Natasha Alligood-Percoco

Women in their 30s and 40s may begin noticing physical and emotional symptoms related to changing levels of various hormones produced by the ovaries. Women in this age group also begin experiencing bone loss due to declining levels of estrogen. Women feeling these changes may ask themselves, “Is this perimenopause?”

What Is

Perimenopause?

Perimenopause is a natural transition that leads to menopause, and while the symptoms can be disruptive, there are treatment options available. Your OB-GYN can help you navigate this stage of life with personalized care and evidence-based treatments. Perimenopause ends once you’ve gone 12 months without a menstrual period, which marks the beginning of menopause. The average age of natural menopause is 51-52 years, although some women may experience menopause early due to surgery, chemotherapy, or natural causes.

Common symptoms of perimenopause include:

— Changes in menstrual bleeding

— Hot flashes and night sweats

— Vaginal dryness or pain with sex

— Difficulty sleeping

— Mood changes

— Decreased libido

— Difficulty concentrating or memory issues

— Weight gain

In perimenopause, symptoms are often mild and cyclic. In menopause, the same symptoms may become more severe and persistent. It’s important to know that symptoms can vary one woman to the next. Some may only notice mild changes, while others may experience more significant disruptions to their daily life.

When to Talk to Your OB-GYN

While these changes are a normal part of aging, you don’t have to just “tough it out.” If symptoms are interfering with your quality of life, it’s a good idea to speak with your OB-GYN.

During your visit, your doctor will take a complete health history, ask about your symptoms, and may perform bloodwork or other tests to rule out other conditions, like thyroid problems. From there, you can discuss the best treatment plan for your needs and health profile. It is not typically helpful to check hormone levels such as estrogen in perimenopause, as these levels fluctuate and do not guide treatment.

Is Hormone Replacement Therapy Right for You?

Hormone replacement therapy (HRT) is indicated for the treatment of hot flashes and night sweats in menopause, the phase of life that follows perimenopause. HRT is not indicated in perimenopause, when women are still ovulating and producing their own reproductive hormones. HRT is the most effective treatment for hot flashes and night sweats, and also helps to relieve vaginal dryness and pain with sex. Other benefits of HRT include protection against osteoporosis and bone fractures, and protection against colon cancer. HRT isn’t appropriate for everyone, and may not be recommended if you:

— Have a history of breast cancer or certain other cancers

— Have a history of blood clots, stroke, or heart disease

— Have liver disease or unexplained vaginal bleeding

— Are not yet in menopause

What Non-Hormonal

Treatments are Available?

There are many effective, non-hormonal treatments that target the various symptoms of perimenopause and menopause. For weight gain, your OB-GYN may recommend a regimented diet, strength training, and a body-positive attitude. Regular exercise has also been shown to improve mood and help with sleep. Your OB-GYN may recommend that you begin supplementing calcium and vitamin D to protect against bone loss. For vaginal dryness and pain with sex, over-the-counter vaginal moisturizers and lubricants can provide relief.

For those favoring plant-based treatments, supplements containing soy, black cohosh, and traditional Chinese herbals may provide relief of hot flashes, night sweats, brain fog, and sleep disturbance. Plants and herbs are not regulated by the FDA, so it’s important to purchase quality supplements and notify your doctor of any supplements you may be taking.

There is no one-size-fits-all approach to managing perimenopause and menopause. What matters most is having open conversations with your provider and building a care plan that supports your health, happiness, and long-term well-being. And always, embrace the change the comes with age!

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Natasha Alligood-Percoco, M.D., is with UPMC Magee-Womens and sees patients at the UPMC Health Innovation Center, 740 High St., Williamsport, and UPMC Outpatient Center, 2370 Old Turnpike Rd., Suite 4, Lewisburg. To make an appointment with Dr. Alligood at either location, call 570-321-3300. For more information, visit UPMC.com/WomensHealthNCPA.