Menopause and Perimenopause

You probably already know the definition of menopause: it’s the very last menstrual period that you have.  How can you tell that you are there?  Only in hindsight.  When it has been more than twelve months since you have had a menstrual period, then you can say that you’ve reached menopause.

Perimenopause comes before menopause, and it can last several years.  During perimenopause, menstrual periods become irregular or abnormal because of unpredictable swings in hormone levels.  These hormone shiftscan cause irritability, mood swings, insomnia, fatigue, memory issues (foggy thinking), and headaches as well as hot flashes, night sweats, and vaginal dryness.  Perimenopause can be harder to deal with than menopause!  Perimenopause is a “normal stage”, yes, but don’t let anyone tell you that this means you should tie a knot and hang on and thatthings will get better eventually!  That’s the same as saying that your quality of life is not important during these years.

For some women, changes in lifestyle can relieve some of the symptoms. Others have found that acupuncture and various herbs and supplements can also help.  But they don’t work for all women.  There is NOTHING better than hormone therapy for controlling perimenopausal and menopausal symptoms.  Hormone therapy includes estrogen (estradiol) as well as progesterone and sometimes testosterone.  It makes sense to use hormones that are biologically identical to the hormones made by your own ovaries.  Bioidentical estradiol and progesterone are available at regular pharmacies and usually insurance covers the cost of these.  They are also available through compounding pharmacies, but insurance does not cover the cost of these.  Bioidentical testosterone for women is available onlythrough a compounding pharmacy. 

Hormone testing can help sort out hormonal imbalances when the symptoms are confusing.  Blood (serum) testing is the “gold standard” for hormone levels.  Saliva testing is preferred by some physicians, but Dr. Clark has found saliva testing to frequently be misleading and inaccurate.  She prefers to discuss your symptoms and concerns with you in detail, obtain a complete medical history, and then order appropriately timed blood testing (and timing is very important!).  Reviewing the hormone levels in the context of symptoms you are having can help to guide treatment.

Dr. Clark is a NAMS (North American Menopause Society) Certified Menopause Practitioner, meaning that she qualifies as an expert in the care of menopausal women.  Her background in reproductive endocrinology and her extensive experience with hormone therapy have helped many women successfully navigate the menopausal transition, and she can help you with yours!