What is perimenopause?
Perimenopause is the time leading up to menopause. During perimenopause, your body starts making less of certain hormones (estrogen and progesterone), and you begin to lose the ability to become pregnant. Women normally go through menopause between ages 45 and 55. Many women experience menopause around age 51. However, perimenopause can start as early as age 35. It can last just a few months or a few years. There is no way to tell in advance how long it will last or how long it will take you to go through it.

Some studies have found that women with a history of depression started perimenopause earlier than women without depression. Women who took antidepressants started perimenopause even earlier. If you start perimenopause early, researchers don't know if you reach menopause faster than other women or if you're just in perimenopause longer.

Symptoms of perimenopause include:

• changes in your menstrual cycle (longer or shorter periods, heavier or lighter periods, or missed periods)
• hot flashes (sudden rush of heat from your chest to your head)
• night sweats (hot flashes that happen while you sleep)
• vaginal dryness
• sleep problems
• mood changes (mood swings, depression, irritability)
• pain during sex
• more urinary infections
• urinary incontinence
• less interest in sex
• increase in body fat around your waist
• problems with concentration and memory

Irregular Periods - Irregular periods are common and normal during perimenopause, but not all changes in bleeding are from perimenopause or menopause. Other things can cause abnormal bleeding. Talk to your health care provider if:

• the bleeding is very heavy or comes with clots
• you're bleeding from the vagina after sex
• the bleeding lasts longer than 7 days
• you have spotting or bleeding between periods

Hot Flashes - We don't know exactly what causes hot flashes. It could be a drop in estrogen or change in another hormone. This affects the part of your brain that regulates your body temperature. During a hot flash, you feel a sudden rush of heat move from your chest to your head. Your skin may turn red, and you may sweat. Hot flashes are sometimes brought on by things like hot weather, eating hot or spicy foods, or drinking alcohol or caffeine. Try to avoid these things if you find they trigger the hot flashes.

Emotional Lability or Mood Swings - Mood changes could be caused by a lot of factors. Some researchers believe that the decrease in estrogen triggers changes in your brain causing depression. Others think that if you're depressed, irritable, and anxious, it's influenced by other symptoms you're having, such as sleep problems, hot flashes, night sweats, and fatigue—not hormonal changes. Or, it could be a combination of hormone changes and symptoms. Other things that could cause depression and/or anxiety include:

• having depression during your lifetime
• feeling negative about menopause and getting older
• increased stress
• having severe menopause symptoms
• smoking
• not being physically active
• not being happy in your relationship or not being in a relationship
• not having a job
• not having enough money
• low self-esteem (how you feel about yourself)
• not having the social support you need
• regret that you can't have children anymore

What can I do to prevent or relieve symptoms of perimenopause?

• Keep a journal for a few months and write down your symptoms, like hot flashes, night sweats, and mood changes. That can help you figure out the changes you're going through.
• Record your menstrual cycle, noting whether you have a heavy, normal, or light period.
• Find a physical activity that you'll enjoy doing.
• If you smoke, try to quit.
• Keep your body mass index (BMI) at a normal level. What is your ideal body weight?
• Talk to your friends who are in perimenopause or menopause. Most likely, they're going through the same things you are!
• Do something new. Volunteer or take a class.
• Use a vaginal lubricant for dryness and pain during sex.
• Dress in layers.
• Try to figure out if certain triggers cause hot flashes, like spicy foods or being outside in the heat. Avoid these things.
• Talk with your health care provider about bio-identical hormone replacement therapy.

What is Menopause?
Menopause refers to that time in every woman’s life when menstruation ceases completely. The ovaries’ decrease their output of estrogen and progesterone and women begin to experience the effects of this decrease in hormones. In addition to signifying the end of a woman’s ability to have children, declines in the female hormones affect the entire endocrine system. Menopause is considered complete when a woman has had no period for a full year. Although timing varies from woman to woman, menopause is generally completed by the time they reach their early 50’s.

What symptoms can I expect during menopause?
Every woman is an individual, of course, but there are a number of side effects that can generally be anticipated. Though some side effects may be considered temporary nuisances to be "toughed out," the reality is that the decline of a woman’s hormonal levels results in changes that can seriously affect her physical and mental health as well as her prospects for longevity.

• Hot Flashes
• Vaginal/Urinary Tract Changes
• Loss of Libido
• Emotional Changes
• Osteoporosis
• Cardiovascular Disease

In addition to diminished levels of estrogen and progesterone, testosterone (also produced in the ovaries) and growth hormone (produced in the brain) are also reduced during menopause. As the levels of all of these key hormones diminish, profound changes begin occurring with growth and metabolism that affect the breasts, vagina, bones, blood vessels, gastrointestinal tract, urinary tract, cardiovascular system, skin, brain, and energy levels.

Treating Perimenopause and Menopause
Dr. Bronner offers bio-identical hormone therapy integrated with proper fitness and nutrition. This preventive medical approach helps put an end to suffering and effects caused by menopause and perimenopause.

Hormones decline as we age and bio-identical hormones replace the hormones that your body needs to function. Dr. Bronner uses bio-identical or natural hormones versus bio-similar or synthetic hormones. Bio-identical hormones are molecule-by-molecule, exactly the same as the hormones present in the human body. Dr. Bronner will assess your individual needs and work to restore these hormones and customize a medical plan specifically for you.

By replacing the hormones that decline as time goes by, you can sustain your health and promote longevity. Using bio-identical versions of estrogen and progesterone reduces the risks of cardiovascular disease and osteoporosis as well. By returning to the physiological hormone levels you had earlier in your life, you can slow down the aging process and maximize your quality of life.