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General Gynecology

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 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 provider

What 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


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.