Women's bodies go through several changes in a lifetime, including menopause. This information was developed by PAMF health educators to help women understand the many aspects of perimenopause and menopause.

Summary

Perimenopause is the 2 -- 8 year period before menstruation stops, when estrogen and progesterone levels fluctuate and decline. Symptoms often include irregular periods, mood swings, sleep disturbance, vaginal dryness and hot flashes. Many of these symptoms are short-lived, although some women will experience them for years. Management of perimenopause includes healthy lifestyle choices, appropriate vitamin and mineral supplements, and may include birth control pills, herbs and/or other medications for specific symptoms.

Menopause is the time after menstrual periods stop altogether, when estrogen and progesterone levels decline. Perimenopause symptoms may persist. Long-term consequences of the hormone decline include bone density loss and vaginal thinning. Postmenopausal women have increased risk of heart disease, colon cancer, breast cancer and changes in cognitive function. Management of menopause includes healthy lifestyle choices, vitamin and mineral supplements, and may include hormone replacement therapy, herbs and/or non-hormone medications.

Hormone replacement therapy continues to be studied regarding its overall benefits and risks for menopausal women. Some reports appear to be conclusive while others are suggestive but need further evaluation. Some results apply to postmenopausal use of estrogen and progestin combined (HRT); other results apply to estrogen only (ERT). The table below summarizes the best evidence to date. All benefits and risks below have been shown in research trials to be "statistically significant" (not likely to be due to chance), but the magnitude of the difference (how many women experience the outcome) differs across studies and for the various outcomes.

Confirmed benefits	Possible benefits	Confirmed risks	Possible risks
Less hot flashes	Less chance of Alzheimer's	Increased chance of breast cancer (HRT)	Increased chance of ovarian cancer (ERT)
Less vaginal dryness	Better mood, sense of well-being	Increased chance of coronary heart disease (heart attacks)
Less spine and hip fractures	Better skin elasticity and tone	Increased chance of blood clots (stroke, leg & lung clots)
Less colon cancer

In deciding how to manage their menopause, women should first review their own risks of the various conditions of aging, based on their personal health and family history. Women should consider the potential risks and benefits of available medications or therapies. Women should talk with their health care providers to weigh all their options and to make informed choices.

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