Perimenopause: Are you Prepared? Video Notes

Perimenopause: Are you Prepared? Video Notes

Important Take-aways from the video:

• Dr. Ashley Alexis is a menopause specialist.
• Perimenopause is a stage in the menopause transition where menstrual cycle changes and menopausal symptoms occur.
• Menstrual cycles can become irregular or skip months.
• Perimenopause typically starts between ages 42 and 50.
• Natural menopause is 12 months of no menstrual cycle.
• Induced menopause occurs through surgery or drugs.
• Early menopause is before the age of 45 and late menopause is after the age of 54.
• Symptoms of perimenopause include anxiety, depression, hot flashes, night sweats, low libido, vaginal dryness, weight gain, brain fog, mood swings, memory loss, irritability, skin and hair changes, fatigue, and insomnia.
• Hot flashes can vary in intensity and last longer than a few minutes.
• Weight gain is common in perimenopause due to changes in metabolic activity and the lean muscle to fat ratio.
• Mood swings can range from depression and anxiety to irritability and anger.
• Insomnia is common in perimenopause and a risk factor for cardiovascular disease and cognitive function.
• Vaginal dryness and related symptoms affect more than half of women after menopause, but many never mention it to a provider.
• Estrogen decline affects the collagen and hyaluronic acid in the connective tissue in the vaginal area.
• Low libido is caused by hormonal changes and mental-emotional factors.
• FSH, estrogen, and progesterone are important hormones in the menstrual cycle.
• Progesterone is only made in the second half of the cycle after ovulation.
• Testing for FSH, estrogen, and progesterone is important to assess hormonal changes.
• Postmenopause is after a woman has gone 12 months without a menstrual cycle.
• Perimenopause can be a tumultuous time due to the inconsistency in hormone production and cycles.
• Hormonal changes in perimenopause include a decline in follicles, increased FSH levels, infrequent ovulation, and a decline in overall estrogen production.
• Estrogen is important for maintaining various aspects of health such as cardiovascular health, cognitive health, bone health, libido, and energy.
• Hormone replacement therapy can be used to improve quality of life, reduce symptoms, and help protect bone health.
• Lab testing can be used to measure FSH, estrogen, progesterone, testosterone, DHEA, cortisol, thyroid function, inflammatory markers, iron, and vitamin D levels.
• Some specialty hormone tests can also look at how estrogen is metabolized, progesterone production and adrenal function. Your provider decides whether testing is needed to start.
• Adrenal adaptogens are sometimes used to support the stress response.
• Hormone testing can provide a comprehensive view of body hormones, especially helpful for perimenopause or considering hormone replacement therapy (HRT).
• Lifestyle treatments such as diet, exercise, stress management, and therapy can reduce symptoms and optimize the perimenopausal experience.
• Non-hormonal options such as various herbs, supplements, and therapies can reduce symptoms in perimenopause.
• HRT includes synthetic and bioidentical hormones with different effects and delivery methods. Bioidentical hormones are derived from plants, while some non-bioidentical estrogens are derived from horse urine. Safety and efficacy vary by delivery method and dose.
• Benefits of HRT include reducing hot flashes, treating vaginal dryness and atrophy, and preventing bone loss. Research on heart and brain benefits is ongoing and depends on when therapy starts.
• Working with a menopause specialist may be helpful, as many general practitioners and OB/GYNs have had little training in menopause management.
• Asking doctors about their experience and knowledge of menopause management can help gauge whether they are a good fit or if a menopause specialist should be sought out.