How to Cope With Perimenopause

Treatment will vary according to the symptoms and your individual health risks.

by Kirk Wessler, OSF HealthCare
There are many things you can do to mitigate the symptoms and how much they impact daily living.
There are many things you can do to mitigate the symptoms and how much they impact daily living.

There’s no getting around it. Women of a certain age—usually in their late 40s to early 50s—will reach menopause. But how you go through the process is unpredictable. The months and years immediately preceding menopause are called perimenopause. The severity and duration of perimenopause symptoms differ from woman to woman, although family history can provide insight into what you might experience.

“Menopause is part of the normal aging process,” says Anastasia Osipova, MD, an OB/GYN for OSF HealthCare. “Unfortunately, nobody knows how long it will last. For some women it takes longer, and for others less. Some women have complaints and others don’t.”

Symptoms and Duration
Perimenopause is the transition from menstruation to menopause, which is officially dated one year after your final menstrual period. Common symptoms of perimenopause are hot flashes, vaginal dryness, sleep disruption and mood swings that can involve depression and anxiety. Other symptoms include aches in joints or muscles, decreased sex drive, hair loss or thinning, overactive bladder, skin dryness, trouble concentrating and weight gain.

This transition is often marked by inconsistent periods, as your ovaries eventually stop releasing eggs. As perimenopause continues, your estrogen levels continue to drop and finally reach a stable, low level. “Approximately 75 percent of women experience symptoms throughout this period,” Dr. Osipova notes. “But it’s probably more. There are symptoms that women are experiencing that they might not even recognize are due to perimenopause.”

The average duration of perimenopause is approximately two to four years, according to Dr. Osipova, but this varies. Some women experience symptoms for eight to 10 years. Others might be affected for only a few months.

When to See Your Provider
Whether you need treatment depends on the severity of your symptoms. “If it comes to the point where your hot flashes are interfering with your day-to-day tasks and events—such as getting a good night’s rest, healthy coping skills, or performing work and home responsibilities—you should seek help from a physician,” Dr. Osipova says. “Additionally, you should seek help if you are unable to successfully alleviate symptoms through a lifestyle change or over-the-counter remedies, if you are gaining weight or experiencing sexual dysfunction to the point where it impedes your preferred lifestyle.”

Specific treatment will vary according to the type of symptoms. Your individual health risks also factor into determining your treatment plan. “It’s easy to treat vaginal dryness, because we can add vaginal hormones. There are plenty on the market, and they come in pills, capsules and creams. They can also help with an overactive bladder,” Dr. Osipova explains. 

“You hear a lot about hormone replacement therapy (HRT). It can be effective treating hot flashes, which are caused by a drop in your estrogen levels. Most of the benefits, with very low risks, are noticed in women before their 60s who are just entering menopause.” There may be concerns about HRT due to side effects, she adds. “We caution patients to be very careful. Even though HRT relieves symptoms like hot flashes, it can also increase the risk of developing blood clots and breast cancer.” 

Some anti-depressants can be helpful in relieving hot flashes. Other oral medications can be effective as well. Talk to your primary care provider or OB/GYN to see what’s right for you.

Holistic Treatment Options
Dr. Osipova counsels women to understand that perimenopause is a natural phase of life. There are many things you can do to mitigate the symptoms and how much they impact daily living. “Not everything that is normal needs to be medically treated,” she notes. “A lot of people don’t like to hear that, because they want an easy fix, but we can’t medically treat something when the treatment’s harm exceeds the benefits.” Lifestyle changes you can adopt to help control symptoms include:

  • Increase your calcium and vitamin D intake.
  • Decrease your calories.
  • Exercise.
  • Eliminate—or at least reduce—carbonated beverages, caffeine, alcohol and smoking.

Dr. Osipova acknowledges there is “kind of a gray zone” between experiencing symptoms or not, and every individual is unique. “The severity of symptoms is very individual,” she says. “Some symptoms can be very mild, and some can be terrible. If you have concerns, see your primary care provider or OB/GYN.” PM
 

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