Wellness -
Menopause/Perimenopause
Natural menopause is the permanent end of menstruation and fertility confirmed by absence of a menstrual period for 12 months. Without secondary causes (i.e. surgical menopause (hysterectomy) or cancer treatments) menopause usually occurs between the ages of 40-58 yrs and on average at 51. Smokers might expect to experience menopause 2 years earlier than non-smokers. Perimenopause is the period of time within 5 or more years from the onset of menopause to 1 year after menopause.
Perimenopause and menopause are caused by the diminished functioning of the ovaries which results in a decrease in hormones levels, primarily estrogen. Signs and symptoms of perimenopause include irregular periods, hot flashes, vaginal dryness/discomfort, sleep disturbances and mood swings. Other conditions or signs related to abnormal uterine bleeding, aging, diabetes, hypertension, obesity and thyroid disease should be investigated and diseases ruled out before a diagnosis is made.
Laboratory tests that might help confirm menopause include FSH (follicle stimulating hormone) and estrogen levels. The NAMS recommends only blood testing (not salivary testing) to determine FSH and estrogen levels. To establish a diagnosis of menopause, typically the FSH level will be constantly high (>30mIU/ml or more) and estrogen may be low.
A variety treatment options for perimenopause and menopause exist and may be utilized for a short or long period of time, depending on the severity of the symptoms, risk of disease in later years, risk/benefit analysis of treatment regimens and personal attitudes about menopause symptom management and medication use. Treatments include:
• Lifestyle changes – include increasing exercise and a healthy diet, low in saturated fat to maintain a proper weight while decreasing stress.
• Non-prescription Remedies – may include vitamin/mineral supplements (Calcium, Vit D, Vit E, etc), vaginal lubricants/moisturizers and herbal/dietary supplements.
• Hormone Therapy – includes estrogen therapy (ET consists of esterified estrogens, estradiol, and/or a custom/compounded estrogen product) or estrogen-progesterone therapy (EPT includes an estrogen component balanced with a progesterone component) for patients who have not had a hysterectomy.
For more information about menopause and perimenopause please make a consultation appointment and in the meantime visit The North American Menopause Society website at
www.menopause.org or in their Early Menopause
Guidebook. For information on the limited scientific research behind
bioidentical hormone therapy visit www.womeninbalance.org.
Wellness Topics:
