Premenopause - Perimenopause

What are the treatments for the condition?

The most common treatment for perimenopause involves the use of oral contraceptives or hormone replacement therapy. The low-dose pills that are available today regulate menstrual flow and frequency. They also can eliminate or reduce hot flashes, vaginal dryness, and emotional and physical symptoms of premenstrual syndrome.

Dietary changes may also help. Women in perimenopause will benefit from a diet high in calcium, low in fat, and rich in fruits, vegetables, and whole grains. This healthful diet helps prevent osteoporosis, heart disease, and some cancers. It may also help reduce symptoms of perimenopause.

Exercise helps control weight, improve sleep, and keep bones strong. Exercise also helps with mood swings. Thirty minutes of exercise on most, if not all, days is recommended for everyone.

What are the side effects of the treatments?

Side effects of HRT can include headaches, bloating, and irritability.

Long-term use of hormone replacement therapy may increase the number of women who get breast cancer. If a woman has a family history of breast cancer, menstruated before age 12, or delayed pregnancy, hormone replacement therapy may not be advised. Women who are at higher risk of developing blood clots may also be unable to use hormone replacement therapy.

The American Heart Association recently issued recommendations about hormone replacement therapy (HRT) in women. For women who have already had a heart attack or have heart disease, it appears that HRT does not protect against having another heart attack or dying from heart disease. The studies that support this information were done with women over 65 years of age. It is unclear if this information also holds true for younger postmenopausal women who take HRT.

For women who have not already had a heart attack or who do not have heart disease, HRT should not be started for the sole purpose of preventing heart disease. The research is not strong enough to support doing that at this time. Also, it is not necessary for a woman to stop HRT if she is doing well on it.

Overall, the decision to use HRT should be based upon the proven benefits and risks of HRT. Women should discuss the benefits and risks with their healthcare provider. Together, they can choose the most appropriate course of action.

What happens after treatment for the condition?

Most symptoms of perimenopause go away after menstruation ceases. Osteoporosis and cardiac risk factors continue unless estrogen is replaced.

How is the condition monitored?

A woman's progression through menopause is monitored in regular gynecological exams, which include pelvic exams and Pap smears. Any new or worsening symptoms should be reported to the healthcare provider.