Perimenopause & Menopause: Symptoms & Treatment

Menopause is a natural stage of life marked by the permanent end of menstrual periods, confirmed after 12 consecutive months without a period. Most women experience menopause between ages 45 and 56, with an average age of 51. Perimenopause is the transitional phase leading up to menopause, during which hormone levels fluctuate and periods become irregular.

Causes

• Natural decline of reproductive hormones – ovaries make less estrogen and progesterone, and fertility declines
• Surgery to remove both ovaries
• Chemotherapy and radiation therapy
• Primary ovarian insufficiency – ovaries do not produce normal levels of reproductive hormones

Symptoms

• Hot flashes and night sweats (vasomotor symptoms)
• Vaginal dryness and discomfort
• Sleep disturbances
• Mood changes
• Changes in sexual function
• Thinning hair and dry skin
• Weight changes
• Urinary issues

Diagnosis

• Clinical evaluation based on symptoms and physical examination
• Blood tests when diagnosis is uncertain, such as in younger women or after hysterectomy

Treatments

• Hormone therapy
• Non-hormonal medication – SSRIs, SNRIs, gabapentin or fezolinetant for women who cannot take hormones
• Vaginal estrogen, ospemifene or moisturizers – for vaginal dryness and genitourinary symptoms
• Lifestyle modifications and cognitive behavioral therapy
• MonaLisa Touch®– minimally invasive laser treatment