Perimenopause

If you are between the ages of 40-55 this could be YOU! According to studies, average age of menopause in America is 51.

Different women experience Perimenopause differently. Many of us can gauge our progress by our mothers or older sisters-but we are not guaranteed to experience the same things.

Many people sail through perimenopause without a problem. One day, your menstrual periods are gone. And after 12 months of no periods-you are officially post-menopausal.

Others have symptoms of hot flashes, night sweats, mood swings, depression, insomnia, vaginal dryness, irregular periods, heavier periods, and lighter periods, period’s closer together and farther apart-even skipping them completely sometimes.

All of this is normal. We all have these symptoms in various combinations and degrees.

So….

Call us if you bleed or spot between periods. Even if your normal period is every 28 days, any period between 21-42 days is normal. However, if you bleed or spot in between periods, this can be a sign of endometrial cancer.

Take 1000-1500mg of calcium with vitamin D. This may protect your bones from the rapid bone loss that occurs during this period.

Take a vitamin supplement that contains folic acid. Folic acid has been shown to protect your heart as well as decrease your risk of colon cancer.

Consider Omega 3 fish oil or flax seed oil supplements (1000mg) as these have been shown to help with PMS symptoms as well as moisturize skin and hair-also a potential problem during perimenopause.

There are many herbal supplements on the market that are designed for women going through this state of life. Some women report good relief from symptoms-other women don’t feel that they help. It is an individual decision for each woman to make.

Next-your mammogram. In spite of all the press-a mammogram is still considered the most essential screening tool for breast cancer. Get one annually. Do yourself exams every month and see us every year for a clinical exam.
Last, but certainly not least, Hormone Replacement Therapy. There are a lot of different opinions now days. Should I take them? What are my risks if I do? What are my risks if I don’t? Do Suzanne Sommers or Oprah Winfrey or Glamour Magazine really know what is right for me? Can I take herbs instead? What are bio identical hormones?

Some women feel a decrease in their sense of well-being, skin tone, hair density, vaginal lubrication. Some women experience insomnia and depression. These things can be related to the decrease in hormones experienced at this time in your life.

First of all, ACOG ( American College of Obstetricians and Gynecologist) recommends that hormones be used only to treat symptoms that are severe enough to affect quality of life. Only YOU can determine that. The lowest dose for the shortest period of time is recommended to limit the risks.

A medication that is plant based and bio identical may sound more “natural” than other forms of hormone but that is really questionable. No matter where the product originally comes from, meaning a plant like soy or yam, pregnant horse’s urine, or a lab, synthetic processing is required to make it usable by the body.

Bio identical hormones are hormones such as estriol, estradiol, estrone, and micronized progesterone. These hormones are available as pharmaceuticals such as Estrace, Estraderm, Vivelle, Climara, Estring, and Prometrium, as well as compounded cream formulations. European studies suggest that these types of hormones might be safer, but they have not been studied extensively long term. There is not a lot of science behind the theory that these forms of the medications are better in relieving symptoms, however, they are probably as good a choice for most women as the other types. If you feel that you would prefer one or the other-talk to us about it. There is new information almost daily.

During perimenopause, an option for some women is using low dose birth control pills to ease symptoms through menopause, “natural” creams are available at health food stores (use these with caution) as well as supplements with phytoestrogens, soy, and vitamins and minerals designed to support your system through these natural changes.

The bottom line: “It’s not safe or natural to have reproductive levels of hormones our entire lives. That’s why menopause happens.”

Written by: Karen Humes, C.N.M., M.S.N