone. This can help with some symptoms of the menopause initially but for many women coming off of
HRT, they experience symptoms of the menopause all over again as a similar drop in hormones is apparent. HRT has also has some bad publication in recent years due to some of the associated side effects and health risks.
In some situations HRT might be necessary or recommended speak to your doctor for more information and in order to carefully discuss and consider your options.
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How Can I Treat The Symptoms
There are a bunch of ways.
Lifestyle changes. A healthy diet and regular exercise program will help manage your symptoms and boost your health. This is a great time to finally kick any old, unhealthy habits like smoking or drinking too much alcohol. To help with hot flashes, dress lightly and in layers. Avoid triggers like caffeine and spicy foods. And if you stay sexually active, that may help preserve your vaginal lining.
Prescription medication for hot flashes. If you still have your uterus, your doctor might prescribe treatment with estrogen and progesterone. This is called combination hormone therapy or hormone replacement therapy . It helps with hot flashes and night sweats, and it may help prevent osteoporosis. If you donât have a uterus, you might get estrogen alone.
Hormone therapy isnât for everyone. Donât take it if you’ve ever had breast cancer, uterine or “endometrial” cancer, blood clots, liver disease, or a stroke. Also don’t take it if you might be pregnant or you have undiagnosed vaginal bleeding.
If you can’t or don’t want to take hormones, other medications can ease symptoms. They include antidepressants, antiseizure drugs, or blood pressure medications to help with hot flashes and mood swings.
Prescription and OTC medication for vaginal dryness and sleep problems. You can try topical estrogen, lubricants, and non-estrogen prescriptions for dryness and painful sex. OTC or prescription sleep aids can help if you have trouble falling asleep.
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Hot Flashes & Night Sweats
Hot flashes and night sweats are common symptoms of perimenopause and menopause, with over 85% of women reporting hot flashes. Hormone changes affect your bodys internal thermostat. A hot flash feels like a wave or sensation of heat across your face, neck, and chest. It can last for several minutes. Hot flashes can happen a few times a day, a few times a week, or less often.
Hot flashes that happen at night are called night sweats, which can cause women to wake up drenched in sweat and disturb sleep. Women are more likely to report hot flashes at night.
Symptoms Of The Menopause
As the decline in hormones oestrogen and progesterone during the menopause is typically quite a gradual progress, it often involves fluctuations along the way. As a result of these fluctuations, a number of symptoms can arise:
- Heavy periods, with a shorter cycle As a result of the fluctuating hormones, and higher levels of oestrogen your periods might become heavier and come more often than every 28 days.
- Irregular periods, lighter flow Irregular periods are common in the lead up to the menopause. Your periods may become lighter and disappear for weeks or months at a time
- Hot flushes and night sweats Hot flushes and night sweats are common symptoms in the menopause. It isnt exactly clear why this happens but it is thought that fluctuating levels of hormones somehow interact with the temperature control centre in the brain, the hypothalamus
- Low libido A combination of mood swings and vaginal dryness as a result of low levels of hormones can affect your libido in the lead up to the menopause
- Weight changes Sex hormones can influence other hormones which are important for regulating your body weight stress hormones and metabolism regulating hormones can easily come under fire
- Mood swings Decreasing levels of hormones can affect your mood mood swings or episodes of low mood arent uncommon.
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What Age Is Considered Early For Menopause
If you reach menopause before age 40, that is considered premature menopause, says Faubion. This occurs in about 1 to 2 percent of women, she says.
Experiencing menopause at 40 to 45 years of age is called early menopause, and that occurs in about 5 to 7 percent of the population, so its safe to say that at least 7 percent of women are going to go through menopause early or prematurely, says Faubion. Menopause at age 46 or older is considered normal, she says.
When Will I Have My Last Period
It is very difficult to predict when you will experience your final menstrual period. On average, U.S. women who go through natural menopause, experience last periods at about age fifty one, but the range from forty to sixty years old is considered “normal.” If you smoke or if your mother had relatively early menopause , you are likely to have your last period earlier than average. If you are or have been poor, have relatively little formal education, or work in a blue-collar job, you are more likely to experience menopause at a younger age .
Having had your first period later than average is also associated with having an earlier menopause, as is never having been pregnant. If you drink alcohol, you are likely to have a later menopause than if you do not drink. Higher income, more education, and higher job status are also associated with later menopause . Women who have had one pregnancy have on average a slightly later menopause than those who have never been pregnant, and those who have been pregnant twice have a slightly later menopause on average than those who were pregnant only once, suggesting that the more pregnancies a woman has, the later her menopause.
Finally, women born later in the twentieth century are experiencing menopause later, on average, than those born earlier in the same century. This change may be because of improved nutrition.
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The Course Of Perimenopause
A change in your periods is often the first sign of perimenopause, but there are other signs to look out for. The most common are hot flashes, sleep problems, vaginal dryness, mood changes, and a decrease in sex drive. Not every woman will experience all of these symptoms. For those who have symptoms, they may come in any order.
Once these symptoms arrive, most women can expect menopause itself to be a few years away.
There are many treatments to help with bothersome symptoms like hot flashes and sleeplessness. Even a few years of hormone therapy can help you get through the worst of it.
If you are prone to anxiety or depression, know that perimenopause can bring those conditions back to the surface. Finding a support network can make a big difference. Antidepressants also may be an option.
Are There Any Tests For Menopause
The most accurate way to tell if it’s happening to you is to watch your menstrual cycles for 12 months in a row. It helps to keep track of your periods and chart them as they become irregular. Menopause has happened when you have not had any period for an entire 12 months.
Your doctor can check your blood for follicle stimulating hormone . The levels will jump as your ovaries begin to shut down. As your estrogen levels fall, youâll notice hot flashes, vaginal dryness, and less lubrication during sex.
The tissue in and around your vagina will thin as estrogen drops, too. The only way to check for this is through a Pap-like smear, but itâs rarely done. As this happens, you might have urinary incontinence, painful sex, a low sex drive, and vaginal itching.
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Should I Be On Birth Control During Perimenopause
Yes. If you do not want to become pregnant, you should use birth control during perimenopause. Even if you are getting your period every few months, you are still ovulating those months. Since its not possible to predict when you are ovulating, you should use birth control until you havent gotten a period for at least 12 months.
How Will I Know If I Am Starting The Transition To Menopause
Sometimes it can be hard for you and your doctor to tell whether you are in perimenopause, the transition to menopause:
- Symptoms: Tell your doctor or nurse about any menopause symptoms, such as hot flashes or trouble sleeping.
- Irregular periods: Track your periods. Irregular periods may be your first sign of menopause.
- Hormone levels: Your doctor may test the amount of hormones in your blood if your periods stopped at an early age . Doctors dont usually recommend this test unless there is a medical reason to do so. This is because, for most women, hormone levels go up and down in an unpredictable way during the transition to menopause. So it is difficult to tell for sure whether you have gone through menopause or are getting close to it based on this blood test.
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Are You Really In Menopause What Is Perimenopause
One possible explanation of a period in menopause is that youre not yet in menopause, but still in perimenopause.
During perimenopause , your menstrual cycles and periods gradually come to an end. The average length of perimenopause is four years and, during that time, your period can become irregular and there can be irregular bleeding between periods.
Just as periods maybe started out irregularly when you went through the changes of puberty, so they become irregular as you go through the changes of perimenopause. From a hormonal standpoint, perimenopause is characterized by irregular estrogen and progesterone levels.
Because of this gradual change, many individuals are unsure when perimenopause ends and menopause begins. In medical terms, menopause is confirmed 12 months after women have their last period.
Perimenopause: Rocky Road To Menopause
What are the signs of perimenopause? You’re in your 40s, you wake up in a sweat at night, and your periods are erratic and often accompanied by heavy bleeding: Chances are, you’re going through perimenopause. Many women experience an array of symptoms as their hormones shift during the months or years leading up to menopause that is, the natural end of menstruation. Menopause is a point in time, but perimenopause is an extended transitional state. It’s also sometimes referred to as the menopausal transition, although technically, the transition ends 12 months earlier than perimenopause .
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My Periods Have Changed Is Menopause Around The Corner
An ob-gyn explains the course of perimenopause.
Its a common scene in any ob-gyn practice: A patient comes in, concerned that her periods have changed. Whats going on? she asks. Is this menopause?
If youre a woman in your 40s, a change in your menstrual periods is the hallmark of perimenopause thats what we call the years leading up to your last menstrual period.
Heres a look at how we diagnose perimenopause and menopause, and what else to expect as you enter this phase of life.
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Of The Reproductive Journey
We usually diagnose menopause in hindsight, after that full year of absent periods. Ive found that most women know theyve reached menopause when they get there.
Even if your irregular periods turn out to be something else, youll face menopause eventually. Talk with your ob-gyn about what youre experiencing. Together we can work through this part of your health journey.
The views expressed in this article are those of Dr. Eisenberg and do not reflect the views of the National Institutes of Health, the Department of Health and Human Services, or the United States government.
Copyright 2021 by the American College of Obstetricians and Gynecologists. All rights reserved. Read copyright and permissions information.
This information is designed as an educational aid for the public. It offers current information and opinions related to women’s health. It is not intended as a statement of the standard of care. It does not explain all of the proper treatments or methods of care. It is not a substitute for the advice of a physician. Read ACOGs complete disclaimer.
Dr. Esther Eisenberg
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Lifestyle Factors To Support You During The Menopause
There are a number of easy self-help tips that you can try at home to help keep the symptoms of menopause under control:
- Diet During the menopause even very small changes in lifestyle factors can make a big difference for better or for worse! Try to reduce refined carbohydrates and sugary sweet treats as you can risk throwing your hormones off further, exacerbating cravings and encouraging weight gain. Eat plenty of fresh fruit and vegetables rich in vitamins and minerals, opt for whole grain sources of carbohydrates, up your intake of omega-3 with lots of oily fish and include a source of protein in every meal
- Think about drinks Its not just what you eat, but also what you drink that matters. Ensure you drink at least 1.5 litres of plain, still water a day to keep you hydrated and your bowels moving regularly. Also, try to avoid sugary drinks, alcohol and caffeine as much as possible as these can put a strain on the endocrine system and make you feel anxious or jittery
- Stress Stress can be exacerbated during the menopause so its important to not let it get on top of you. Practice breathing exercises, or try taking part in a yoga class after work, above all else make sure you take time out to do things you enjoy and take your mind off the stresses of modern life
- Exercise – Regular moderate exercise can help with many of the symptoms of menopause. It can help support your mood, sleep, body weight and often helps to keep pesky food cravings under control too!