Perimenopause Learn more about perimenopause: Select each item to learn more. Facts This marks the period “around menopause” Declining fertility Transition towards menopause Usually in the 40’s Estrogen levels rise/fall – “unstable” Biggest complaint is menstrual irregularities Duration 2-8 years (average 5 yrs.) Presenting Symptoms Irregular periods Menopausal symptoms PMS symptoms Vaginal dryness Urinary incontinence Mood swings Sexual dysfunction Decreased fertility Risk Factors Family history – research shows no link Undergo menopause at a younger age Smokers Type 1 DM Increased altitude Undernourished/vegetarians Cancer treatment Hysterectomy Managing Perimenopause Transition Patient education Prevention of endometrial cancer Individualized symptomatic relief Menstrual control Minimizing hot flashes Mood disturbances Treatment Begins with Education Anticipatory guidance - Should begin at age 40 at yearly visits Vaginal dryness/Atrophy: Replens, Astroglide, KY jelly, lubrin, Canola oil, Vit E 100-600/day, evening primrose oil 2-4 capsule/day Diet, Exercise for prevention of osteoporosis, Calcium 1000-1200mg/day with 1000IU/day of Vit D Yearly mammogram and pelvic examination & BSE Need for contraception until 1 year of no menses Post menopausal bleeding and risks Prolapse- Kegels/pelvic floor PT Treatment of Perimenopause Symptoms Treatment should be catered towards presenting symptoms Bleeding – after confirming bleeding is benign and from hormonal instability, COC, POP, LNG-IUD, cycling progesterone, cryoablation Vaginal atrophy – OTC lubricants, vaginal estrogen RX Mood irritability – antidepressants – SSRI (fluoxetine 10mg), Effexor 37.5mg Menopausal symptoms – often relieved if you can stabilize hormones. COC a good option. Gabapentin (neurontin) reduced HF/NS
Facts This marks the period “around menopause” Declining fertility Transition towards menopause Usually in the 40’s Estrogen levels rise/fall – “unstable” Biggest complaint is menstrual irregularities Duration 2-8 years (average 5 yrs.) Presenting Symptoms Irregular periods Menopausal symptoms PMS symptoms Vaginal dryness Urinary incontinence Mood swings Sexual dysfunction Decreased fertility Risk Factors Family history – research shows no link Undergo menopause at a younger age Smokers Type 1 DM Increased altitude Undernourished/vegetarians Cancer treatment Hysterectomy Managing Perimenopause Transition Patient education Prevention of endometrial cancer Individualized symptomatic relief Menstrual control Minimizing hot flashes Mood disturbances Treatment Begins with Education Anticipatory guidance - Should begin at age 40 at yearly visits Vaginal dryness/Atrophy: Replens, Astroglide, KY jelly, lubrin, Canola oil, Vit E 100-600/day, evening primrose oil 2-4 capsule/day Diet, Exercise for prevention of osteoporosis, Calcium 1000-1200mg/day with 1000IU/day of Vit D Yearly mammogram and pelvic examination & BSE Need for contraception until 1 year of no menses Post menopausal bleeding and risks Prolapse- Kegels/pelvic floor PT Treatment of Perimenopause Symptoms Treatment should be catered towards presenting symptoms Bleeding – after confirming bleeding is benign and from hormonal instability, COC, POP, LNG-IUD, cycling progesterone, cryoablation Vaginal atrophy – OTC lubricants, vaginal estrogen RX Mood irritability – antidepressants – SSRI (fluoxetine 10mg), Effexor 37.5mg Menopausal symptoms – often relieved if you can stabilize hormones. COC a good option. Gabapentin (neurontin) reduced HF/NS
This marks the period “around menopause” Declining fertility Transition towards menopause Usually in the 40’s Estrogen levels rise/fall – “unstable” Biggest complaint is menstrual irregularities Duration 2-8 years (average 5 yrs.)
Irregular periods Menopausal symptoms PMS symptoms Vaginal dryness Urinary incontinence Mood swings Sexual dysfunction Decreased fertility
Family history – research shows no link Undergo menopause at a younger age Smokers Type 1 DM Increased altitude Undernourished/vegetarians Cancer treatment Hysterectomy
Patient education Prevention of endometrial cancer Individualized symptomatic relief Menstrual control Minimizing hot flashes Mood disturbances
Anticipatory guidance - Should begin at age 40 at yearly visits Vaginal dryness/Atrophy: Replens, Astroglide, KY jelly, lubrin, Canola oil, Vit E 100-600/day, evening primrose oil 2-4 capsule/day Diet, Exercise for prevention of osteoporosis, Calcium 1000-1200mg/day with 1000IU/day of Vit D Yearly mammogram and pelvic examination & BSE Need for contraception until 1 year of no menses Post menopausal bleeding and risks Prolapse- Kegels/pelvic floor PT
Treatment should be catered towards presenting symptoms Bleeding – after confirming bleeding is benign and from hormonal instability, COC, POP, LNG-IUD, cycling progesterone, cryoablation Vaginal atrophy – OTC lubricants, vaginal estrogen RX Mood irritability – antidepressants – SSRI (fluoxetine 10mg), Effexor 37.5mg Menopausal symptoms – often relieved if you can stabilize hormones. COC a good option. Gabapentin (neurontin) reduced HF/NS