This Changes Everything for Women Going Through Perimenopause.

Menopause marks a significant transition in a woman’s life when the ovaries cease hormone production, but the journey toward this pivotal moment can span several years. This phase is known as perimenopause.

Typically, women experience menopause around age 51, with many starting to notice perimenopausal symptoms in their mid-40s. Symptoms can differ greatly from one individual to another. While hot flashes and irregular periods are frequently highlighted as indicators, not everyone experiences these signs.

Moreover, within the same individual, symptoms can vary in type, frequency, and intensity.

More than 75% of women report experiencing a range of symptoms, with about 25% indicating their symptoms significantly affecting their quality of life. Common complaints include sleep disturbances, anxiety, and weight gain.

Nevertheless, these symptoms are often attributed to other medical conditions based on expert assessments.

Symptoms and Treatment

Insomnia can be one of the earliest signs, sometimes emerging in a woman’s late 30s or early 40s. Research indicates that up to 60% of women over 40 experience insomnia.

Other symptoms may encompass mood fluctuations, leading to feelings of anger, irritability, sadness, and depression.

In addition, individuals may face challenges such as brain fog, memory issues, difficulty concentrating, joint and muscle pain, vaginal dryness, diminished sexual desire, and discomfort during intercourse.

It’s important to note that many women may delay seeking medical advice due to embarrassment or the desire not to “make a fuss.” However, consulting a healthcare provider is crucial since there are currently no menopause tests for women over 45.

Tracking specific symptoms and their timing is advisable. Sharing this information with your doctor can lead to a better understanding of your experience and help identify the most suitable treatment options.

Research supports the effectiveness of hormone replacement therapy (HRT) based on guidelines from the National Institute of Health and Care Excellence, particularly for alleviating hot flashes and night sweats.

HRT may also enhance sleep quality and alleviate some negative cognitive symptoms. Besides, studies indicate that cognitive behavioral therapy (CBT) can assist in managing vasomotor symptoms like hot flashes and night sweats, along with helping regulate mood and sleep patterns.

Additional research has shown that HRT can help maintain bone density and reduce the risk of osteoporotic fractures later in life.

HRT comprises various medications, including estrogen, combinations of estrogen and progestogen (another female hormone), and testosterone, with administration options like patches or gels.

The choice of HRT type and dosage depends on the condition being treated, individual risk factors, and personal preferences. There is no specific cut-off age for starting HRT, as its benefits may outweigh the perceived risks.

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New Research

Women undergoing HRT may also see a reduction in the risk of colorectal cancer and type 2 diabetes. Additional studies suggest that initiating estrogens as part of HRT early during menopause might further decrease coronary artery disease risk and conditions like heart disease and Alzheimer’s.

The cardiovascular benefits, including lower mortality rates, are noted primarily for women who begin HRT in their 50s, as opposed to those starting after 60. However, HRT is not recommended solely for the purpose of preventing cardiovascular diseases or dementia.

When using HRT tablets, estrogen-only formulations are usually given without progestogen protection, which increase thromboembolic risks (like deep vein thrombosis or pulmonary embolism) for certain HRT types and can elevate uterine cancer risk.

Concerns regarding breast cancer prevalence are complex, influenced by historical clinical trial data and individual family history, as well as lifestyle factors like alcohol use and obesity.

This variability impacts the clinical relevance of existing data for individuals.

Current findings indicate that estrogen-only HRT has minimal or no association with breast cancer risk, while combined HRT might correlate with an increased risk of 3-4 cases per 1,000 women.

Topical estrogen HRT has proven highly effective in managing and preventing vaginal and vulvar dryness, pain, and recurrent urinary tract infections.

Additively, testosterone treatments combined with estrogens may benefit some women experiencing low sexual desire.

However, a review of current trials does not demonstrate improvements in cognitive function, bone density, body composition, muscle strength, or mental health regarding testosterone treatment.

Moreover, some women, particularly those with a breast cancer history, may opt against HRT.

Historically, alternative treatments for perimenopausal symptoms focused on antidepressants and clonidine, but these have shown limited effectiveness and significant side effects. Recently, Fezolinetant, a non-hormonal medication, has been approved to assist with managing vasomotor symptoms.

Lifestyle Changes

In addition to medication, changes in lifestyle—such as improved sleep, increased physical activity, and better nutrition—can provide substantial benefits without associated risks.

Prioritizing sleep can be an ideal starting point. Quality rest allows for better focus on increasing activity and enhancing diet.

Implementing good sleep hygiene practices, including avoiding screens before bedtime, maintaining a consistent sleep schedule, and using CBT techniques, has been shown to improve insomnia and other sleep disorders for women experiencing menopause.

Engaging in regular physical activity is also advantageous, particularly exercises that build and preserve muscle and bone density, like strength training. This can help prevent osteoporosis, enhance flexibility, and reduce insulin resistance.

Aerobic exercises such as running, swimming, or cycling can also enhance long-term cardiovascular and brain health. Regardless of life stage, a balanced diet rich in whole foods and limited ultra-processed items is beneficial.

While navigating menopause can be challenging, various proven strategies can facilitate a smoother transition.

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