Perimenopause, the transition phase of menopause, occurs when women start to have symptoms of menopause. Most women start to notice perimenopause symptoms in their 40s, but it can also happen a little earlier or later. Perimenopause may last for 4 to 8 years.
Both prescription and over-the-counter treatments exist to help with perimenopausal vasomotor symptoms (hot flashes, night sweats, and insomnia) and vaginal symptoms (painful intercourse, vaginal dryness, and bladder problems).
The pill is a hormone medication that you take daily. The combination pill contains both estrogen and progestin and requires a blood pressure reading. The mini pill contains progestin only and doesn't require a blood pressure reading.
The contraceptive skin patch is a small (1.75 square inch), thin, adhesive patch that you place on your skin every month. It is removed every 3 or 4 weeks. The patch releases both estrogen and progestin, which are absorbed through the skin into the body.
The vaginal ring is a flexible, plastic ring that is placed in the upper vagina. It releases estrogen and progestin that are absorbed through the vaginal tissues into the body. It is removed every 3 or 4 weeks.
Depo-subQ Provera 104 is a shot (injection) that helps relieve endometriosis related pain. It contains a hormone called medroxyprogesterone acetate (MPA). The shot is given once every 3 months, just under the skin on your thigh or belly, and can be self-administered.
Norethindrone 5mg is a form of progesterone, a female hormone important for regulating ovulation and menstruation. The medication dosages need to be adjusted for treatment of endometriosis related pain.
Patients seeking diagnosis or treatment for depression or anxiety are encouraged to visit the Alpha Mental Health Service, which is a part of Alpha Membership Plus.
Blood work is rarely necessary. Clinicians can diagnose when most women are in the perimenopause based on responses to a detailed medical history.
The types of hormones depend upon your where you are in the menopause transition, your medical history, and treatment preferences. If you are still having periods, even if they are sporadic, hormonal contraceptives (birth control) may be appropriate for you because menopausal hormones do not suppress ovulation, and can potentially lead to an unplanned pregnancy or irregular periods.
Certain lifestyle choices or life events may influence when you start perimenopause including: smoking, family history, cancer treatment, or removal of ovaries. The onset of menopause occurs one to two years earlier in women who smoke due to smoking’s effect on circulating estrogen levels.
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