Menopause Hormone Therapy

Irregular periods are common during perimenopause, the transitional phase before menopause. As ovulation becomes less predictable, the time between periods may vary, with cycles ranging from shorter to longer. The flow can also fluctuate, from light to heavy, and some periods may be skipped altogether. A consistent change of seven days or more in cycle length suggests early perimenopause, while intervals of 60 days or more between periods typically indicate late perimenopause. These changes are due to hormonal fluctuations characteristic of this phase in a woman's reproductive life. If experiencing irregular periods and suspecting perimenopause, it is advisable to consult a healthcare provider for personalized advice and support.

Hot flashes and sleep disturbances are frequent occurrences during perimenopause. Hot flashes, characterized by sudden feelings of warmth, can vary widely in intensity, duration, and frequency. They often disrupt sleep, either directly causing night sweats or indirectly leading to sleep disturbances. However, sleep problems during perimenopause can also occur independently of hot flashes, becoming unpredictable regardless of their presence.

Mood changes such as mood swings, irritability, or an increased risk of depression are common during perimenopause. These symptoms can be influenced by disrupted sleep patterns associated with hot flashes and night sweats. However, it's important to note that mood changes during perimenopause can also stem from factors unrelated to hormonal fluctuations. 

When estrogen levels decrease during perimenopause, changes can occur in vaginal and bladder health. Diminished estrogen can lead to vaginal tissues losing lubrication and elasticity, which can cause pain during intercourse. Additionally, lower estrogen levels may increase susceptibility to urinary and vaginal infections. The loss of tissue tone can contribute to urinary incontinence as well.

As ovulation becomes irregular during perimenopause, fertility decreases. Despite this, as long as menstrual cycles continue, pregnancy remains possible. If pregnancy is not desired, it's advisable to use birth control until menstruation has ceased for at least 12 consecutive months.

During perimenopause, changes in sexual function can occur, affecting sexual arousal and desire. However, if you experienced satisfactory sexual intimacy before menopause, it is likely that this will continue through perimenopause and beyond. 

As estrogen levels decline during perimenopause, there is a higher rate of bone loss compared to bone replacement. This imbalance increases the risk of osteoporosis, a condition characterized by brittle and fragile bones. 

As estrogen levels decline during perimenopause, there can be adverse changes in blood cholesterol levels. This often includes an increase in low-density lipoprotein (LDL) cholesterol, commonly referred to as the "bad" cholesterol, which contributes to a heightened risk of heart disease. Additionally, many women experience a decrease in high-density lipoprotein (HDL) cholesterol, known as the "good" cholesterol, further elevating the risk of heart disease as they age.