Perimenopause is a phase that many encounter as they approach their 40s and 50s, manifesting through various symptoms such as mood swings, memory issues, and hot flashes. Yet, despite its prevalence, perimenopause remains an often misunderstood transition.
The Gen X and millennial generations are now advocating for open discussions and treatments regarding this natural phase. A host of influencers are promoting supplements and products aimed at easing this transition.
Identifying perimenopause can be tricky since it lacks a definitive test, unlike menopause, which marks the end of menstruation. Here’s a guide to understanding symptoms and exploring treatment possibilities.
Seeking Comprehensive Care
Michelle Rockwell, at 40, faced sleep disturbances and was surprised when her doctor initially dismissed perimenopause as a possibility. “ They said, ‘You’re too young,'” she recounts. After consulting multiple providers, Rockwell found relief through hormone therapy with a specialist. The Menopause Society offers an online database of certified specialists for those seeking expert care.
Dr. Monica Christmas, an associate medical director at the Menopause Society, emphasizes the benefit of consulting specialists who are less restricted by time and possess more in-depth knowledge of perimenopause.
Navigating Uncertainty
Hormone fluctuations characterize the transition into menopause, which makes perimenopause uniquely challenging. “ Perimenopause is the most tumultuous time for many people,” states Christmas. Many find relief after transitioning into menopause, when estrogen production decreases.
The changes often overlap with the aging process, compounded by midlife pressures such as careers and family responsibilities. Accepting the inherent chaos of this period can be crucial, with some patients finding solace in simply knowing their symptoms are legitimate.
Other Health Considerations
Before attributing symptoms to perimenopause, clinicians often recommend screening for other conditions. “The 40s are a time in life when a lot of different autoimmune diseases can begin to show up,” notes Nanette Santoro, a gynecologist. Conditions like early diabetes, thyroid issues, and mental health concerns should be ruled out first.
Exploring Treatment Options
Hormone therapy for severe symptoms such as hot flashes and mood swings has been debated, but it can be transformative for some. “ I would love to be able to say that hormone therapy reduces cardiovascular risk or cognitive decline later on in life,” says Christmas, though more research is needed.
While past studies like the Women’s Health Initiative raised concerns about hormone therapy risks, reassessments and new therapies have shifted the perspective. Still, it’s crucial to consider personal health history when opting for hormone therapy, as it may not work for everyone and can sometimes lead to side effects.
For those experiencing perimenopause early, hormone therapy can be particularly beneficial, as shared by Krista Russell-Adams, who found relief from symptoms like anxiety and skin changes.
Alternative pharmaceutical options are available for symptom management, such as using birth control or an IUD to address heavy bleeding. “I think of it as a really nice way of cheating the menopause transition,” says Christmas.
Adopting Healthy Aging Practices
Some symptoms can be attributed more to aging than to perimenopause. Research highlights significant aging milestones around ages 45 and 60. Santoro advises focusing on healthy lifestyle choices, such as diet, exercise, and sleep, to counteract these changes.
Christmas encourages patients to be mindful of their health as they age, stressing the importance of adapting lifestyle habits to maintain well-being. Such proactive measures can be as impactful as medication, if not more so.
Embracing these strategies can lead to substantial improvements in quality of life during this transitional period.
Copyright 2025 NPR
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