Perimenopause refers to the time around menopause, during which a woman’s body makes its natural transition towards permanent infertility. Women start perimenopause at different ages, and may notice signs of progression toward menopause, such as menstrual irregularity, sometime in their 40s. But some women notice changes as early as their mid-30s. The level of oestrogen— the main female hormone — rises and falls unevenly during perimenopause. Menstrual cycles may lengthen or shorten, and some women may experience menopause-like symptoms, such as hot flashes, sleep problems and vaginal dryness. Treatments are available to help ease these symptoms.
Drug therapy is often used to treat perimenopause symptoms. These drugs may include:
Hormone therapy comes in the form of a pill, skin patch, gel or cream, and is considered to be the most effective treatment options to alleviate perimenopause symptoms and menopausal hot flashes and night sweats.
Vaginal oestrogen can be used to relieve vaginal dryness. It can be administered directly to the vagina through the use of vaginal tablets, rings or creams. This treatment releases a small amount of oestrogen, which is then absorbed by the vaginal tissue.
Certain antidepressants related to the class of drugs called selective serotonin reuptake inhibitors (SSRIs) may reduce menopausal hot flashes. An antidepressant for management of hot flashes may be useful for women who can't take oestrogen for health reasons or for women who need an antidepressant for a mood disorder.
Gabapentin is approved to treat seizures, but it has also been shown to help reduce hot flashes. This drug is useful in women who can't use oestrogen therapy for health reasons and in those who also have migraines.
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