What is Perimenopause and Menopause?

Perimenopause refers to the period before menopause when women's bodies begin to decrease the number of eggs available, and hormone levels begin to change. The average age of perimenopause is 45, although it varies from woman to woman. Perimenopause lasts between 2 and 8 years. Menopause is defined as a woman not having her period for at least 12 months. In some cases a woman has her ovaries removed and goes into menopause immediately.

During perimenopause several hormonal changes occur. Follicle stimulating hormone (FSH) levels rise, estrogen levels decrease during the later stages of perimenopause and progesterone levels drop. Interestingly, estrogen levels are very high near menopause and then make a dramatic drop.

What symptoms may I see if I am perimenopausal/menopausal?

Menopause is a time in a woman's life when many changes occur: physically, mentally, socially, spiritually and emotionally. It is a time when women are presented with options for dealing with the less appealing aspects of menopause. Symptoms vary widely and may include:

• Hot flashes
• Mood swings
• Insomnia
• Vaginal dryness
• Lowered libido
• Depression or anxiety
• Loss of memory
• Irregular bleeding/"missed" periods
• Urinary dysfunction.

What steps should I take to deal with the symptoms?

Each woman has a different and unique experience during perimenopause and menopause. Some have more debilitating symptoms, while other have very mild symptoms. However, no matter what your symptoms, age or medical history, each woman has an opportunity to improve her health during this phase of her life. Menopause is a great opportunity to embrace your changes and make steps to improve your life. Some preventive measures that women should be starting or continuing to incorporate into their lifestyles at this age are:

• An exercise program that is appropriate for your age and health which includes weight bearing and aerobic activities.
• Assessing your lifestyle habits that may be detrimental to your long term health including smoking, alcohol intake, saturated fat intake, sedentary lifestyle, unhealthy weight.
• Find a primary healthcare practitioner that you trust and are comfortable with, who takes time to address your concerns and discuss testing options such as bone mineral density testing and blood tests. Ensure that you get a complete annual physical exam. Request that your practitioner explain pros and cons of treatment and preventive options with you.
• Maintaining adequate dental health. It has been shown that having healthy teeth and gums is a good indicator for overall health.
• Beginning to consider how you can prevent developing osteoporosis, heart disease and age-related diseases.

How can a naturopathic doctor help me during this phase of my life?

Each woman is faced with the task of deciding which direction to take her health. There are many options for a more holistic, natural approach to perimenopause, menopause and menopausal symptoms. Each woman is unique, and her healthcare should be too, especially during this phase when there are so many things to consider. There are controversies surrounding hormone replacement therapy and your naturopathic doctor can help to assess your needs and discuss natural alternative options with you. In addition, it is important to assess a woman's risk of diseases such as cardiovascular, osteoporosis and age-related cancers. Together with your naturopathic doctor a comprehensive plan can be found to decrease the side effects of menopause and increase your health in this phase of your life.