Understanding Perimenopause and Menopause


Women experience a range of hormonal changes throughout their lives – and the terms defining them can be hard to understand. Dr. Jo Ernst, OB/GYN at Renown Health, helps explain these varying and often confusing life stages.


In general this refers to any time before menopause. There are no noticeable changes, but some hormonal changes develop such as mood changes, irritability, and hot flashes may start.


The definition of this phase means “around menopause,” marking the end of the reproductive years. Some societies also refer to this the “menopausal transition period.”

What’s going on in there?

Estrogen levels rise and fall during this phase, and menstrual cycles may lengthen or shorten. During this phase, some menstrual cycles may not allow ovulation.

Signs and symptoms of perimenopause:

  • Irregular and/or abnormal periods (that may be heavier or lighter in flow)
  • Hot flashes
  • Night sweats
  • Breast tenderness
  • Weight gain
  • Worsening symptoms of PMS (before a period begins)
  • Thinning or loss of hair
  • Lower sex drive (or loss of sex drive)
  • Vaginal dryness
  • Headaches and muscle aches
  • Problems concentrating
  • Memory problems
  • Mood swings
  • Increase in heart rate
  • More urinary tract infections (due to hormonal changes)
  • Problems getting pregnant
  • Bone loss

When to see your doctor

If any of the above symptoms interfere with your life, it may be time to consult your doctor.


Menopause is official after 12 months without a menstrual period, and marks the end of female reproduction.

Signs and symptoms of menopause:

  • Irregular periods
  • Vaginal dryness
  • Hot flashes
  • Chills
  • Night sweats
  • Sleep problems
  • Mood changes
  • Weight gain and slowed metabolism
  • Thinning hair and dry skin
  • Loss of breast fullness

What’s going on in there?

In particular, your ovaries stop producing estrogen and progesterone causing hot flashes and mood swings. Bone loss may occur due to decreasing levels of estrogen. Changing hormone levels can also raise cholesterol levels, increasing heart disease and stroke risk.

When to see your doctor

Frequently symptoms can range in severity. Some women transition smoothly, while others struggle with daily symptoms interfering with their well-being. Consult your doctor to get expert advice and treatment options during this natural phase of life.

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Menopause Relief

Fortunately, there are many ways to ward off the annoyances that this change of life brings.

Hormone Therapy (HRT)

HRT is sometimes used to relieve hot flashes and vaginal discomfort. Notably HRT is also known to prevent bone loss, reducing fracture risks. Although the benefits are many, consult your doctor about the risks. Individual treatments vary, and each woman needs a tailored plan for their specific symptoms.

Low-dose Antidepressants

Selective serotonin reuptake inhibitors (SSRIs) may help alleviate hot flashes. For women who are at risk taking HRT, low-dose antidepressants may be a good alternative to help reduce symptoms and mood disorders associated with perimenopause and menopause.

Vaginal Estrogen

This option is placed directly using a vaginal cream, tablet or ring. When estrogen is absorbed into the vaginal tissues, it helps relieve dryness, discomfort during sex and even urinary symptoms.

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Relieving Symptoms Naturally

Eat Well

Foods rich in calcium and vitamin D help prevent bone loss during menopause. Additionally, regularly eating high-quality protein may help prevent lean muscle loss. These foods include: meat, fish, eggs, legumes, nuts and dairy.

Maintain a Healthy Weight

Aging changes your metabolism. It’s not uncommon to see your weight shift – in new places such as your waist. Belly fat may increase your risk of developing heart disease and diabetes.

Exercise Regularly

We know exercise is always good for us, however regular exercise can help alleviate many menopausal symptoms. Of course, the added benefit of exercise is it helps you maintain a healthy weight – check, check!

Drink Plenty of Water

Water intake is key to help reduce bloating and dryness occurring from low estrogen. Drinking 64 ounces, or 8-12 glasses of water a day is recommended.

Skip Processed Foods and Refined Sugars

The sharp rise in blood sugar from a diet high in refined carbs and sugars can make you feel tired and irritable. Eliminating these foods may help reduce your low-mood and possible depression risk. Adding replacement foods such as fresh fruit will not only fill you up, but satisfy your sugar craving!

What about All the Natural Menopause Relief Products on the Market?

If you Google search this topic, you will find hundreds of products all advertising to reduce menopausal symptoms. We recommend making an appointment with your doctor to find the best treatment for your needs and beliefs before purchasing products which may not be beneficial.

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