Question 1

What’s the difference between perimenopause and menopause?

Accepted Answer

Perimenopause or the menopause transition is a time of changes for many. It begins with changes in the menstrual cycle length and flow and people may experience other symptoms such as hot flashes and night sweats.

The length of perimenopause is different for everyone but can last for several years.
Menopause is the final menstrual period, which is confirmed 12 months after no further periods. You are considered “menopausal” 1 year after your final period.

Question 2

What age does perimenopause usually start?

Accepted Answer

The range of perimenopause or the menopause transition can be 4-10+ years before menopause. The age after menopause is 51. This means that many people can experience symptoms in their early to mid-40’s and some even in their late 30’s.

Question 3

What symptoms are normal during perimenopause?

Accepted Answer

Many people will experience a range of symptoms including hot flashes/night sweats, mood changes, brain fog, sleep issues, and more unpredictable cycles. Even though these symptoms are common during this transition, it doesn’t mean that one must suffer in silence! We recommend discussing symptoms, especially if they affect your daily life with a provider knowledgeable in perimenopausal care.

Question 4

Why are my periods so irregular now?

Accepted Answer

During the menopause transition, the hormones responsible for ovulation are in flux and are decreasing over time. This means one may skip a period due to not ovulating one month and may ovulate twice in another month.

Question 5

Are hot flashes the only symptom — or are there others?

Accepted Answer

There are many symptoms associated with the perimenopausal transition and menopause. Hot flashes, night sweats are common, but some people also experience mood changes, brain fog, weight gain, vaginal dryness, and sleep disturbances. Much like adolescence some people may experience only one or 2 mild symptoms and others significant symptoms.

Question 6

Why am I gaining weight even though nothing has changed?

Accepted Answer

Weight gain during perimenopause and menopause is so frustrating!  Weight gain is often due to decreasing estrogen levels which cause fat distribution changes to the abdomen. This also can lead to reduction in muscle mass. Also as we age, metabolism changes. Lastly, if people are experiencing hot flashes/night sweats, sleep disturbances, etc, they are likely not feeling their best and may not be able to keep up with diet and exercise as well as they otherwise would.

Question 7

Is anxiety or depression related to hormonal changes?

Accepted Answer

Possibly! We believe that the changes in hormones can affect mood in some people. This with the added responsibilities, obligation and sometimes little time for self-care can result in increased anxiety and depression for some people. Everyone is different and it is important that you talk with your health care provider to optimize your mood.

Question 8

What’s causing my sleep problems — and how can I fix them?

Accepted Answer

Many people experience sleep disturbances due to fluctuations in hormones. In addition, hot flashes and night sweats can significantly disrupt sleep. Good sleep hygiene, diet and exercise can improve these symptoms, but talk to your health care provider for more information.

Question 9

Does menopause affect memory and concentration (“brain fog”)?

Accepted Answer

There are estrogen receptors everywhere in the body including the brain. About half of midlife women report difficulty focusing, concentrating, or remembering words or names. These changes are typically mild and will get better after the menopausal transition and are not signs of dementia.

Question 10

How does menopause impact sex drive and vaginal health?

Accepted Answer

Without estrogen, the vaginal lining becomes thinner and less elastic. There is less blood flow and lubrication.  The pH and normal flora change.  In addition, patients can experience urinary frequency and urgency.  All these changes can negatively affect desire and vaginal estrogen can help.

Question 11

What treatments actually work for symptoms?

Accepted Answer

Hormone therapy is very effective in treating vasomotor symptoms and genitourinary symptoms.  Not everyone wants hormones and fortunately there are lots of treatment options that are not hormonal that can help.

Question 12

Is hormone therapy safe for me?

Accepted Answer

Hormone therapy is safe but there are contraindications. Systemic hormone therapy should not be used by patients with a history of breast cancer, heart attack, stroke, venous thromboembolism or liver disease.  Patients at high risk for these conditions should also probably avoid it.  Vaginal estrogen can be safely used for almost all patients.

Question 13

Are there lifestyle changes that really make a difference?

Accepted Answer

Daily movement, healthy food intake, adequate sleep, stress reduction and avoiding excessive alcohol are critical steps that have the potential to improve life more than medications.

Question 14

How long do perimenopause and menopause symptoms last?

Accepted Answer

Vasomotor symptoms last on average for 7 years but can last longer for some patients.  Genitourinary symptoms might be life long for some patients.

Question 15

When should I see a menopause-trained physician instead of “waiting it out”?

Accepted Answer

It is always best to make an appointment with your health care provider if you have concerns.

MENOPAUSE & PERIMENOPAUSE FAQs