What about menopause/perimenopause?

The average age of menopause is 51 years old. In patients with premature ovarian insufficiency or complex pelvic conditions like endometriosis it can happen much earlier.

This can be due to genetic reasons for primary ovarian insufficiency or premature failure or surgical menopause meaning menopause caused by removing the ovaries in surgery.

Ovaries removed for cysts whether cancerous or precancerous cause hormone deficiency and may cause menopause if the remaining ovary doesn’t respond fully and take over the body’s full ovarian hormone production.

The technical definition for menopause is defined by lack of menstruation for 12 months or more.

Blood tests can help identify menopause or the peri-menopausal period when hormones first start to fluctuate. The optimal time to check the hormone levels for menopause or perimenopause is at the beginning of the menstrual cycle on day 2/3 of the bleed.

Although there is a lot of buzz right now on menopause itself peri-menopause can last for years! For the average patient this is 4 years. Hormone swings, mood swings, weight gain, brain fog, low libido, skin and vaginal dryness can be just some of the symptoms that can start in the peri-menopause years and this is all while you still maybe having normal periods and cycle length. Despite popular opinion hormone balance can be achieved even in the peri-menopause years to help you feel your best!

Menopause symptoms can be numerous and include hot flashes, brain fog, low libido, joint pain, skin dryness and loss of elasticity, vaginal dryness and irritation, mood changes, depression, weight gain, and loss of muscle tone, sounds awful!

It is important to note that vaginal bleeding after complete menopause (12 months of no periods) is a RED FLAG, you should speak to your gynecologist immediately. A biopsy maybe required to rule out uterine pathology such as hyperplasia or early cancer.

It is important to work with a Doctor who examines all aspects of health and offers treatment options or therapies depending on your goals and needs

Remember that multiple different treatment options exist!

For patients not interested in hormone replacement, non-hormonal treatments exist!

Increasing studies show the Neuro-cognitive benefit in earlier initiation of HRT, which really reinforces when patients feel the brain fog, poor cognition, poor ability with numbers and memory early on.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8394691/

https://alzres.biomedcentral.com/articles/10.1186/s13195-022-01121-5

https://www.cnn.com/2023/04/03/health/alzheimers-hormone-replacement-therapy-wellness/index.html