Perimenopause and menopause are natural phases in a woman's life, marked by hormonal shifts that bring about significant changes physically and mentally. Understanding the distinctions between perimenopause and menopause, recognizing symptoms and exploring management options can help you navigate this time.
Difference between perimenopause and menopause
The average age of menopause in the United States is 51, with hormonal changes often starting years before. This stage is known as perimenopause, the transitional period leading up to menopause. Perimenopause can start as early as the mid-30s and last for several years. During this time, the ovaries begin to produce less estrogen and progesterone. This can lead to changes in your periods, such as heavier or lighter bleeding and irregular or skipped periods.
Perimenopause turns into menopause when menstrual periods have ceased in a woman, meaning that the ovaries have stopped producing eggs and estrogen levels have fallen significantly. Menopause is typically diagnosed after a woman has gone 12 months without a period.
Symptoms
The decreased estrogen levels during both phases impact various body systems, from head to toe. In addition to changes in your menstrual cycle, perimenopause and menopause can cause a variety of other symptoms, including:
- Hot flashes
- Night sweats
- Sleep problems
- Mood swings
- Vaginal dryness
- Weight gain
- Hair loss
- Skin changes
- Changes in libido
Testing and diagnostics
There is no single test that can diagnose perimenopause or menopause. Your doctor may order an FSH (follicle-stimulating hormone) blood test to measure your hormone levels but typically levels will not be elevated until you have gone several months without a period. The most important indicator for determining if you are perimenopausal or menopausal is to pay attention to how you feel both physically and mentally. Are you irritable? Having hot flashes? Experiencing anxiety or depression? Talk to your doctor about changes and any other symptoms you’re experiencing so he or she can recommend treatment options.
Treatment and lifestyle changes
The first step in managing symptoms of perimenopause and menopause is through lifestyle changes, including:
- Practicing mindfulness
- Regular exercise
- Eating a healthy diet
- Acupuncture
- Wearing layers
- Getting enough sleep
- Managing stress
- Avoiding smoking and alcohol
If lifestyle changes do not help to relieve your symptoms, talk to your doctor about treatment options. Treatment options include over-the-counter supplements, non-hormonal medications and hormone replacement therapy (HRT). Antidepressants are common non-hormonal medications prescribed to help with mood, sleep and hot flashes. While not primarily designed for this purpose, their impact on certain neurotransmitters can offer relief from some of the symptoms experienced during perimenopause and menopause.
Hormone replacement therapy (HRT) involves giving back a little of the estrogen that’s being lost. To help relieve your symptoms, your doctor will prescribe estrogen-only therapy or estrogen plus progestin therapy. Estrogen-only therapy is prescribed to women who have had a hysterectomy and no longer have a uterus. This is because when prescribed estrogen alone, there is an increased chance of uterine cancer. Women who still have a uterus are prescribed estrogen plus progestin, as the adding of progestin lowers the risk of developing uterine cancer back to normal. HRT can be administered via patch, pill, injections, vaginal ring or topically. Certain HRT treatments may increase the risk of some health conditions, so talk to your doctor to determine which treatment is right for you based on your medical history and symptoms.
Perimenopause and menopause are transformative phases in a woman’s life. At Endeavor Health, our Obstetrics & Gynecology team is here to support you and navigate this time successfully. To learn more, visit us online or call (773) 878-7787.
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