From the Guidelines
Women experiencing premenopause typically exhibit symptoms such as irregular menstrual cycles, hot flashes, night sweats, sleep disturbances, mood changes, vaginal dryness, and decreased fertility, which can significantly impact their quality of life. These symptoms occur due to the fluctuation of estrogen and progesterone levels in the body. According to the American Cancer Society/American Society of Clinical Oncology breast cancer survivorship care guideline 1, vasomotor symptoms such as hot flashes are common in women experiencing premature menopause.
Common Symptoms of Premenopause
- Irregular menstrual cycles
- Hot flashes and night sweats
- Sleep disturbances
- Mood changes, including irritability, anxiety, or depression
- Vaginal dryness and discomfort during intercourse
- Decreased fertility
- Changes in sexual desire
- Worsening of premenstrual syndrome
- Fatigue
- Headaches
- Weight gain, particularly around the abdomen
- Thinning hair or dry skin The guideline recommends offering selective serotonin-norepinephrine reuptake inhibitors (SNRIs), selective serotonin reuptake inhibitors (SSRIs), gabapentin, lifestyle modifications, and/or environmental modifications to help mitigate vasomotor symptoms of premature menopausal symptoms 1.
Management Strategies
- Hormone therapy (low-dose birth control pills or hormone replacement therapy)
- Vaginal lubricants for dryness
- Regular exercise
- Stress management techniques
- Maintaining a healthy diet It is essential for women experiencing bothersome symptoms to consult with a healthcare provider to discuss personalized management strategies, as these symptoms can significantly impact their quality of life 1.
From the Research
Symptoms of Pre-Menopause
The symptoms of pre-menopause, also known as perimenopause, can vary from woman to woman. Some common symptoms include:
- Vasomotor symptoms, such as hot flashes and night sweats 2, 3
- Genitourinary symptoms, such as vaginal dryness and discomfort 2, 3
- Mood fluctuations, including anxiety and depression 2, 3
- Cognitive changes, such as memory loss and difficulty concentrating 2, 3
- Sleep disturbances, including insomnia and disrupted sleep patterns 2, 3
- Low sexual desire and decreased libido 2, 3
- Bone loss and increased risk of osteoporosis 2, 3
- Increase in abdominal fat and changes in body composition 2, 3
- Adverse changes in metabolic health, including increased risk of diabetes and cardiovascular disease 2, 3
Hormonal Changes
The symptoms of pre-menopause are caused by hormonal changes, including:
- Decreasing levels of estrogen and progesterone 3, 4
- Wide fluctuations in hormone levels, leading to unpredictable symptoms 3, 4
- Altered responsiveness to gonadal steroid feedback, leading to changes in menstrual patterns and ovulation 3
Treatment Options
Treatment options for pre-menopause symptoms include: