by Catherine Westerband, M.D.
Perimenopause is defined as the phase in a woman’s life when the body progresses from previously regular cycles of ovulation to the complete stop of menstrual bleeding for 12 consecutive months.
It is a process, a gradual transition, a natural shift that occurs usually in your 40‘s. It occurs sooner if you smoke. It can last a few weeks or a few years.
Perimenopause is caused by a progressive decline in the ovarian function resulting in an inconsistent hormonal production of estrogen and progesterone. This imbalance in hormonal levels is responsible for the changes and symptoms noticed during perimenopause.
Some symptoms you might experience are:
Cycles become shorter or longer and spotting occurs. Periods can become very heavy resulting in anemia. You need to see your doctor for evaluation. Once uterine cancer has been ruled out, we can offer different forms of treatment including low dose birth control pills or progesterone therapy.
Uterine ablation provides an effective way of removing the lining of the uterus, where the bleeding occurs. It is a convenient in office procedure with short recovery time. In more than 90% of the time, it stops the bleeding or reduces it. Some women might need a hysterectomy.
HOT FLASHES, NIGHT SWEATS AND SLEEP PROBLEMS
These symptoms occur more often in late perimenopause. They can be mild or very disturbing. They can last a few months or a few years. Some women never experience them. The lack of sleep often results in increased difficulty of concentration. This adds to the general sensation of not feeling so well. Talk to your doctor to see if estrogen therapy is the right treatment for you. Estrogen can also be found in some plants like soy. In some cases, low dose birth control pill will be helpful.
VAGINAL DRYNESS AND PAIN DURING INTERCOURSE, VAGINAL IRRITATION AND BLADDER DISCOMFORT
The decrease of estrogen production results in a decrease in both vaginal elasticity and thickness, and lubricant production by vaginal glands. All those factors result in pain during intercourse. The bladder has estrogen receptors and is very sensitive to the drop of estrogen levels .Estrogen therapy is effective in reducing those symptoms. They can be given orally or in the form of transversal patches or intra vaginally. Your doctor will help you to see if estrogen is right for you. Lubricants during intercourse are also helpful.
The ability to conceive decreases and stops once you reach menopause. In perimenopause, pregnancy, although very rare, is a possibility and contraception should be used.
SUGGESTIONS FOR EVERYONE
Healthy balanced life style choices will help ease the symptoms of perimenopause.
- Stop smoking
- Eat right
- Exercise physically and mentally
- Minimize stress
- Strive for balance in a socially fulfilled life
Many women find perimenopause challenging and complex. Hopefully a little information will help you to embrace this transition with grace and serenity.
We would be happy to discuss your personal symptoms of perimenopause with you, and would appreciate your referral to us of a family member or friend with these concerns.
Wishing you good health from the Genesis OB/GYN family of physicians.
Catherine Westerband, M.D.
A native of Alsace, France, Dr. Catherine Westerband attended University Louis Pasteur of Strasbourg, France, prior to coming to the United States. She completed a residency program in Obstetrics and Gynecology at University Hospitals of Cleveland, the primary teaching affiliate of Case Western Reserve University, Cleveland, Ohio. Dr. Westerband is board certified by the American Congress of Obstetricians and Gynecologists and also a Diplomat of the European Board of Obstetrics and Gynecology.
Dr. Westerband has a special interest in emerging gynecological surgery methods and the new laparoscopic approaches. She offers in-office procedures, including endometrial ablation, an alternative to hysterectomy in selected circumstances.
She is fluent in English, French and German, and conversational in Spanish. Her office is located at 1871 W. Orange Grove Road, Tucson. Appointments may be arranged by phoning 498-5000.