What is Perimenopause?
Perimenopause can last several years, during which people may experience changes in their menstrual cycle, including irregular periods, and a range of symptoms due to fluctuating hormone levels. These symptoms may include hot flashes, night sweats, mood changes, difficulty sleeping, and changes in libido, among others.
Menopause is defined as the point in time when someone has gone 12 consecutive months without a menstrual period, marking the end of reproductive ability. Post-menopause refers to the time after menopause, when hormone levels remain low, and symptoms may persist but typically stabilise.
Symptoms of Menopause
Perimenopause symptoms can vary widely, but common ones include:
o Period Changes: Periods might become irregular, lighter, or heavier before stopping altogether.
o Hot Flushes: Sudden feelings of heat in the face, chest, and body, often occurring unexpectedly.
o Night Sweats: Waking up drenched in sweat, which can disrupt sleep.
o Mood Swings: Increased irritability, anxiety, or feelings of depression.
o Fatigue and Poor Sleep: Tiredness, often due to night sweats or insomnia.
o Brain Fog: Trouble concentrating, memory slips, or feeling mentally sluggish.
o Loss of Sexual Desire: Reduced interest in or pleasure from sex.
o Joint and Muscle Aches: Soreness due to lower estrogen levels.
o Hair and Skin Changes: Thinner, less shiny hair, dry or itchy skin, and possibly some facial hair growth.
o Worsening Migraines: Increased frequency or severity of migraines.
o Vaginal and Urinary Issues: Vaginal dryness, discomfort, frequent urination, or bladder infections.
o Other possible symptoms include breathlessness, palpitations, dry eyes, and mouth issues.
Diagnosing Perimenopause
If you’re over 45 and notice changes in your periods—such as increased frequency, skipped periods, or changes in flow—we can often diagnose perimenopause based on your symptoms without needing tests. For those under 45, or individuals who don’t have periods due to contraception or medical conditions, a hormone test may be recommended, though it’s not always necessary. Keeping a record of your symptoms can help us better understand your experience and offer appropriate treatment.
Potential Health Risks from Perimenopause and Menopause
During perimenopause and menopause, long-term health risks may include:
o Osteoporosis: Reduced estrogen levels increase the risk of weakened bones, making them more prone to fractures.
o Cardiovascular Disease: Estrogen helps maintain healthy blood vessels and regulate cholesterol. Fluctuating estrogen levels can increase the risk of heart disease, stroke, and vascular dementia. Other risk factors include high blood pressure, smoking, being overweight, and family history.
o Other Risks: The lack of hormones after menopause may raise the risk of osteoarthritis, type 2 diabetes, and dementia for some individuals.
Treatments for Perimenopause
There are various treatments available to manage perimenopause symptoms and improve quality of life:
o Consult a doctor: Seek professional advice about your treatment options.
o Don’t Wait: You don’t need to wait for your periods to stop to address symptoms.
o Consider HRT: Hormone Replacement Therapy can alleviate symptoms like hot flashes and mood swings and can be started during perimenopause.
o Personalised Care: Treatment should be tailored to your unique needs and health history.
Healthy Lifestyle During Perimenopause
Staying healthy is particularly important during perimenopause. Consider these tips:
o Eat a Balanced Diet: Focus on foods rich in calcium to protect bones and reduce osteoporosis risk.
o Exercise Regularly: Aim for 30 minutes of moderate exercise five days a week, including aerobic activities and weight-bearing exercises.
o Limit Alcohol and Smoking: Alcohol can worsen hot flashes and disrupt sleep. Smoking increases health risks; reducing and eventually quitting is ideal.
o Get Enough Vitamin D: Essential for bone health, vitamin D can be obtained from sunlight, food, or supplements.
o Relax: Manage stress through activities like yoga, meditation, walking, or spending time with loved ones.
Hormone Replacement Therapy (HRT)
At Milton Menopause Clinic, our focus is in helping women navigate the perimenopause and menopause transitions with tailored treatments, including HRT. Our aim is to manage symptoms and improve long-term health by replacing hormones your body no longer produces.
What is HRT?
o Estrogen Replacement: We offer various methods, such as skin patches, gels, and tablets. Our clinic uses 17 beta-estradiol, a natural form of estrogen derived from yam root, which closely matches your body’s hormones.
o Progestogen for Uterine Protection: For women with a uterus, we combine estrogen with micronised progesterone (Prometrium) or offer the Mirena coil, which delivers progestogen directly to the uterus.
o Testosterone for Symptom Management: For symptoms like persistent fatigue, brain fog, or low libido, we may recommend testosterone cream (Androfeme), which has proven benefits.
Benefits of HRT
o Symptom Relief: Many patients feel like themselves again within 3-6 months of starting HRT.
o Bone Protection: Reduces osteoporosis risk by strengthening bones.
o Cardiovascular Health: Lowers the risk of heart disease, stroke, and vascular dementia.
o Additional Benefits: Decreases risks of type 2 diabetes, osteoarthritis, bowel cancer, and depression.
Risks of HRT
For most women under 60, the benefits outweigh the risks. However, safety is our priority:
o Breast Cancer: Risk is small, especially with micronised progesterone. We assess individual risks and monitor treatment closely.
o Blood Clots: Estrogen patches or gels are recommended for those with a history of clots, as they avoid the clotting risks associated with oral forms.
Side Effects of HRT
Some women may experience breast tenderness or light bleeding initially, but these symptoms often subside within a few months.
When Should You Start HRT?
Starting HRT during perimenopause provides effective symptom management and long-term health benefits. Early discussions can help prevent complications such as osteoporosis and heart disease.
Your Personalized HRT Journey
There is no time limit for using HRT. Treatment can continue as long as it’s beneficial. At Milton Menopause Clinic, we ensure every patient receives individualised care, empowering them to make informed decisions about their health.
Milton Menopause Clinic: Tailored Care for You
Led by experienced practitioners Dr. Mardi Vory and Dr. Karyn Huntley, our clinic offers comprehensive evaluations and personalised management plans. With extended 45-minute consultations, we address metabolic health, nutrition, sleep, exercise, mood, supplements, and, when necessary, hormone therapy. Seamlessly integrating with your regular GP, we provide a novel approach to menopause care.
Book a Consultation
Menopause consultations can be booked online or by calling our reception team at (07) 3367 0333. Let us guide you through this transition with expert care and understanding.
Written by: Dr Karyn Huntley
Comentarios