Navigating Perimenopause with Confidence

Perimenopause marks the beginning of a new phase in a woman’s life. It’s a natural transition that represents the gradual end of her reproductive years. With expert guidance from professionals like Dr. Erica Giwa, an OB/GYN physician and former assistant professor in the Department of Obstetrics and Gynecology at Baylor College of Medicine, Legacy Community Health offers women the support and resources they need to embrace perimenopause with confidence.

What is Perimenopause?

Perimenopause, which means ‘around menopause,’ is the timeframe in a woman’s life leading up to her last menstruation. It’s a normal phase in every woman’s life, yet many aren’t prepared.

“I find that most women have absolutely no idea what to expect as they enter menopause. Women know that their cycle will stop, and they may have hot flashes, but they don’t frequently know what other symptoms accompany the transition,” says Dr. Giwa.

This highlights the importance of having open conversations with your doctor about what actually takes place and the symptoms and experiences that women undergo.

Perimenopause and menopause is a natural process all women undergo at some point in middle age. Perimenopause usually begins when a woman is in her mid-40s, but can start as early as her 30s. The transition from perimenopause to menopause can last several years, with an average of four, but can range from two to eight years.

During perimenopause, the ovaries gradually produce less estrogen and progesterone, which causes changes in the menstrual cycle. Unlike menopause, where menstruation completely stops and a woman can no longer get pregnant, perimenopause is usually characterized by irregular periods and other symptoms that indicate these hormonal shifts.

Recognizing the Symptoms of Perimenopause

Dr. Giwa notes that women are often unaware of what to expect beyond hot flashes. This can lead to confusion and concern. They don’t realize they are in perimenopause until they speak to their doctor about symptoms they’re experiencing.

“Many women come in with other complaints like menstrual irregularities, vaginal dryness, vaginal itching, mood changes, etc.,” she says. Knowing what the normal range of perimenopause symptoms are can therefore put someone’s mind at ease.

Symptoms, some of which can impact daily life, range from physical to emotional:

• Irregular periods
• Longer or shorter periods than a woman previously had
• Hot flashes
• Heavy sweating
• Night sweats
• Trouble sleeping
• Joint and muscle aches
• Headaches
• Loss of bone density
• Weight gain
• Vaginal dryness, making vaginal intercourse uncomfortable
• Lower sexual drive
• Mood changes
• Irritability
• “Brain fog” such as trouble concentrating

While some of these symptoms improve on their own after menopause, others don’t. That’s why women need to consider whether their symptoms are disruptive enough to seek medical care. They can discuss their concerns with their doctor to jointly explore medical management options that are tailored to their unique needs.

Navigating the Options of Hormone Replacement Therapy

One of these medical treatment options is hormone replacement therapy (HRT), which can be a valuable tool in managing perimenopausal symptoms.

Dr. Giwa highlights the evolution of HRT and its role in minimizing and alleviating discomfort for many women. “Several years ago, a large trial called the Women’s Health Initiative released a study, and the finding showed that hormone therapy was associated with adverse side effects” and “many practitioners stopped prescribing HRT.”

Recently, however, “researchers have evaluated the finding and realized that findings are not applicable to the population of women who would benefit most from HRT. Women who are perimenopausal can really benefit from hormone replacement,” she says.

Hormone replacement comes in many different forms. Dr. Giwa notes that “the type of therapy best for you depends on [your] symptoms.”

• Pills provide systemic hormones and are best for vasomotor symptoms like hot flashes and night sweats.
• Patches provide systemic hormones and are thought to carry a lower risk profile compared to oral supplements.
• Vaginal creams, also called local estrogen therapy, are used to treat vaginal dryness.
• Pellets, which are injected under the skin by trained physicians, provide systemic hormones that are slowly released into the body.

Legacy Community Health Empowers Women Through Education and Resources

When it comes to effectively managing perimenopause, patient education is key. We offer patients resources and information to help them better understand this life transition. By fostering a community of support, women are empowered to take control of their health.

We recommend women consult with experts like Dr. Giwa to make informed decisions about HRT and other perimenopause treatments.

“Before initiating any method of HRT women should have a conversation with their provider to determine if they are a candidate an[d] discuss which method would be best,” says Dr. Giwa.

Our physicians provide a safe space for open discussions about symptoms, treatment options, and lifestyle adjustments. Our personalized approach ensures patients feel heard, supported, and empowered to manage their health proactively.

“Women should not have to suffer through perimenopause and menopause. If women are considering treatment they should talk to their health care provider to determine [what] is appropriate for them,” she adds.

Get in Touch With Legacy Community Health

If you’re experiencing perimenopause and seeking guidance, Legacy Community Health is here to help. Legacy offers a wide range of services to support women during perimenopause, including OB/GYN care, Endocrinology, and Behavioral Health.

Beyond these services, we ensure patients have access to other services like Adult Primary Care, HIV/STD Screening, LGBTQ Services,  Pediatrics, Pharmacy, Senior Care, Vaccinations & Immunizations, and Vision as well, regardless of income or ability to pay.

Visit us online or call (832) 548-5000 to schedule an appointment.