Menopause and perimenopause Archive

Using hormone therapy, which involves taking estrogen and sometimes progesterone, doesn't stop or slow the approach of menopause. The arrival of menopause is determined by women's ovaries, not by the amount of these hormones in the body.

Women receive less information about perimenopause compared with the earlier milestones of puberty and pregnancy. Some women deal with an array of symptoms they don't connect to perimenopause and aren't aware that lifestyle changes can offset them. The menopause transition often involves weight gain from both shifting hormones and aging. Regular exercise and strength training can mitigate weight gain. Healthy eating habits and sounder sleep can also offset perimenopausal symptoms.

Women officially reach menopause a year after periods end. Any vaginal bleeding after menopause should be evaluated. Bleeding can come from vaginal dryness or atrophy, medication side effects, various infections, endometrial thickening, or cancer.

The FDA added a boxed warning in December 2024 to fezolinetant (Veozah), a nonhormonal drug that reduces hot flashes and night sweats in menopausal women. The drug may cause rare but serious liver injury.

As estrogen levels drop, women's bodies store more fat around the abdomen, fueling a weight shift to the belly. Women can counter this by ramping up protein intake and doing strength training to maintain muscle mass and metabolism.

Over-the-counter menopause test kits detect levels of follicle-stimulating hormone (FSH) in a urine sample. But FSH levels can be high just before ovulation as well as when menopause is approaching, making test results ambiguous.

A new type of nonhormonal medication to prevent hot flashes and night sweats due to menopause, Veozah, was approved by the FDA in 2023. An ad for the drug has useful information, but some key questions are not answered.

Dozens of over-the-counter supplements are marketed to women in the menopause transition that purportedly help relieve bothersome symptoms such as hot flashes, low libido, brain fog, or mood shifts. But because these products don't require FDA approval or rigorous testing, women should be wary about their effectiveness. Women who consider menopause supplements should avoid blended products, stop taking them if they experience side effects, and try healthy lifestyle changes such as diet, exercise, and weight control to allay symptoms.