Column: Ease your transition into menopause

Hot flashes, irregular periods and mood swings are typically labeled menopause. Today, your health care provider is likely to call this perimenopause — a term for the transitional years leading up to the end of menstruation.

Perimenopause often begins in your late 40s and can last two to 10 years. During this time, the ovaries gradually become smaller and fertility declines. Levels of the hormones estrogen and progesterone become unstable. At times, estrogen levels may be higher, which may trigger symptoms similar to premenstrual syndrome (PMS). At other times, estrogen levels may decrease, which may trigger irregular periods, painful sex and hot flashes or night sweats.

Some providers use blood tests to help assess perimenopause, but one of the most reliable ways to detect it may be to look at symptoms.

Hot flashes – These are sudden surges in body heat, causing flushing and sweating. Hot flashes that disrupt sleep are called night sweats.

Try this: Keep cool by dressing in easy-to-shed layers, keep the room temperature cool and a fan handy, drink cold water, and avoid spicy foods. Log hot flashes in a journal to identify triggers.

Irregular menstrual cycles – your period may change in frequency and flow. You may have spotting between periods.

Try this: Your provider may recommend low-dose birth control pills or a progesterone intrauterine device (IUD). These can regulate periods, decrease any heavy bleeding.

Urinary issues – You may have sudden or frequent urination, leakage and more frequent urinary tract infections (UTIs).

Try this: Daily Kegel exercises can increase bladder control by strengthening pelvic muscles.

Vaginal problems – These may include dryness, itching or irritation of the vagina and genitals, which can make sex uncomfortable.

Try this: Water-based vaginal lubricants can help, or talk with your doctor about using prescription estrogen products.

Feeling hormonal or stressed out? – Around the time of perimenopause, many women report feeling sad or angry. Some say they have difficulty concentrating, and their moods swing from one extreme to another.

Try this: Practice stress management techniques, such as yoga or meditation. Stay active with aerobic activity and strength training to strengthen bones, lose weight, boost mood, and aid with sleep.

Hormone replacement therapy is used, if needed, to treat perimenopausal symptoms and can help prevent bone loss. Prescriptions exist in the form of a pill, patch, gel, vaginal cream, or slow-releasing suppository or ring that you place in your vagina. Your care provider can determine which hormone therapy is right for you.

If perimenopause is making your life difficult, talk with your care provider. Together, you can choose the treatment option that’s right for you and find relief.


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Dr. Clare Rudolph is a board-certified OB-GYN with Barton Women’s Health. Learn more about managing menopause during a FREE wellness webinar with Dr. Amy Tomlinson of Barton Women's Health on Thursday, October 14 at 5pm. Register online at BartonHealth.org/Lecture.