The point 12 months after a woman’s final menstrual period marks the start of menopause. It’s a natural process that marks the end of fertility, but changing levels of hormones produce bothersome symptoms for many women. The symptoms may begin earlier, during the preceding phase called perimenopause. There’s no predictable way to identify when perimenopause or menopause will begin because it varies widely among women. Perimenopause may start as early as the mid-30s in some, but usually, it happens sometime in a woman’s 40s. Menopause usually starts anywhere between 45 and 55, but it can be earlier or later as well.
Menopause symptoms may start during perimenopause or in menopause itself. Some symptoms may never develop, or they may be more severe or less severe than what other women experience. The most common symptoms include:
Pregnancy remains possible during the perimenopause stage, during which irregular periods are common. If you’re sexually active and are unsure whether you’re in full menopause or not, you may want to use birth control and watch for signs of pregnancy.
The most effective treatment for the hot flashes associated with menopause is estrogen therapy. If started within 5 years of the last menstrual period, there are indications that estrogen therapy may help your heart. Estrogen therapy also wards off loss of calcium from the bones, which may help prevent osteoporosis. There are some concerns about health risks associated with hormone therapy, but these are generally small. Gemini OBGYN also recommends the use of bioidentical hormone replacement therapy to further reduce the risks.
Vaginal estrogen, in the form of cream, tablet, or ring, may combat the symptoms of vaginal dryness, discomfort during sex, and some urinary symptoms associated with menopause. Some low-dose antidepressants may be effective at reducing menopausal hot flashes. If you’d like medication to help alleviate menopause symptoms, your doctor will discuss treatment options and help you decide which option is best for you.