Perimenopause

Making certain healthy lifestyle choices can help ease perimenopause symptoms and promote overall health as you age:

• Ease vaginal discomfort: Over-the-counter water-based lubricants or moisturizers can help with vaginal dryness. Be sure to choose products that don't contain glycerin if you're sensitive to it. Staying sexually active also helps by improving blood flow to the vagina.
• Eat healthy: Since your risk for osteoporosis and heart disease increases during perimenopause, a balanced diet is more important than ever. Focus on a low-fat, high-fiber diet rich in fruits, vegetables and whole grains. Add calcium-rich foods to support bone health. If hot flashes are an issue, try cutting back on alcohol and caffeine. Talk to your doctor about whether you should take a calcium or vitamin D supplement.
• Be active: Regular exercise helps prevent weight gain, improves sleep and boosts your mood. Aim for at least 30 minutes of physical activity most days but avoid exercising too close to bedtime. Staying active also supports bone density and can reduce the risk of hip fractures in older women.
• Get enough sleep: Stick to a consistent sleep schedule and avoid caffeine, which can make it harder to fall asleep. Limit alcohol, which can disrupt sleep patterns.

Many women find that medication helps manage perimenopause symptoms effectively:

• Vaginal estrogen: Delivered via tablets, rings or creams, vaginal estrogen helps with vaginal dryness and discomfort during sex. It also helps with some urinary symptoms by releasing small amounts of estrogen directly to the vaginal tissue.
• Antidepressants: Some antidepressants (SSRIs) can reduce hot flashes and may be recommended for women who can’t take estrogen or who need treatment for mood disorders.
• Gabapentin: Originally used for seizures, gabapentin can help reduce hot flashes and is often used for women who cannot take estrogen. It may also help women who have migraines.
• Fezolinetant: This hormone-free medication helps relieve hot flashes by blocking a brain pathway that helps regulate body temperature.

Along with traditional treatments, many women find that complementary therapies can help manage perimenopause symptoms. Integrative medicine is a holistic approach that combines conventional healthcare with alternative treatments to focus on overall health—body, mind and spirit.

Here are some complementary therapies that may provide relief:

• Acupuncture: While research on acupuncture for hot flashes is still mixed, some women find it helpful. Acupuncture is believed to help balance the body’s energy and may reduce some symptoms of perimenopause.
• Meditation and mindfulness: These practices can help reduce stress and anxiety, which often increase during perimenopause. Meditation and mindfulness can also help you sleep better and manage mood swings, leading to improved emotional health.
• Massage therapy: Massage is a great way to relieve tension, reduce stress and improve sleep. It may also help with common perimenopause symptoms like joint pain and muscle aches.

Before trying any complementary therapies, it’s important to talk to your healthcare provider. They can help guide you on what’s safe and effective for you and show you how to combine these treatments with conventional care for the best results.

Hormone replacement therapy (HRT) is a common treatment used to manage perimenopause symptoms. As your body’s hormone levels change during perimenopause and menopause, HRT helps to replace the hormones your body may not be producing as much of anymore. This can help ease symptoms like hot flashes, night sweats, mood swings and vaginal dryness.

There are different types of hormone replacement therapy, and the right one for you will depend on your specific symptoms and health needs. For many women, HRT can significantly improve quality of life during this time of transition.