Understanding Perimenopause and menopause Symptoms, Diagnosis, and Treatment Options
As we age, the body produces lower levels of key sex hormones like progesterone, estrogen, and testosterone. This decline can lead to significant changes in both the mind and body. Menopause, which typically occurs around age 51, is marked by 12 consecutive months without a period. However, there’s an important phase leading up to menopause known as perimenopause. During perimenopause, you may experience a range of unusual symptoms, and your perimenopause symptoms could begin as early as 10 years prior to your actual menopause.
The symptoms of perimenopause are often vague and can be difficult to pinpoint, making it hard to recognize when this phase is ending. For many women, perimenopause symptoms can be more intense than those of menopause itself. It’s essential to pay attention to these early signs and manage them effectively, so you can step off the hormonal roller coaster before menopause fully arrives.
Most women with perimenopause may experience the following symptoms, but not limited to: anxiety, irritability, skin and hair changes, difficulty sleeping, discomfort during sex, hot flushes, increases in facial hair, night sweats, weight gain, etc.
How can we diagnose perimenopause?
Many labs may help to understand your perimenopause. Those labs include estradiol, progesterone, Testosterone, DHEA (If doing Saliva DHEA-S), progesterone to estradiol ratio, baseline CMP (rule out liver and renal issues), baseline CBC (will show anemia if menorrhagia is severe, normal period should not cause anemia), lipids (at least a baseline at age 25 and every 5 years if no other risk factors), baseline TSH, FT3, FT4 (thyroid imbalance can cause menstrual irregularity)
Treatment Options Explained
Oral Hormones:
Hormone replacements like estradiol and progesterone can effectively alleviate symptoms. Convenient daily capsules or tablets, often covered by insurance with copays. Slower absorption through the digestive system. Some herbal and natural supplements are available; though, it may take longer to see and feel relief.
Topical Creams:
Topical creams with estradiol, progesterone, and testosterone deliver targeted, localized relief. Estradiol, progesterone, and testosterone creams provide targeted relief with faster skin absorption and fewer systemic effects.
Pellet Therapy:
Implantable hormone pellets offer consistent 3-6 month hormone delivery. Requires trained provider insertion; dose adjustments are challenging once implanted.
Age: Women who start hormone therapy at age 60 or older, or more than 10 years after the onset of menopause, have a higher risk for these conditions. However, starting hormone therapy before age 60 or within 10 years of menopause seems to offer benefits that may outweigh the risks.
Perimenopause vs. Menopause Treatment
Perimenopause symptoms often begin 10 years before actual menopause, affecting women as early as their 30s. Our approach addresses:
Risks Associated with HRT
In the largest clinical trial to date, hormone replacement therapy using an estrogen-progestin pill (Prempro) was linked to an increased risk of several serious conditions, including:
Managing HRT Risks & Benefits
While the 2002 WHI study raised concerns about HRT risks, current research shows benefits often outweigh risks when:
Cost & Program Options
Oral hormones may have insurance coverage with copays. Creams and pellets are typically not covered but offer superior absorption and customization. We provide transparent pricing and receipts for potential insurance reimbursement.
Let’s talk!
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Explore Other Therapies at Island Balance Clinic
I have been fortunate enough to have found Island Balance Clinic…
…and Mie Fowler via a referral from a friend.
My experience has been amazing! She is the first practitioner who have actually listened to my questions and concerns regarding menopausal symptoms, and the benefits of HRT.
I am so relieved to have someone on my side in this journey!
Mahalo Mie
Mie Fowler, APRN is a very knowledgeable, compassionate provider…
…who excels in all her endeavors. She is sharp and highly talented with a great attitude. Obviously well experienced, kind and extremely professional in every aspect. Our clinic loves working with her!
I love that she was so knowledgeable and was able to accommodate my schedule…
…to offer me high quality HRT without the worries you usually get from healthcare or the lack of knowledge or options available from my primary provider. Mie was great! I’ve been on hormones for about 2 weeks and I’m already noticing improvements in my energy and vitality!
FAQs
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