Treating Menopause Symptoms

Perimenopause is the time leading up to menopause.

• This stage usually starts in your 30s, 40s, or 50s.
• It can last 4 to 10 years, with symptoms coming and going.
• During this time, your body's levels of estrogen and progesterone are changing rapidly.  You may experience changes in your period, as well as other symptoms, because of these spikes and dips.

Menopause is when your periods stop completely for 12 months in a row and you can no longer get pregnant.

• It usually happens between the ages of 45 and 55 but can vary.

Postmenopause is the period after menopause.  Typically, your menopause symptoms will lessen over time.

Not everyone experiences the same menopause and perimenopause symptoms, but these are the most common:

• Hot flashes (sudden feelings of heat that can cause sweating or redness)
• Night sweats (hot flashes at night that may wake you up)
• Irregular periods (they may get closer together, further apart, or be heavier or lighter than usual)
• Mood changes (feeling irritable, anxious, sad, etc., more often)
• Trouble falling or staying asleep
• Fatigue
• Vaginal dryness, which can cause discomfort or pain during sex
• Dry skin
• Thinning hair or hair loss
• Changes in your nails
• Weight gain, especially around the belly
• Change in sex drive (libido)
• Joint pain
• Breast tenderness
• Heart pounding or racing (palpitations)

There’s no one-size-fits-all approach.  Talk to your medical provider about the symptoms that bother you the most, and they can help determine the best treatment.

Treatment options include:

1) Lifestyle changes

• Avoid triggers that can make hot flashes worse (alcohol, caffeine, spicy foods, hot drinks, etc.).
• Stay cool by wearing lightweight clothes, using fans or ice packs, or lowering the room temperature.
• Stay active.  Regular exercise can help with mood, sleep, and weight management.
• Eat healthy.  Focus on fruits, vegetables, whole grains, beans, and calcium-rich foods.

2) Medications

• Hormone treatments that replace estrogen and/or progesterone can reduce symptoms like hot flashes and prevent bone loss.
• Nonhormonal medications (certain antidepressants and other drugs) can help with mood changes or hot flashes.

3) Mind-body practices

• Acupuncture can help make hot flashes less frequent and less intense.
• Yoga, meditation, or deep breathing can help you manage stress.

4) Supplements (see below)

Finding a combination that works may take trial and error.  Consider trying the following:

1) Black cohosh (Remifemin)

• The dose depends on the formulation, so follow the package directions.
• If taking Remifemin, take 20 mg 1 to 2 times a day.
• Limit use to 6 to 12 months.
• There are very rare reports of liver injury.  If you have liver disease, talk to your provider.

2) Rheum rhaponticum (Estrovera)

• Take 4 mg daily.

3) Maca (Femmenessence)

• Take 1,500 to 3,000 mg daily with food.

4) Soy isoflavones

• Try 40 to 80 mg daily.
• Or add more soy to your diet with foods like miso, tempeh, tofu, edamame, or soy milk.

Menopause and perimenopause symptoms can interfere with your everyday life. Let us know if you want to discuss treatment options or need support.

During perimenopause, reach out to a medical provider if you:

• Notice your periods get heavier or last longer
• Have vaginal bleeding more than once a month

After menopause, let a medical provider know if you have any vaginal bleeding.

If you're taking hormones, let your provider know right away if you notice:

• Upset stomach
• Nausea
• Vomiting
• Abdominal pain
• Leg swelling or pain
• Chest pain
• Difficulty breathing