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Community Womens Services

Perimenopause: A time of transition

Perimenopause is the time in a woman’s life when her body makes the transition between having monthly menstrual periods and entering menopause, the permanent end of her periods. As your body ages, your ovaries release fewer eggs, resulting in changing hormone levels and decreased fertility. While this is a natural process, each woman’s experience is different.

Photo of two womenFacing the change

Perimenopause often begins when a woman is in her 40s, but may occur as early as her mid-30s. Some women have mild symptoms, while others have more severe symptoms. Understanding menopause symptoms can help you deal with them more easily.

Mood changes — Changing hormone levels don’t lead directly to altered moods or irritability, but many women in midlife experience mood changes. Simple ways to cope include talking with friends or making time to relax every day. Talk with your doctor if you have sad moods that are prolonged or severe.

Hot flashes — Hot flashes occur possibly because of declining hormone levels. It helps to avoid hot flash triggers such as high temperatures, spicy food, alcohol and caffeine. Also, try dressing in layers you can remove.

Vaginal dryness — Lower estrogen levels can result in less vaginal lubrication, making sex uncomfortable. Try using an over-the-counter vaginal lubricant to improve the comfort of intercourse. Regular sexual activity can also help you avoid discomfort and dryness.

Sleep changes and night sweats — It’s common to wake up at night soaking from sweat followed by chills. You may also have trouble getting back to sleep or have insomnia. Wear cool pajamas to bed and keep an extra pair on hand for when you wake up. Avoid caffeine and try relaxation exercises to help reduce sleep disturbances.

Diet and exercise can help

Thomas A. Ferrara, M.D., a Community Health Network obstetrician/gynecologist, recommends practicing overall good health habits to help relieve the symptoms of perimenopause. “Women often forget strength training as part of a focused exercise regime. I recommend carrying free-weights while walking,” says Dr. Ferrara.

The HRT debate

Until recently, hormone replacement therapy (HRT) was thought to be a fairly safe alternative for women dealing with menopausal symptoms. However, a study within the National Institutes of Health’s Women’s Health Initiative was stopped in 2002 when it revealed that HRT increased the risk for breast cancer and other diseases.

Despite these findings, experts believe that HRT can be suitable for short-term relief of severe menopausal symptoms. “I recommend HRT for relief of perimenopausal symptoms such as hot flashes and mood swings,” says Stuart Fraley, M.D., a Community Health Network obstetrician/gynecologist. “For postmenopausal patients, we discuss steps they can take to help prevent osteoporosis. It’s important to have those discussions with your physician.”

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