As women enter their late 30s and early 40s, they may begin noticing physical and emotional changes that can feel confusing or even concerning. Irregular periods, mood swings, hot flashes and disrupted sleep often lead to the same question: “Is this perimenopause?”

Perimenopause is a natural transition that leads to menopause, and while the symptoms can be disruptive, there are options available to help manage them. One of the most commonly asked-about treatments is hormone therapy. Your OB-GYN can help you navigate this stage of life with personalized care and informed recommendations.

What is perimenopause? 

Perimenopause refers to the time when a woman’s hormones like estrogen and progesterone begin to shift. It ends once you’ve gone 12 months without a menstrual period, which marks the beginning of menopause.

• Common symptoms of perimenopause include:
• Irregular periods
• Hot flashes and night sweats
• Vaginal dryness or discomfort during intercourse
• Trouble sleeping
• Mood changes or increased anxiety
• Decreased libido
• Difficulty concentrating or memory issues

It’s important to know that symptoms can vary from woman to woman. Some may only notice mild changes, while others may experience more significant disruptions to their daily life.

When to talk to your OB-GYN

While these changes are a normal part of aging, you don’t have to just “tough it out.” If symptoms are interfering with your quality of life, it’s a good idea to speak with your OB-GYN.

During your visit, your doctor will take a complete health history, ask about your symptoms, and may perform blood work or other tests to rule out other conditions, like thyroid problems. From there, you can discuss the best treatment plan for your needs and health profile.

Is hormone therapy right for you?

Hormone therapy, or menopausal hormone therapy (MHT), can be highly effective for treating moderate to severe hot flashes, night sweats, and vaginal dryness. It works by supplementing the body’s decreasing levels of estrogen (and sometimes progesterone) during perimenopause and menopause.

However, hormone therapy isn’t appropriate for everyone. It may not be recommended if you:

• Have a history of breast cancer or certain other cancers
• Have a history of blood clots, stroke or heart disease
• Have liver disease or unexplained vaginal bleeding

For some women, non-hormonal medications, lifestyle adjustments, or targeted therapies like vaginal estrogen creams may be better suited. Your OB-GYN can help you weigh the benefits and risks and decide together on the best course of action.

There is no one-size-fits-all approach to managing perimenopause. What matters most is having open conversations with your provider and building a care plan that supports your health, comfort and long-term wellbeing.

(Dr. Ethan Gable is with UPMC Magee-Womens. For more information, visit UPMC.com/WomensHealthNCPA.)