Women2Women - Fall 2017 - 38
Mental, Spiritual, Physical Health & Wellness
omen who experience symptoms of
perimenopause - from hot flashes, to
difficulty sleeping, to moodiness and more
- often suffer in silence.
But women needn't stay silent, because
medical treatment is available, says Anna M.
Grassi, DO, a gynecologist and obstetrician
with Reading Health Physician Network -
Advanced Care for Women.
"About 80 percent of perimenopausal women
experience symptoms that are distressing or
are impacting their quality of life, yet only
20 percent to 30 percent seek medical care,"
Dr. Grassi says. "A large percentage of women
suffer in silence, and it's important for them
to know that treatment is available to ease
Perimenopause represents a slowing down
of ovarian function and occurs as levels of
estrogen, the predominant female hormone,
increase and decrease during the transition to
menopause. Many of the physical changes that
perimenopausal women experience occur as
their estrogen level decreases.
Perimenopause may last as long as four
years and usually occurs when women are
in their late 40s and early 50s. Occasionally,
perimenopause occurs in women in their midto late-30s. These women should seek medical
care because hormone replacement therapy is
indicated in women under 40 to protect their
cardiovascular and bone health because this is
considered preamature menopause. Women
are considered menopausal when they have
completed a full year without a menstrual cycle.
During perimenopause, women experience
irregular periods. About 80 percent of perimenopausal women experience hot flashes, and
other symptoms may include vaginal dryness,
difficulty sleeping, moodiness, memory loss,
difficulty focusing, muscle or joint pain, and
anxiety or depression.
Physicians diagnose perimenopause by
considering factors such as a woman's age,
38 Women2Women Fall 2017
Perimenopause may last as long as four years and usually
occurs when women are in their late 40s and early 50s.
menstrual history, and body changes and
symptoms. Dr. Grassi encourages women to
talk to their physicians about symptoms they
may be experiencing, because treatment options
are available. For example, hot flashes can be
treated with hormone replacement therapy or
low doses of antidepressants called selective
serotonin reuptake inhibitors (SSRIs), which
have been proven to help reduce hot flashes.
"Hormone replacement therapy has gotten
negative attention, but when used appropriately, it is safe and many women are good
candidates for using it," Dr. Grassi says.
"During an initial consultation, the patient
and her physician will discuss her symptoms,
her medical history and any risks of treatment
to determine if she is a candidate."
Vaginal dryness, which may occur when a
woman's estrogen level decreases and the vaginal
tissue thins, also is treatable. Women may use
a water-based lubricant before intercourse,
and physicians may prescribe topical vaginal
estrogen that is safe and relieves dryness.
"When women experience physical symptoms and others such as anxiety or depression,
it is helpful for them to talk with their
physician, because their physician will assess
the patient's health and determine if the
patient would benefit from treatment and
from counseling," Dr. Grassi says. "Their
physician also may recommend lifestyle
Lifestyle modifications that can help reduce
perimenopausal symptoms include healthy
eating, reduced alcohol consumption, adequate
sleep and increased exercise.
"One of the most-effective modifications
is to exercise three to five times a week," Dr.
Grassi says. "Studies show that women who are
overweight or obese are more likely to experience
hot flashes, so exercise and dietary modifications
in an effort to lose weight can help reduce hot
flashes for women in this population."
Women also can prepare for hot flashes by
dressing in layers. Hot flashes prompt sweat and
then may lead to chills when the hot flash ends.
Wearing layers of clothing that can be taken on
and off helps ensure a woman is more comfortable
before, during and after the hot flash.
Dr. Grassi notes that no perimenopausal
symptom is too small to discuss with a