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Perimenopause symptoms: What’s normal, what’s not

For women, the time period of hot flashes, irregular menstrual cycles and mood swings is commonly known as menopause. A more accurate term to describe this phase of life, however, is perimenopause.  

“Perimenopause is simply the timeframe leading up to menopause itself,” says Heide Moeling, M.D., an obstetrician and gynecologist at Piedmont. “It’s a normal process characterized by fluctuating symptoms, due to variations in hormone levels.”

Most women experience some or all of the following symptoms at some point in perimenopause. The key to relieving unpleasant symptoms is knowing when to try at-home remedies and when to seek medical intervention.

Irregular menstrual cycles

“Irregular menses are common during this time, but patients should contact their doctor if their bleeding becomes prolonged or unusually heavy,” says Dr. Moeling.

If your period lasts longer than seven days or the flow requires you to change feminine products at least once an hour, it is considered unusually heavy.

Vaginal dryness

There are a multitude of products available for vaginal dryness, including over-the-counter water-soluble lubricants such as KY Jelly or Astroglide, and personal lubricants that require a prescription, such as Rephresh and Replens. Dr. Moeling warns against using oil-based products, such as petroleum jelly or baby oil, because they do not break down and can lead to infection.

“Women who have severe vaginal dryness or discomfort/pain during intercourse may find that over-the-counter lubricants don’t provide enough relief,” she says. “In these cases, there are prescription options available that are extremely effective and have minimal risks and side effects.”

Mood swings and decreased sex drive

“These are somewhat more difficult to address,” says Dr. Moeling.

Lifestyle changes are often the first step in treatment.

“Regular exercise has consistently been proven to improve sleep, mood and libido, as well as reduce hot flashes and combat weight gain,” she explains. “Reduction in caffeine, alcohol and spicy foods can reduce the number and severity of hot flashes and night sweats.”

For more complicated cases, hormone replacement therapy may be a good option.

If your symptoms are not under control after implementing lifestyle changes, talk to your doctor. 

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