Perimenopause is the time of transition from regular menstrual cycles to menopause, which is defined as having 1 full year without a menstrual period. During this time, fluctuating hormones can cause a wide range of symptoms, including hot flashes, sleep disruption, brain fog, weight gain, and vaginal dryness to name a few.
This transitional period can last up to 10 years before menopause, and symptoms may persist well beyond it - about 40% of women continue to experience hot flashes after age 60.
In addition to noticeable symptoms, important changes are happening beneath the surface. Declining estrogen levels increase the risk of conditions such as heart disease and osteoporosis, making appropriate care especially important during this stage of life.
There are many options for care during perimenopause and menopause, but no single approach works for everyone.
Menopausal hormone therapy (MHT), which typically includes estrogen and progesterone, is one option. It is effective in relieving symptoms and reducing the risk of osteoporosis and heart disease. However, it is not suitable for everyone, and requires an individualized medical assessment before starting.
For those who cannot or prefer not to use hormones, a non-hormonal prescription option is now available in Canada to treat hot flashes and night sweats. This medication works on the KNDy neurons in the brain to help stabilize temperature regulation. This is a great option for women who are having significant hot flashes, but aren’t good candidates for hormone therapy.
There are other options for treatment, that can be done along side medication, or on their own. This include lifestyle approaches such as balanced nutrition, regular exercise, and sleep-supportive practices like mindfulness or meditation. Many herbal options are also available to support symptom management.
In summary, while perimenopause can bring both symptoms and long-term health considerations, there are effective options available. If you’re experiencing symptoms, talk to your doctor to explore the approach that’s right for you.
References:
Monteleone P, et al. Nat Rev Endocrinol. 2018 Apr,14(4):199-215
Lega IC et al. CMAJ 2023.195:E677082
Khan SJ et al. Int J Women’s Health. 2023:15;273-287
