Is there any treatment for perimenopause?

Dr. Jeanne Morrison, PhD
Family Practitioner

Women who have severe hot flashes and night sweats during perimenopause sometimes choose to use drugs to help relieve the symptoms. In most cases, menopausal hormone therapy (MHT) is used. A woman who no longer has her uterus can use estrogen alone. Women who still have their uterus usually use a combination of estrogen and progesterone or progestin (a drug similar to progesterone) to help protect the lining of the uterus from cancer, as estrogen alone increases your risk for endometrial cancer.

MHT can be in many different forms, including pills, skin patches, and creams, and using many combinations of hormones. Because MHT can have serious side effects, the FDA recommends using the lowest dose possible to relieve symptoms and using the drug for the shortest time possible. The goal is to relieve symptoms, not to restore hormones to reproductive-age levels. Nonhormonal drugs, such as low doses of an antidepressant, can also sometimes help relieve hot flashes.

Marcy Holmes, MSN, NP
Nursing Specialist

Women’s health nurse practitioner and menopause clinician Marcy Holmes discusses some alternative treatment options for perimenopause symptoms. Watch Marcy's video for tips and information women's health.

Dr. Mehmet Oz, MD
Cardiologist (Heart Specialist)

Just because you’re going through perimenopause—the time before women go through menopause—doesn’t mean you have to suffer. There are medical treatments and lifestyle strategies to help deal with symptoms some women have in perimenopause. It will depend on your specific symptoms, your personal preferences and what your doctor recommends. The most commons symptoms women experience during this time of life—usually between the ages of 47 and 55—are hot flashes, night sweats and vaginal atrophy, which causes vaginal dryness, itching and irritation.

Some doctors do not like to offer menopausal hormonal treatments as a first-line option during perimenopause because your natural hormones are still in flux. They may prefer to try non-hormonal strategies first. You can ask your doctor if a low-dose estrogen cream, gel or vaginal ring is right for you. This can increase the lubricating fluids inside the vagina. And if you are bothered by the irregularity of your periods, you can ask about taking a low-dose birth control pill.

Patricia Geraghty, NP
Women's Health

Most women have symptoms during the years before and after the last menstrual period and most women fail to choose effective and safe treatment because of statements over simplifying risk. The risks, though small, become significant when hormone use is continued into the sixth decade but not at ages closer to the final menstrual period. The most effective treatments are estrogen with or without progestin. For women who can't use menopause hormones, medications used to treat depression can also help reduce symptoms. The treatment plan needs to be individualized to each woman.

There are a number of things you can try to help ease symptoms of perimenopause. Ask your doctor about hormonal contraceptives (birth control pills, ring, or patch); even if you don't need it for birth control, the hormones can ease symptoms. Or just ask about menopause hormone therapy (MHT) if you are no longer having periods. MHT contains much lower doses of hormones, and thus has less risk for side effects. (If you are over 35, you should not take birth control pills if you smoke or have a history of blood clots.) Make sure to let your doctor know if you are looking into complementary medicine as well; many herbal medications with a reputation for helping menopausal symptoms have not been shown effective in clinical tests, but may still interfere with other medications.

Lifestyle changes that may improve symptoms include the following:

  • Get 30 minutes or more of exercise most days or the week to keep your weight down, sleep better, strengthen bones, and improve mood. Ask your doctor before starting a new exercise program.
  • If your diet can be healthier, go for it! Lots of whole-grain foods, vegetables, and fruits will help you feel good and lower risk for heart disease and cancer. Calcium-rich foods and vitamin D also may improve bone strength. or take a calcium supplement to obtain your recommended daily intake. Avoid alcohol or caffeine, which also can trigger hot flashes in some women and prevent good sleep.
  • Find healthy ways to cope with stress. Meditation, yoga, tai chi, practicing mindfulness, and other such things can help you relax and deal with symptoms.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.