Perimenopause – Making It a Smoother Transition


Perimenopause, the time around menopause, can last a few months to several years. It can begin as early as the late thirties but typically starts in the forties. An occasional woman will have normal cycles with no symptoms until her last menstrual period in her fifties but that’s the exception rather than the rule. For many women, it’s a rocky road, where they feel they’ve lost control over their bodies!

What changes are associated with perimenopause?

Women will notice that their menstrual cycles shorten from 28 days to 20-24 days. At the same time, the menstrual flow usually gets heavier and/or longer. Instead of the typical four or five-day period, it becomes seven to ten days! The period may worsen so that she’s bleeding three weeks out of each month! The bleeding can be profuse and associated with huge clots and some women are homebound on those days.

Excessive bleeding at this time is the most common cause for the 600,000 hysterectomies that are done each year! If women educate themselves about this problem, they will be able to seek medical help and prevent the need for such hysterectomies!

A woman may have never had premenstrual syndrome (PMS) but she suddenly finds she’s experiencing PMS symptoms like irritability, mood swings or migraine headaches in the time preceding their period. Weight gain especially around the midline, is another bothersome symptom! Women complain they’re eating the same as before but they’re gaining weight for no apparent reason. Or diets that previously worked for them have no results!

Other perimenopausal symptoms include insomnia, hot flashes, palpitations, dizzy spells, constipation and fluid retention. The symptoms are similar to menopause but they are milder and often intermittent. This intermittent aspect can present a challenging problem because if the woman is given hormone replacement (HRT) for bad symptoms when her body’s production of estrogen is low, HRT can later cause weight gain and other symptoms when her own estrogen “comes back!”

Each and every woman will go through perimenopause at some time in her life. Educating yourself now and working with an experienced physician who also recognizes these changes will greatly facilitate this time in your life.

Could Your Insomnia Be Due To An Imbalance In Your Hormones?

What causes insomnia?

Bonnie has always been able to enjoy good sleep in the past. No matter how stressed she might be, she could count on laying her head on her pillow, falling fast asleep and waking up the next morning refreshed and rejuvenated. However, when she reached her mid 40’s, her periods started changing and she began experiencing sleep problems. First, she would just have insomnia the night before starting her period. As her periods became more irregular, she started waking up in the middle of the night around 2 or 3 am and would find herself wide awake and unable to go back to sleep. With so little sleep, she would be exhausted the next morning. Over-the-counter sleep aids would make her feel sluggish the following day. By the afternoon and early evening, she would be crashing. She came to see me on maximal doses of prescription sleep medicine and still was sleeping poorly.

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Tying Your Tubes: The Rest of The Story

The Truth About Tubal Ligation

The euphemistic term “tying your tubes,” actually means the tubes are surgically and permanently severed or scarred to prevent the passage of an egg. That is after all, the goal. Tubal ligation methods may differ in their effectiveness for preventing pregnancy and in the risk of damaging the blood supply to the ovaries. Many women don’t understand that a tubal ligation may cause them to go through perimenopause prematurely. There are structures in the tubes, such as nerves and blood vessels feeding the ovaries, which can be damaged in the procedure. Damage to blood supply can affect the function of the ovaries. At the very least, after tubal ligation, some women begin having heavy bleeding with their periods and they may also develop symptoms akin to perimenopause. Rarely, tubal ligation can lead to premature menopause.

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Does Estrogen-Only HRT Decrease Breast Cancer Risk? Here’s The Rest of The Story!

Estrogen-Only Hrt

A recent study in Lancet Oncology looking at data from the Women’s Health Initiative (WHI) reported that the use of estrogen (Premarin) alone was NOT associated with an increased risk of breast cancer and the use of estrogen-progestin (Prempro) increased the risk of breast cancer.

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Greta’s Dilemma: HRT & Diabetes

Despite the negative news about hormone replacement therapy (HRT) in recent months, new research suggests that HRT may provide a significant benefit in helping some women reduce their risk of diabetes. But even the study researchers say it's still too early to make any recommendations about using HRT as a tool to prevent type 2 diabetes.

According to the American Diabetes Association, diabetes was the sixth leading cause of death in 2007. Ninety-five percent of diabetes is type-2 that develops in older people or at any age in overweight people. Diabetes dramatically increases the risk for heart disease and stroke.

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M.D., F.A.C.E.


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