Hot flashes are a common symptom during the midlife transition. Many women have these for several years after menopause. Some experience hot flashes for 10 or more years. Schmidt and his colleagues found that women who were at risk of depression and taking estrogen therapy were less likely to become depressed during perimenopause. The medicine prevented dips in estrogen and seemed to prevent mood plunges as well. Gabapentin (Neurontin®): This medicine is a seizure medication that also relieves hot flashes for some women. People in menopause are also at an increased risk for heart disease and other cardiovascular health conditions. Can I get pregnant if I am in perimenopause? Hormone therapy can help relieve some symptoms of perimenopause. In general, healthcare providers recommend that people who opt to use hormone therapy start it within 10 years of beginning menopause symptoms and use it for less than five years. Estrogen and hormones have been linked to an increased risk of heart problems and some types of breast cancer.

And it’s worth pointing out that often women will be prescribe estrogen or progesterone separately, and some women’s symptoms will improve with (body identical) progesterone alone.

Toys

Hamoda H, Mukherjee A, Morris E, et al. Joint position statement by the British Menopause Society, Royal College of Obstetricians and Gynaecologists and Society for Endocrinology on best practice recommendations for the care of women experiencing the menopause. Post Reprod Health. 2022;28(3):123-125. Doi:10.1177/20533691221104879 Dr Louise Newson is a GP and menopause specialist with a passion for improving education about the perimenopause and menopause among the public and health professionals. Along with unpredictable periods, a woman may have other symptoms—both physical and emotional. Hot flashes, poor sleep, and mood changes are common. Some women have vaginal dryness, weight gain, and thinning hair. Bone density may also start to decrease. The hormonal changes you experience during perimenopause are mostly caused by declining estrogen levels. Your ovaries make estrogen, which plays a vital role in maintaining the reproductive system. Once you enter perimenopause, your estrogen levels start to decrease. As estrogen decreases, it throws off the balance with progesterone, another hormone produces by the ovaries. These two hormones together are responsible for ovulation and menstruation. It’s common for hormone levels to fluctuate during perimenopause — to go up and down like a rollercoaster. For the most severe cases, the surgical removal of your womb and your ovaries is an option, but this should only be considered after all other options have been unsuccessful.

Effects of Pharmacologic and Nonpharmacologic Interventions on Insomnia Symptoms and Self-reported Sleep Quality in Women With Hot Flashes: A Pooled Analysis of Individual Participant Data From Four MsFLASH Trials. Guthrie KA, Larson JC, Ensrud KE, Anderson GL, Carpenter JS, Freeman EW, Joffe H, LaCroix AZ, Manson JE, Morin CM, Newton KM, Otte J, Reed SD, McCurry SM. Sleep. 2018 Jan 1;41(1). doi: 10.1093/sleep/zsx190. PMID: 29165623.

Using high doses of body identical progesterone in the form of Cyclogest 400mg vaginal pessaries twice daily may improve symptoms, however this treatment is not currently part of any recognised treatment guidelines. Guidance for healthcare professionals says those with PMS should be advised on ways to improve diet and sleep, increase exercise, stop smoking, reduce alcohol intake and reduce stress. For those who have moderate PMS symptoms, the next step recommended in NAPS guidance is a combined oral contraceptive pill, such as Yasmin. This should be taken continuously without a break for the most benefit.

The perimenopause is a natural process, but it’s not always easy to cope with. If you’re experiencing symptoms, there are some things that you can do that may help. Symptoms are often more severe around times of hormonal change – so puberty, after having a baby and the perimenopause are key times for this,’ Dr Ward says. Dr Newson empowers women to confidently take charge of their health and their changing bodies. It's never too early to learn about perimenopause or menopause and this essential book will equip you with everything you need to know. Some people start experiencing the perimenopause before they are 40. This can be as a result of medical treatments, such as surgery to remove the ovaries, but sometimes there’s no cause. If you think you’re experiencing the perimenopause before you’re 40 then you must speak to your doctor. What are the signs of the perimenopause? Avoid alcohol and caffeineif they seem to trigger your hot flushes, or if you’re having trouble sleeping.The shift in hormones slows down your metabolism. It’s very common for women in perimenopause to gain weight once their estrogen levels start to decline. Maintaining a healthy diet and regular exercise can help prevent weight gain during the transition to menopause. One of the symptoms can be suicide ideation: a recent international study found that a third (34%) of 2,700 women affected by PMDD who completed a questionnaire said they had attempted suicide [3]. These lifestyle changes, particularly increasing movement, can have a beneficial impact, Dr Ward says. But your healthcare provider may recommend over-the-counter or prescription perimenopause treatment to help ease symptoms. Your provider may recommend: For women who have a hard time falling asleep, relaxation breathing can help. Slowly breathe in through your nose. With a hand below your ribs, feel your stomach push your hand out. Slowly exhale through your mouth. You can do this for several minutes to relax. Rollercoaster Moods