How to cope with this midlife milestone

Some women consider menopause a health problem to bring to the doctor. Others view it as a natural part of life to be managed, not treated. Either way, this time of life can be a bit like traveling in a new city without a map — or even a clear destination. In fact, you may not even realize you’re there until you’ve passed it. 

Many of the symptoms of perimenopause show up as hormonal shifts. During perimenopause, a woman’s ovaries make different amounts of hormones than usual, causing estrogen and progesterone production to vary greatly. Sometimes symptoms go away by themselves, and often lifestyle changes can help. Here are some common issues and ways to cope with them. 

Unpredictable Periods
Often the first sign of perimenopause, menstrual irregularity is common as women enter their mid- to late 40s. Periods may come more or less often, last shorter or longer, or be lighter or heavier. 

If you’re experiencing heavy periods, talk with your health care provider about various treatment options. There are different types of medications and hormonal contraceptives that may reduce the bleeding and related problems.

The Heat Is On
As many as 75% of perimenopausal women experience sudden surges of heat, known as hot flashes or flushes. They’re considered night sweats if they occur with perspiration during sleep. Usually, the upper body starts to feel hot, and sometimes heavy sweating and cold shivering follow this sensation. Hot flashes can make your skin look blotchy and red as blood vessels in the skin surface expand. 

To beat the heat, try these tactics:

• Dress in easy-to-shed layers.
• Drink cold water when you feel a hot flash coming on.
• Avoid triggers like spicy foods, alcohol and caffeine.
• Keep rooms cool.
  

Losing weight, if you’re overweight, may also help improve hot flashes. And if you feel one starting, try relaxation breathing — slow, relaxed, deep breathing at an even pace. 
Some women may get relief from eating soy foods or taking supplements. Potentially helpful herbs include black cohosh and red clover. Talk with your provider about any herbs or supplements you’re considering, since they may not mix well with other medications. 

What About Medication?
Prescription hormone therapy can reduce hot flashes, alleviate night sweats and relieve vaginal symptoms. But it may raise your risk for blood clots, heart attack, stroke, breast cancer and gall bladder disease. Because of this, the U.S. Food and Drug Administration advises using hormone therapy at the lowest dose that relieves symptoms for the least time needed.

If vaginal dryness and discomfort aren’t relieved by OTC care, prescription medicines are available. Providers can also prescribe vaginal estrogen, which doesn’t carry the same risks as taking hormone pills.

Finally, if your emotions feel out of control, consider seeing a therapist or joining a support group. Or talk with your provider about whether you may have an underlying condition, such as depression.