When approaching menopause the changing levels of hormones such as estrogen and progesterone can result in a wide range of symptoms and conditions. Some women will experience serious symptoms, while others will go through this transitional period easily, experiencing only very mild symptoms and in some instances absolutely no symptoms at all. Perimenopause symptoms are very similar to the symptoms of menopause so the following symptoms apply to perimenopause as well. Let’s examine the most common signs of menopause.

A change in period bleeding and menstrual cycle is quite common.
Periods may become irregular with more or less bleeding. Some women may have very heavy bleeding for a few days and then very light bleeding for a couple more days, sometimes periods are less than 22 days apart and you may have spotting between periods.

Hot flashes are one of the very frequent signs of menopause; the vast majority of menopausal women experience them. Hot flashes demonstrate with sudden heat strokes in the upper part of the body and redness in the face and neck. Night sweating is also associated with these flashes and it can be mild or quite severe, they usually disappear a few years after menopause.

Vaginal dryness is quite commonly observed as one of the signs of menopause. The tissues of the genitalia become thin and less elastic and some women have problems with regular sexual intercourse due to pain and discomfort and they become more prone to vaginal infections. The signs of menopause include changes in sex drive with some women experiencing a sudden loss of libido or trouble getting aroused. In some cases though, women feel freer since pregnancy is no longer an issue and they become more sexually active. However, women are still advised to use condoms because menopause doesn’t offer any immunity to sexually transmitted diseases.

Many women experience urinary problems, infections, incontinence and a more frequent need to use the bathroom. In some cases, it causes small leaks of urine when sneezing, coughing, or during any sudden move.

Women may also begin to experience mood swings which can vary in intensity. For some women, the symptoms can include anxiety and clinical depression which may require prescription medication in order to overcome it. Fortunately, for most women, the symptoms aren’t that serious and are very similar in nature to the mood swings during menstruation. Exhaustion is quite common and because of night sweats and interrupted sleep, it becomes increasing difficult to feel truly rested. And, of course, less sleep leads to more stress and more mood swings so it becomes a bit a vicious cycle.

The signs of menopause also include weight gain, most often around the mid section. Lean muscle mass decreases and it becomes increasingly difficult to maintain or gain lean muscle. The skin becomes less flexible and loses its elasticity.

Heart problems might also appear, although they’re usually not serious and they’re usually short term; palpitations and tachycardia are among them and they are quite regular and common in women between the ages of 45 and 55. In some cases though these signs could mimic symptoms of other diseases and conditions, therefore it’s important to consult with a doctor to avoid complications and other potential health problems.

The signs of menopause are many and varied and each woman’s experience will be different. In the case of anxiety and depression, it’s important to see a doctor and explore possible medications in order to control the symptoms. Unfortunately for the rest of the annoying symptoms there is not a lot that can be done. The best thing you can do is to try to get plenty of sleep, reduce your stress level, invest in some vaginal lubricant, do weight bearing exercises and just generally try to be good to yourself while you ride out this challenging time. If you think you’re having unusual or severe problems with menopause then it’s always in your best interest to make an appointment with your doctor. If possible, keep a sense humor about the whole thing and try to keep in mind that this a natural phase of life that women have been enduring since the dawn of time.

1. Hot flashes/Night Sweats
2. Vaginal Dryness
3. Weight Gain
4. Moodiness/Irritability

5. Loss of Sex Drive
6. Incontinence
7. Muscle Soreness
8. Irregular periods
9. Exhaustion
10. Random Hair Growth (like on the chin)

 
6 Less Common Additional Symptoms

1. Ringing in Ears (called Tinnitus)
2. Depression/Anxiety
3. Memory Problems
4. Bowel Problems
5. Osteoporosis
6. Sleep Problems

Well, a healthy lifestyle is the most obvious choice. Eat more natural foods with high fiber. Choose fruits and vegetables with lots of variety in color to get all your different vitamins and mineral. Take a multivitamin and calcium to supplement your diet if needed.

Quit smoking. Enough said.

Reduce caffeine intake. Caffeine has been linked to hot flashes and makes getting to sleep more difficult.

Limit alcohol use.

Do regular weight bearing exercises such as weight lifting, walking, aerobics, and dancing. Weight bearing exercise just means that you’re on your feet and your bones are supporting your weight, so activities like biking and swimming aren’t included. Make sure to choose an activity you like and mix it up a bit so you don’t get bored. A work out partner not only gives you motivation but will increase you odds of staying with a work out program. 

Try Soy Foods. Soy is high in phytoestrogens which is a plant chemical that acts like estrogen which is produced naturally in the body.  “These plant estrogens are thousands of times weaker than natural estrogen,” says nutritionist Mindy Kurzer of the University of Minnesota. “But they also circulate in the blood at levels thousands of times higher than natural estrogen.” That’s why researchers want to know if plant estrogens work like natural estrogen. Limited studies have produced limited evidence that soy is a good remedy but soy would have virtually no side effects and it’s generally good for you overall. 

Herbs that might help include black cohosh, dong quai, St. John’s Wort, ginseng, and evening primrose oil, red clover and chasteberry. These herbal remedies have little clinical proof that they help with the signs of menopause, but many women still use them.

As with all medical treatments, you should discuss your options with a doctor. If you choose to take a homeopathic route, make sure to discuss your plans with your doctor as herbal medicines can interact with prescription medications and be harmful if taken at inappropriate levels.

It’s unfortunate in some ways that the medical community, and women themselves, have taken the view that menopause is a medical condition that needs treatment. While some of the symptoms of menopause do impact the quality of your life such as sleeplessness, hot flashes and depression, it’s also a fact that it’s a necessary part of the aging process. True some of the potentially more dangerous conditions of menopause, such as depression and osteoporosis, may need to be dealt with medically, but as with all medical treatments comes the fact that the cure may be worse than the “disease”. And this has proved true in the case of hormone replacement therapy (HRT).

For years, the best medical treatment recommended for menopause
was the use of HRT, but in 2002 all of this began to be questioned when the US government stopped a drug trial of the Women’s Health Initiative (WHI) to test the uses of hormone replacement therapy. Evidence began to emerge that HRT caused an increase in breast cancer, heart disease, blood clots, strokes, and endometrial cancer. Even though this study also showed HRT use decreased osteoporosis risk and maybe also colon cancer, in 2002, the cons began to outweigh the pros and women began to reject HRT.

More information is available for women today due to new studies and tests, but there are still questions and concerns regarding HRT. A study conducted by WISDOM (Women’s International Study of Long Duration Estrogen after Menopause) started in the early 1990’s was closed early due in part to the problems found in the WHI study but WISDOM was breaking down HRT use by the age and was getting some more promising data on the use of HRT. The Women’s Health Initiative studied women aged 50 – 79 years old and the study reflected the long term effects of HRT use but not short term use by women just starting menopause. Unfortunately both of these studies left questions. Two questions listed in the WISDOM study as specifically not addressed are: 1) What is the long term effect of HRT if started at the onset of menopause? 2) Are there differences among the various types of HRT available?.

HRT is still in use today, but it is generally only recommended for short term use, usually one to two years for women who are under going natural menopause. Young women having surgical menopause brought on my hysterectomy or other procedures stay on hormone replacement therapy longer, sometimes until the onset of natural menopause.

HRT has many different forms and many different delivery systems. It usually includes a low dose estrogen with progesterone, or sometimes a synthetic progesterone, called progestin may be used. Testosterone is sometimes included in the treatment and this is used to help treat loss of sexual desire. Various combinations of these hormones may be given depending on what your doctors feels is the best way to proceed. Delivery systems include pills, creams, patches, IUDs, vaginal rings and sometimes shots.

 HRT Risks:

• Breast cancer
• Ovarian cancer
• Gallbladder disease
• Moodiness
• Water retention
• Nausea
• Blood Clots
• Heart Attacks
• Strokes
• Breast sensitivity

Some of these side effects depend on the type of dosage and delivery system used. For example, creams and gels might upset your stomach. Also, these risks depend on the type of estrogen or progesterone taken. Conjugated equine estrogens (CEE) have been the most prescribed HRT so most of the current testing has been done on them and because most of the studies conducted have been done on equine estrogens, only the side effects and risks attributed to these estrogens are known. These same risks are not applicable to bioidentical human estrogen and more studies still need to be conducted as these treatments are gaining in popularity.

Only a discussion with your doctor can help you decide if HRT is the choice for you. If you do have a family medical history of cancer or any of the other HRT risks listed above, be sure to discuss this with your doctor.

When treating menopause, both the symptoms of menopause and the underlying hormone fluctuations of menopause need to be treated in order to achieve maximum relief. Unfortunately at this time, there are very limited treatment options available for the vast majority of menopause symptoms and it’s important to keep in mind that menopause itself is not a disease, it’s the most natural occurrence on earth just like puberty and pregnancy.

Prescription drugs- Bio-identical hormone therapy is one option available for menopausal woman. These drugs have similar chemical hormone balances as the female body. It is the most natural, prescription choice available on the market, due to the fact that the hormones are derived and extracted from plants. These hormones are available in cream and gel form for quick absorption, reducing side-effects significantly. The only disadvantage to the therapy is the lack of research on safety and effectiveness of the product range. Of all the therapy types, estrogen therapy also known as hormone replacement therapy or HRT, a combination of progesterone and estrogen, is probably the best known. Estrogen assists in reduction of hot flashes and cholesterol while also successfully treating uncomfortable urinary and vaginal problems related to menopause.

Estrogen disadvantages- Estrogen therapy unfortunately has some major disadvantages such as increased risk of cancer specifically breast and endometrial, heart attacks, strokes, thrombosis, clotting, discomfort during sex and gallstones. Estrogen is available in creams, gels, patches and capsules

SSRI’s – Selective serotonin reuptake inhibitors also known as SSRI’s
are a class of medications used to treat depression. When depressed menopausal women were taking SSRI’s, they had fewer hot flashes. Many women, whether depressed or not, have found relief from hot flashes while using SSRI’s. Only a short dose is needed to tell whether the treatment will work or not, usually you will know in a week or two if SSRI’s will get results. Unfortunately, SSRI’s don’t work on all women for treating menopause.

Clonidine and Gabapentin – Limited testing of these drugs on menopausal women for the treatment of hot flashes has yielded positive results, but not enough clinical testing has been done. Clonidine is typically used to treat ADHD and gabapentin is used to treat epilepsy so they have been tested for the treatment of these diseases, just not for the treatment of hot flashes.

Other traditional treatments- Calcium intake can be increased to 1500 mg’s per day, this will help combat osteoporosis. Anti- depressants as well as anti-anxiety medication are also prescribed to reduce panic, depression and anxiety attacks often associated with menopause. Vitamin and mineral supplements are highly recommended as nutritional deficiencies are also common during menopause.

Of the treatments listed above, only estrogen has been tested extensively for the treatment of menopause. SSRI’s, clonidine, and gabapentin have been found to give results for hot flashes but more testing needs to be done. Sometimes a doctor may be willing to try these options if you aren’t getting relief from other medical treatments.

Perimenopause is an inevitable phase in every woman’s life and usually happens after the age of 40 but it can sometimes occur as early as your 30’s. Perimenopause symptoms are generally the same as with menopause but usually less severe and less frequent. The symptoms are caused by the gradual change in hormonal levels and can range from hot flashes to depression. The vast majority of women, almost 95%, will suffer from one or more of these perimenopause symptoms.

The most common and serious perimenopause symptoms are as follows:

Hot Flashes – It’s usually the first and most common symptom. It feels like a sudden sensation of heat spreading over the body. In most cases it creates some kind of redness, mostly noticed on the face. Flashes occur as a reaction to the low levels of estrogen, the hormone of the reproductive system. Not all women will suffer from hot flashes, but it is one of the most common complaints during menopause

Night Sweats – The night version of hot flashes and they are usually much more intense and annoying, as they disrupt sleep and can cause you to wake up several times a night. Some women find it difficult to get a good nights rest which can then exacerbate other symptoms such as moodiness.

Irregularity in Period – Women who are approaching menopause suffer from irregular menstrual cycle; their periods get more or less frequent, they might have heavy bleeding for a few months and then very light for the rest of the time. In many cases, women can skip a month and then get back to normal, then skip again and so on.

Loss of Libido – Low libido is often associated with perimenopause. Women will start having peaks and lows in their sexual drive and function but in some rarer cases though, the exact opposite might occur.

Vaginal Dryness – This is another very common perimenopause symptom caused by the tissues and walls of the vaginal area becoming less elastic and less moist sometimes causing sex to become painful or uncomfortable.

Fatigue – Although this can be a symptom of general aging, it’s also a perimenopause symptom. Tiredness and lethargy can disrupt the general quality of a woman’s life because it affects productivity, energy levels, and leaves a general feeling of exhaustion.

Weight Gain – Many women experience weight gain due to hormonal changes as the metabolism slows down progressively during this transitional phase of life.

Emotional Swings – Just like during menstruation, some women have mood swings which can range from general moodiness to angry outbursts.

Although these perimenopause symptoms can be disruptive to your life, most can be controlled with some simple life changes. Eat a good diet, exercise, try to get a good night’s sleep, make time for romance and you’ll be well on your way to conquering your perimenopause symptoms

Medical Treatment for Perimenopause Symptoms:

Low Dose Contraceptives – These help control irregular bleeding, vaginal dryness and help reduce hot flashes.
Progestin Treatment – For women who can’t take oral contraceptives, this can help with bleeding problems.

Endometrial Ablation – This is when the uterus lining is broken down with a laser to help control heavy bleeding. Generally this is only used in the most severe cases.

Natural Treatment

Exercise – This helps preserve bone density, reduce stress, and helps you sleep better

Sleep – Without proper sleep, you will suffer more irritability and fatigue.

Reduce Stress – Stress is a killer, both literally and figuratively. Continued stress can cause additional health problems such heart attacks and high blood pressure but for women with perimenopause symptoms, stress will just make all your symptoms worse.

Eat a Balanced Diet – Since this is the age when the risk of osteoporosis and heart disease increases, it is important to get enough calcium and fiber in your diet.

Reduce alcohol and caffeine – These can cause hot flashes.

As with most medical conditions, everyone will have varying degrees of severity in their perimenopause symptoms. After consulting with a doctor, you will be able to determine what is the best course of action to take, but if you are willing to make some small changes in your lifestyle, such as eating better, doing yoga, exercising and getting a full 8 hours of sleep you can reduce the possibility of having very severe symptoms.

The technique is very simple and easy to follow. It should be done when sitting comfortably in a calm relaxing environment for 15 minutes twice a day, set a timer so that you won’t get distracted thinking about the time.

Breath in slowly for a count of 5 seconds expanding the diaphragm, then exhale slowly for a count of 5 seconds. Practice keeping your mind and body still and focus on your breathing.

Osteoporosis is a very slow acting disease. The weakening of the bones and bone density loss occurs over a period of years and even decades – just a slow gradual loss of bone strength. In menopausal women, osteoporosis can be directly attributed to the loss of estrogen and in aging men; a drop in testosterone can also result in osteoporosis. Some bone loss may also be attributed to a lack of calcium in the diet. In most cases, most people aren’t even aware they have osteoporosis until in is already in an advanced stage.

Besides a lack of calcium and aging there are other conditions that can lead to osteoporosis. These include extended bed rest, Cushing Syndrome, hyperthyroidism, hyperparathyroidism, rheumatoid arthritis, excess corticosteroid levels from using certain medications. If you have a family history of osteoporosis this would also put you into a higher risk group. In addition, other risk factors such as alcoholism, early menopause, no periods, eating disorders, low body weight, smoking, steroids and anti-seizure drugs can also put you into a higher risk group.

Testing

There are several tests available which can indicate osteoporosis. The most widely used is the bone density test called a densitometry or DEXA scam. In addition, spinal CT scans and hip x-rays may also be used but they are not as accurate as the DEXA. In some cases, blood and urine testing may be done to see if there is an underlying medical condition.

Drug Treatment

When treating osteoporosis, your doctor will try to control your pain, prevent further bone loss, try to strengthen your existing bones, and try to prevent future bone breaks.

There are several drugs available which work to both prevent and treat bone loss in postmenopausal women. Biophosphonates are medicines that include Fosamax, Boniva and Actonel and are all fairly well know osteoporosis treatments. Most of the biophosphates come in pill form and are taken weekly or monthly. Calcitonin is another treatment that is either injectable or inhaled as a nasal spray and it works to relieve pain and slow bone loss. Although hormone replacement therapy is an osteoporosis treatment, due to its many side effects it has fallen out of favor as a universal treatment for menopausal women. A separate type of hormone treatment with the parathyroid hormone is used in women at high risk of fractures. This treatment requires a daily injection with Teriparatide (Forteo) and is easily administered at home. Raloxifene (Evista) is another treatment option that has been shown to reduce spine breaks by just under 50%. Unfortunately it does not appear to help with the other common breaks such as hip and wrist fractures.

Lifestyle Treatment

In addition to getting the required 1,200 mg of calcium per day that are recommended, you need to get 800 – 1,000 IU of vitamin D3. The vitamin D helps your body better absorb the calcium.

Weight bearing exercises as well as balancing exercises can both be valuable tools in controlling osteoporosis. The weigh bearing exercises help to reduce bone loss and the balancing exercises reduce the risk of falls. Weight bearing exercise simply means any exercise where you’re on your feet working against gravity. It includes pretty much all sports activities except biking and swimming. There are a lot of fun weight bearing exercises that you can work into your routine such as walking, dancing, tennis, weight lifting, and hiking. Exercises that can help you prevent falls and promote better flexibility include yoga and tai chi.