Transcript of "Chapter 20 Perimenopause and Menopause"
What is the difference between
Perimenopause and Menopause?
The ovaries function
erratically and hormonal
fluctuations may bring a
range on changes.
Can be a one-to-ten year
Changes include: Hot
flashes, night sweats,
trouble sleeping, and
heavy menstrual bleeding.
Each woman is affected to
the transition differently.
Ovaries settle down and
hormones have declined
to low, steady levels.
Marked by the final
menstrual period (final
after one year with no
Brings the end of
social, and physical
Everything from a
new sort of
loneliness to a
profound sense of
new freedom may
The menopause transition may fill our
minds with all sorts of questions:
What do I want to do?
What am I not able to do?
What can I control?
How do I want to live?
Have I reached
Transition can begin
from late 30’s to 60
and can last from 1-10
Smokers tend to reach
Women typically begin
the transition at the
same age as their
According to Endocrinologist, Jerilynn Prior, if
you apply to any three of the list below, you
can assume you have begun perimenopause:
New-onset heavy and/or longer flow
Shorter menstrual cycles (less than 25 days)
Newly sore, swollen, or lumpy breasts
New midsleep wakening
Onset of night sweats (esp. around menstrual
New or markedly increased migraine headaches
New or increased premenstrual mood swings
Weight gain without changes in exercise or
Non-medical self help
approaches to alleviate
family and friends
Premenstrual Syndrome (PMS)
◦ Swollen/tender breasts, bloating, anxiety, etc
Menstrual Cycle Changes
◦ Shorter cycles, skipped periods
Abnormally Heavy Bleeding
◦ 25% of women in perimenopause experience
Facts about Perimenopause
Contrary to popular
belief, you can still
20-30% of women
never experience hot
are common in both
Ways to Eliminate Sleep
Cut out caffeinated
Avoid or limit
Go to bed at
same time each
Before bed, take a
bath, listen to music
Filter out noise and
Vaginal dryness is a
common change in early
decline and the vaginal
walls frequently become
thinner, drier, less
flexible, and more prone
to tears and cracks
Finding the need to
urinate more often
(sudden strong urge to
urinate followed by
Incontinence can be
treated, and sometimes
cured (i.e. kegal
Tips to Relieve Vaginal Dryness
and Sexual Discomfort
Wait until fully
Drink more fluids
The ratio of body fat to muscle mass
increases as we grow older, so it is very
important to exercise to maintain muscle
Weight gain is common due to a
combination of slower metabolism,
decreased activity, and increased caloric
Eating well can help prevent/manage
chronic diseases and enhance sexuality.
Bone Loss and Osteoporosis
Osteoporosis is a condition of significantly
low bone density.
As we get older, we start to lose bone
faster than we replace it.
Prevention includes: yoga, jogging,
strengthening with weights, avoiding
harmful habits, eating healthy, etc.
Vitamins that limit bone loss and reduce
fractures are Calcium, Vitamin D, and
Care and Treatment for
Alternative therapies such as herbs or
Western medicine of drugs or surgery
Establishing a relationship with a
healthcare practitioner or clinician whose
philosophy is similar to yours and is
Possessing insurance and access to
Nonhormonal medications such as
bisphosphonates, anti-depressants, or
Hormone Therapy is the process which
women receive treatments and
medications to help the body replace
hormones that are no longer produced
Pros: Relieves discomfort of menopause
(hot flashes, night sweats, vaginal
Cons: Causes health risks (breast cancer,
stroke, blood clots)
Debate over Hormone Therapy
There is a current debate regarding the
use of hormone therapy. Some feel that
because perimenopause and menopause
are not diseases, then treatments should
not be pushed on women. Although HT
may provide negative effects, others who
suffer during this time are happy to know
that there are treatment options and are
willing to take the risks.
What are your thoughts on the
debate over hormone therapy?
“ Intellectually, I know some of my physical
and mental capacities will diminish as I
age, but I want to deal with this with a
sense of self-acceptance [and] not lower
expectations. I hope my generation of
feminist boomers will not deny the limits of
aging and not give in to internalized ageist
attitudes towards others and ourselves as
we age” (546)
The Boston Women’s Health Book
Collective.“Chapter 20: Perimenopause and
Menopause” (pages 505-546). 2011. Our Bodies,
Ourselves. New York, NY: Simon & Schuster.
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