Female Hormones at Midlife
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Early this spring, in between the snowstorms and heat waves just days apart, my husband joked, “Mother Nature is perimenopausal!
She needs some serious hormone therapy!” Funny guy. But as any woman in the throes of this “natural” midlife stage of life will tell you (loudly, and often), perimenopause is no joke.
In fact, the very beginning stage is generally the most difficult for women, says Dr. Anthony Retodo, director of medical services at Kaiser Permanente Folsom. “Women are experiencing a dramatic physical realization that things can’t remain the same; that we’re human, and we age. We all have to accept a certain level of change.” Traditionally, notes Dr. Retodo, women have had a hard time dealing with the drama of perimenopause without much support. “For years, women were told ‘it’s all in your head’ or ‘get over it.’ But it’s a true obstacle, and we need to work through it.”
Perimenopause describes the stage in a woman’s life when her ovaries start producing less estrogen and progesterone – the hormones responsible for ovulation and menstruation, commencing anytime between the late 30s and early 50s, with the average age of menopause being 51. Declining levels of estrogen and progesterone result in “just about every symptom you can imagine,” marvels Dr. Timothy Phelan, of Folsom’s Creekside OB/GYN: from the most common (menstrual irregularities, vaginal dryness, difficulty sleeping, hot flashes, loss of libido) to some surprising issues (depression, severe itching, increased libido, hair loss and thinning, an inability to heal from injuries, headaches). “One of the things my patients complain most about...is the loss of focus. They report not feeling as productive as they once were,” says Phelan.
When midlife interferes with life, a patient should seek immediate relief. “It may in fact take a couple visits to tease out what’s going on,” Dr. Phelan explains. “We rule out other suspects like early diabetes, depression or thyroid disorder.” Blood work, pelvic exams and baseline hormone measurements are completed. Treatment options are then discussed. If the symptoms are severe, medications are available: low-dose birth control pills can get menstrual irregularities and pain under control; an antidepressant can help with depression; sleep aides for insomnia; and lubricants to alleviate dryness.