Menopause & Perimenopause
Perimenopause and menopause are periods of change that occur when a woman’s reproductive years are coming to an end. They represent a transition into a new phase in life, and can impact a woman’s health and well-being. With training and credentialing through the North American Menopause Society, the certified menopause practitioners at University Hospital offer expert care, education and support for women throughout all stages of perimenopause and menopause
Make an Appointment with a UH Women’s Health Expert
To schedule a one-on-one appointment at the UH Menopause Clinic, please call 216-844-3941.
Find an UH OB/GYN providerWhat Is Perimenopause?
Perimenopause is a gradual process in which woman’s ovaries slowly begin to stop releasing eggs over a period of two to eight years preceding menopause. Ovulation becomes irregular before stopping altogether. During this period, your menstrual cycles may become shorter and irregular, and your fertility begins to decrease. For some women, perimenopause can begin in their 30s, but it usually starts in a woman’s 40s.
During the transition time before menopause, the supply of mature eggs in a woman's ovaries diminishes and ovulation becomes irregular. At the same time, the production of estrogen and progesterone decreases. The sharp drop in estrogen levels causes most of the symptoms associated with menopause.
What Is Menopause?
While perimenopause is a transitional phase between reproductive and post-reproductive years, menopause is complete when a woman hasn’t had a menstrual period for one year. The average age for menopause is 51, but anytime from 40 to 60 is considered normal. Menopause may occur earlier as a result of:
- Primary ovarian insufficiency: When the ovaries fail prematurely in women under age 40.
- Surgical menopause: The surgical removal of one or both ovaries may cause women to go into menopause prematurely.
Signs & Symptoms
The symptoms experienced during perimenopause and menopause are similar, and are caused by hormonal shifts in the body. When estrogen is higher, you may have symptoms similar to PMS, such as bloating, abdominal discomfort, breast tenderness and acne. When estrogen is low, you may have hot flashes or night sweats. These hormone changes may be mixed with normal cycles. Symptoms include:
- Hot flashes
- Mood changes
- Night sweats
- Sleep disruptions
- Headaches
- Changes in sexual desire
- Vaginal atrophy or dryness
- Pain during sex
- Hair growth
- Memory problems
- PMS-like symptoms
Women may experience these symptoms differently and with varying degrees of severity.
Management & Treatment
University Hospitals streamlines the process of exploring perimenopause and menopause symptoms and treatment options with our Menopause Clinic, one of only a handful of dedicated programs across the nation. The program offers a multidisciplinary approach to individualized menopause care, featuring:
- Treatment of symptoms, such as hot flashes, with hormone and non-hormone therapies
- Education and support groups
- Psychotherapy
- Cognitive behavioral therapy
- Therapy for sexual and vulvovaginal concerns
Treatment Options
- Hormone therapy
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Hormone therapy involves taking progesterone and estrogen or estrogen alone in the form of pills, patches or vaginal rings. This therapy helps to level out hormones and relieve symptoms of perimenopause and menopause such as hot flashes, night sweats and vaginal dryness.
- Non-hormonal treatment
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This type of treatment often involves the use of other types of medicines to relieve some of the symptoms associated with menopause such as vaginal dryness. This can include over-the-counter lubricants and moisturizers, as well as prescription medications.
- Gabapentin
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Gabapentin is a seizure medication that can also help with hot flashes, and can be used by women who can’t tolerate hormone therapy or who also have migraines.
- Clonidine
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This medication can lower blood pressure and is used to prevent migraines. It can also help manage hot flashes in perimenopausal and menopausal women.
- Cognitive behavioral therapy
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Talking with a licensed therapist can help women work through the emotional aspects related to perimenopause and menopause.
- Lifestyle changes
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Other lifestyle changes that can help relieve the symptoms of perimenopause and menopause include:
- Regular exercise.
- A diet rich in vegetable, fruit and whole grains.
- Learning and avoiding/limiting your triggers for hot flashes, such as caffeine or alcohol.
- Getting at least 1,000 milligrams of calcium daily through diet or supplements.
Group Education to Better Understand Menopause
The menopause experience often feels isolating to many women. University Hospitals is changing that with the only Menopause Discussion Group in the region. At these collaborative, small group meetings led by our team of menopause experts, we discuss a range of topics, such as:
- Changes associated with menopause
- Hormone and non-hormone treatments for menopause
- Cancer fears
- Relationship issues
- Sexual function
- Health issues related to midlife transition
To learn more about the group education program, please call 216-983-5640.
Additional Menopause Resources
Learn more about menopause and related topics with our library of health articles, podcasts and webinars.
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