Menopause

Midlife Transition – Perimenopause to Menopause

Midlife is a stage of life between the ages of 40 and 60 years.  Menopause is defined as the absence of menstrual cycles for one year.  The average age of menopause is 51.7 years but the changes that are experienced in the midlife transition begin before menopause and extend after the cessation of the menstrual cycles.  It is an ongoing time of transition.

 

During the perimenopausal years, there is a gradual change in estrogen levels.  Women will notice several changes, which may arise very slowly. Most women may not even be aware of the changes as they happen. These changes are due to the decreasing size of the ovaries and the resulting decrease of the body’s estrogen levels.

The decrease in estrogen can lead to many symptoms. The most common is irregularity of menstrual cycles. During this time, patients will also notice hot flashes, primarily at night, and insomnia. Vaginal and urinary changes will also be noted as well as a decrease in sexual desire.  Vaginal dryness and urinary frequency will respond to vaginal estrogen cream. During your consultation regarding the midlife transition, I will discuss the ways to handle these symptoms.

 

Less obvious are the skeletal changes that occur. A loss of bone density is a side effect of menopause and it is important to monitor it and help you manage any changes in density appropriately. I emphasize a range of approaches, including supplementing your diet with calcium and vitamin D, and exercise, especially weightlifting.

 

Increase in cardiovascular risk, in particular a rise in cholesterol, high blood pressure and the development of diabetes, all are more common in this stage of life.  These risks will be increased by inactivity, smoking, and in patients who are overweight or who have a strong family history of cardiovascular disease.  My goal is to prevent heart disease, vascular disease, and strokes and help you achieve healthy living during these final years.

Emotional concerns, whether depression and/or anxiety, are also common during these years. There are multiple therapies that can help including aerobic exercise, stress control methods, antidepressants, and hormone replacement therapy. My goal is to help you find the best combination of methods to control your symptoms.