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Prevention & Management of Symptoms During Peri-Menopause  

What options are available to prevent and manage the symptoms of peri-menopause?

There are many options available to prevent and manage the symptoms of peri-menopause.

Peri-menopause (also called perimenopause) means around the time of menopause. In adult women, peri-menopause is the time in women’s lives that precedes complete menopause. To learn about causes of peri-menopause and symptoms that may occur, see our Q&A called Peri-Menopause.

Feeling anxiety about peri-menopause can cause a cascade of physiological events that can lead to more physical and psychological symptoms than you normally might have experienced.

Therefore, the best attitude for you to have during peri-menopause is to not label yourself and to not be anxious over a passage in life. Allowing your body to adjust to this transition in life and practicing lifestyle behaviors that create a sense of well-being will reduce the stress of natural changes in your life and help you to enjoy the ride.

Despite the fact that some symptoms may occur during your body’s transition, the following healthy approaches can help you prevent and manage symptoms:

• Avoid smoking cigarettes
• Avoid consuming excessive amounts of caffeine, alcohol, and other stimulants
• To avoid feeling fatigued or light-headed, to prevent headaches, and to stabilize your level of blood sugar, eat breakfast and your other meals at regular intervals throughout the day and evening
• Reduce your intake of sugar
• Eat foods that are rich in calcium and vitamin D
• Take multivitamin/mineral supplements containing vitamin C, vitamin D, vitamin E, boron, calcium, and magnesium
• Increase your dietary intake of grains and vegetables (e.g., soybeans) rich in phytoestrogens (i.e., substances that mimic some of the effects of estrogen)
• Take ground flaxseed or flaxseed oil
• Take herbal supplements (e.g., soy isoflavones, black cohosh, and red clover) containing phytoestrogens, which can help prevent certain symptoms including hot flashes and menstrual cramps. Be sure to consult your integrative medical physician and gynecologist regarding the proper amount for you.
• Take herbal supplements containing soy isoflavones or ipriflavone to help prevent osteoporosis
• Take herbal supplements such as chasteberry, evening primrose, and Panax ginseng
• During the weeks other than during your period, take the herbal supplement, dong quai
• Eat fish (such as halibut, herring, mackerel, salmon, sardines, and tuna) that is rich in omega-3 fatty acids
• Take fish oil supplements that are rich in omega-3 fatty acids
• To help improve memory, take supplements containing gingko
• If you have hot flashes, boron and the bioflavinoid, hesperidin, can help reduce the symptoms
• If you have uncomfortable hot flashes, take a homeopathic remedy, such as arsenicum album, calcarea carbonica, cimicifuga (black cohosh), lachesis mutus, phosphorus, pulsatilla, sepia, sanguinaria, or sulfur. See a homeopath, a healthcare professional experienced in the use of homeopathic remedies, for guidance regarding the proper remedy and appropriate dose for you.
• Use progesterone cream sparingly. See your integrative medical physician and gynecologist for guidance.
• Use lubricants during intercourse if you are experiencing dryness of your vagina
• Have a good support network of other peri-menopausal women and menopausal women to whom you can talk about
helpful approaches to this time of transition
• Lead an active life, including exercising regularly

For treatment of loss of libido, take an herbal supplement and/or a homeopathic remedy. See your integrative medical physician for guidance on use of the following herbal supplements for treatment of loss of libido:

• Avena sativa
• Black cohosh
• Dong quai. To prevent dong quai from increasing menstrual bleeding, the herbal supplement can be taken during the weeks other than during your period
• Vitex

For guidance on selection of the proper homeopathic remedy for loss of libido and choice of the appropriate dose for you, talk with a homeopath, a healthcare provider experienced in the use of homeopathy. Examples of homeopathic remedies for loss of libido are:

• Arsenicum album
• Lycopodium
• Kali phosphoricum
• Natrum muriaticum
• Nux vomica
• Pulsatilla
• Sarcode
• Sepia

If these integrative and alternative medical remedies do not restore your libido, talk with your integrative medical physician and your gynecologist about topical application of:

• Small amounts of progesterone cream
• Tiny amounts of testosterone cream

If symptoms persist despite following these healthy practices, consult your integrative medical physician and gynecologist. Hormone replacement therapy (HRT), involving a combination of the hormones, estrogen and progesterone, may be used in peri-menopausal women who have not undergone surgical removal of the uterus.

A benefit of HRT is a reduction in hot flashes. In HRT, progesterone is used to reduce the risk of cancer of the uterus. In peri-menopausal women, a low dose of HRT may be used for a short period of time.

If you have undergone a hysterectomy (i.e., surgical removal of the uterus) and are experiencing
symptoms of insufficient estrogen despite following the healthy practices discussed, consult your integrative medical physician and gynecologist. A benefit of estrogen replacement therapy (abbreviated ERT), which consists of estrogen, is a reduction in hot flashes.

In peri-menopausal women, a low dose of ERT may be used for a short period of time. Options for ERT include:

• Applying an estrogen cream to the vagina
• Wearing an E-string in the vagina
• Wearing an estrogen patch on the skin
• Taking estrogen (pills) orally

During your body’s transition, the wide range of lifestyle and medical options can help your life to be active, pleasurable, and full.


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