Perimenopause and Menopause Care

Perimenopause and menopause are two different, but related stages in the reproductive development of women. The average woman will go through menopause between 45 and 55 years of age. Menopause is a naturally occurring process, which marks the end of the natural reproductive ability of a woman. The process occurs gradually and is preceded by a transition period known as perimenopause. These processes lead to several symptoms that might affect the quality of your life. For women who go through sudden or induced menopause, the symptoms are more severe. Perimenopause care refers to procedures, therapies, medications, and lifestyle adjustments applied to reduce the severity of these symptoms. Gyn LA offers a variety of perimenopause and menopausal care services based on the symptoms and their severity to women in Los Angeles.

Overview of Menopause and Perimenopause

Perimenopause is the transition phase just before menopause. It is characterized by a decline in the level of estrogen that the ovaries can produce. This phase can last a few months to as many as twelve years and ends when a woman does not have a period for twelve months (when the ovaries stop producing eggs). One of the common signs of perimenopause is irregular periods. Other symptoms include:

  • Breast tenderness
  • Reduced sex drive
  • Vaginal dryness that leads to discomfort during sex
  • Hot flashes
  • Sleeping problems
  • Mood changes
  • Fatigue
  • An urgent need to urinate
  • Urinary leakage
  • Severe premenstrual symptoms

These symptoms are normal, but you can still talk to your doctor to help you minimize their intensity. However, if you experience one of the following symptoms, you need to see a doctor:

  • Very heavy periods
  • Blood clots
  • Periods that last longer than usual
  • Spotting during periods or after sex
  • Periods that are closer together

These symptoms could signal a more serious underlying condition such as hormonal problems, pregnancy, fibroids, and problems with blood clotting and in rare cases, cancer.

If you do not intend to have children, you should talk to your doctor about the best birth control for you. Perimenopause decreases a woman's fertility, but you can still get pregnant. You might also consider fertility treatments to help you get pregnant.

The end of perimenopause marks the beginning of menopause. You are said to be experiencing menopause if you go for 12 consecutive months without a period. Menopause differs in every woman and may start suddenly or gradually. It happens when the ovaries stop producing estrogen or progesterone. The symptoms include:

  • Painful sex
  • Vaginal soreness, dryness, and itching
  • Reduced sex drive
  • Mood swings, anxiety, and irritability
  • Sweating
  • Hot flashes
  • Trouble sleeping
  • A racing heart
  • Urinary incontinence

Menopause is a non-reversible process but can be managed with treatment, lifestyle changes, and medication. Your doctor will help you in managing conditions that may arise during menopause.

Management of menopause is especially crucial for women who go through menopause suddenly. The sudden onset of menopause due to genetics, medical procedures, or illness is known as premature menopause.

Treatment and Management

Perimenopause and menopause are the natural declines of a woman's reproductive system. Once they begin, you cannot reverse them. However, you can manage their symptoms to make your life more manageable.

Before treatment begins, your doctor may carry out tests and investigate your medical history. Some of the factors the doctor considers when determining whether you are perimenopause or menopause include your age, symptoms, and menstrual history.

Women are advised to keep track of the changes in their menstrual period and the accompanying symptoms. With such a record, it becomes easier to establish when your symptoms began and the progress you have made into menopause.

Your doctor may also make tests to check your thyroid function and the levels of FSH (follicle-stimulating hormone).

Some of the treatment options include:

Hormone Therapy

Hormone therapy involves the introduction of estrogen in the body. It is by far the most effective perimenopause and menopausal treatment. Hormone therapy aims at reducing the severity of hot flashes, night sweats, and other perimenopause and menopausal symptoms. Estrogen will also reduce bone loss, thus preventing osteoporosis.

Doctors usually administer low doses of estrogen and for a shorter period due to the risk of developing some cancers. The hormone is available in estrogen pills, patches, topical estrogen creams, gels or sprays, and vaginal estrogen. The form in which the estrogen will be administered depends on your symptoms. For example, if you suffer from vaginal dryness and itching, the doctor might recommend vaginal estrogen.

For women whose uterus is intact, the doctor may offer combination therapy, which includes estrogen, progesterone, and progestin. Combination therapy comes in two forms: an oral progestin and intrauterine progestin. Combining estrogen and progesterone also reduces the risk of developing cancers of the endometrium.

Hormone therapy does not apply to all women. If you have conditions such as blood clots, cancers in the breast or uterus, heart diseases, liver disease, pregnancy, stroke, or heart attacks, you will have to get an alternative treatment.

Women who use hormone therapy may experience side effects such as bloating, breast tenderness, headaches, mood swings, nausea, and vaginal bleeding.


Antidepressants are an alternative to hormonal therapy used to manage hot flashes and mood changes during perimenopause and perimenopause. They may also help with sleep.

Before using over-the-counter antidepressants, you have to talk to your doctor about any health conditions you have or medications you are taking.

Your doctor will recommend one of the four main types of antidepressants:

  • Monoamine oxidase inhibitors
  • Selective serotonin reuptake inhibitors
  • Serotonin-norepinephrine reuptake inhibitors
  • Tricyclic antidepressants

Using antidepressants may lead to side effects such as nausea, vomiting, restlessness, insomnia, and a dry mouth. Tricyclic antidepressants can cause urine retention, drowsiness, blurred vision, and constipation.

Although they are generally safe to use, antidepressants may not be ideal if you have high cholesterol, heart diseases, glaucoma, or at a higher risk for a heart attack or stroke.

The use of antidepressants with illicit drugs or some medications can lead to serious health issues. Some of these may be life-threatening and need immediate treatment. They include:

  • Confusion
  • Dilated pupils
  • Muscle rigidity, spasms or tremors
  • Rapid heartbeat
  • Sweating
  • Unresponsiveness

Doctors usually administer low levels of antidepressants to deal with hot flashes and night sweats, however, you may need alternative treatments to deal with other symptoms.

Lifestyle Changes

You can address perimenopause and menopause symptoms by adjusting your lifestyle. These adjustments include:

Stop smoking: Smoking is a major cause of premature menopause. Also, smoking increases the severity and frequency of hot flashes.

Reducing alcohol: Alcohol tends to worsen the symptoms of menopause such as insomnia, hot flashes, and night sweats. Consuming alcohol during menopause increases the risk of developing diabetes, dementia, obesity, and stroke; menopausal women should aim at taking a maximum of one alcoholic drink per day.

Maintaining a healthy weight: Menopause leads to weight gain around the abdomen on the hips and thighs. The hormonal changes, muscle loss, and reduced metabolism due to age contribute to weight gain during and just before menopause. Such weight gain increases the risks of developing type 2 diabetes, breathing problems, heart diseases, and vascular problems, cancers of the breast, colon, and endometrium. Perimenopause and menopausal women should engage in physical activities, reduce their food potions, and reduce the intake of sugar and alcohol. Ideally, you should develop a plant-based diet and reduce the consumption of meat.

Increasing the intake of calcium to maintain strong and healthy bones during perimenopause and menopause and reduce the risk of osteoporosis. Age and declining hormone levels lead to the loss of bone mass and strength. When not controlled, it can result in fractures, especially on the bones of the hip and back. In addition to calcium supplements, you need to increase your intake of Vitamin D, which helps in the absorption of calcium. Some healthy sources of calcium include green leafy vegetables, cheese, legumes, salmon, milk, yogurt, and oatmeal. Fish and eggs are good examples of foods rich in vitamin D.

Exercise: Exercise is important in maintaining a healthy weight, active metabolism, and reducing hot flashes and night sweats. Regular exercises improve your bone and joint health and help in dealing with insomnia. Once you start exercising, you will notice that your anxiety and depression decline. You are also likely to reduce the risk of diseases such as cancer, high blood pressure, heart disease, osteoporosis, and stroke.

Taking more phytoestrogens: Soybeans, tofu, flax seeds, beans, and sesame seeds contain phytoestrogens, which are plant-based components that imitate the function of natural estrogen. Such products are important in reducing hot flashes, cholesterol levels, blood pressure, and less severe night sweats. Processed products may have a lower amount of phytoestrogens, so it is best to consume natural products.

Keep yourself hydrated: Water relieves the dryness caused by a decline in estrogen levels during perimenopause and menopause. Hydrating will also help you deal with other conditions such as weight gain and bloating.

Cut off processed foods: Processed foods are high in sugar, which contributes to fatigue, irritability, and depression among perimenopause and menopausal women due to fluctuating blood-sugar levels. Processed foods also increase the risk of developing osteoporosis.

Increase the intake of proteins to prevent the loss of lean muscle mass and encourage weight loss. Proteins make you feel full faster, thus reducing the food you consume.

Use lubrication during sex to counter vaginal dryness. You can experiment with options such as lubricants and vaginal moisturizers. Relaxing before sex and spending more time in foreplay can improve arousal and prevent pain during sex. Discuss with your partner about the changes your body is going through and let him or her help you through the process. you may need an evaluation to eliminate other medical causes of vaginal dryness and pain during sex such as UTIS

Natural Methods

Societies around the world have developed means of dealing with the symptoms of menopause and perimenopause. Before applying these methods, you may need to speak to your doctor to ascertain that they are ideal for you. They include:

  • Black cohosh, which helps in alleviating hot flashes. It is relatively unsafe, especially for women who have had or at risk of developing breast cancer.
  • Yoga to improve strength and coordination
  • Acupuncture
  • Hypnotherapy to reduce hot flashes

Sometimes, perimenopause and menopause can affect your mental wellbeing. If this is the case for you, talk to a therapist or join a support group. You can ask your gynecologist to recommend an appropriate support group or therapist.

Getting an Appointment

Taking charge of your perimenopause and menopausal health begins with booking an appointment with your gynecologist. During the appointment, discuss your concerns with him or her, including the time when you started noticing these symptoms. With the information you provide, your gynecologist will be in a better position to diagnose menopause or perimenopause.

Ideally, you should have prepared the questions and concerns you would like your gynecologist to answer. The list will be informed by the symptoms you are experiencing. While you may feel embarrassed to talk about some issues, remember that they are trained professionals, and they are aware of these issues.

You can ask your partner, a family member, or friend, to accompany you for the appointment. He or she will help you in noting some of the things your gynecologist tells you. You can also carry a notebook to take important notes.

If you are still in doubt about what the gynecologist told you, you can contact another gynecologist for a second opinion. Do not rush into taking treatment if you are not sure or comfortable about it. Also, consult with the gynecologist about the lifestyle changes you can make, support groups in your area, and medication you may need to control your symptoms.

Find a Gynecologist Near Me

Perimenopause and menopause can be upsetting and can interfere with the quality of your life. If you experience symptoms of perimenopause or menopause, you should contact a gynecologist to help you evaluate and manage your symptoms. Gyn LA dedicates its service to caring for women, including those experiencing perimenopause or menopausal symptoms. We offer perimenopause and menopausal care to women in Los Angeles who are experiencing the onset of menopause. Our treatment and management services are customized to fit the needs and health of every woman. Reach out to us at 310-375-8446 for an evaluation.