Presentation
She completed a graduate program and 4 years after presentation was in a leadership position in education. 11 The author of this case report defined menopause-related cognitive impairment as shown in the Box. [practicalneurology.com]
Quality statement 1: Diagnosing perimenopause and menopause Quality statement Women over 45 years presenting with menopausal symptoms are diagnosed with perimenopause or menopause based on their symptoms alone, without confirmatory laboratory tests. [nice.org.uk]
Women who are using a Mirena or other progesterone only contraceptive may also present a diagnostic challenge. [menopause.org.au]
Nesse artigo também abordamos as alterações hormonais presentes durante a transição menopausal, e o seu possível papel de "gatilho" no surgimento/exacerbação de quadros depressivos. [scielo.br]
PM Llorca has received over the past 5 years research grants, fees for presentations at congresses or participation on scientific advisory boards from Allergan, Gedeon Richter, Gilead Sciences, Janssen, Eli Lilly and Company, Lundbeck, Otsuka, Recordati [tandfonline.com]
Entire Body System
- Chills
Hot flashes frequently are followed by a cold chill. Night sweats are hot flashes at night that interfere with sleep. [menopause.org]
[…] vasomotor symptoms and urogenital symptoms 1, 2 vasomotor symptoms 2 reported in 50%-82% of women with natural menopause in United States symptoms include hot flashes, characterized by sudden sensation of heat in the upper body perspiration flushing chills [dynamed.com]
A major hot flash can induce facial and upper-body flushing, sweating, chills, and sometimes confusion. Having one of these at an inconvenient time (such as during a speech, job interview, or romantic interlude) can be quite disconcerting. [health.harvard.edu]
A chilled feeling after the heat. Hot flashes not only feel different for each person — they also can last for various amounts of time. Some women only have hot flashes for a short period of time during menopause. [my.clevelandclinic.org]
- Swelling
Clinical Assessment Many perimenopausal women complain of a myriad of symptoms including irregular menstrual cycles, heavy or a scarcity of menstrual bleeding, headaches (3), breast swelling and tenderness (4), mood swings, anxiety and depressed mood [menopause.org.au]
This may lead to overall swelling of the body swelling due to fluid accumulation. This fluid may contribute to transient weight gain, which may be transient. [medicinenet.com]
It can reduce the number and severity of hot flashes. footnote 5 Possible side effects include sleepiness, dizziness, and swelling. Other Treatment Many women have turned to alternative medicine for menopause symptom relief. [healthlinkbc.ca]
- Inflammation
Decreasing estrogen levels during the menopause transition cause a variety of biological changes in a woman's body, leading to vaginal atrophy, the thinning, drying, and inflammation of the vaginal walls. [eurekalert.org]
Estradiol cream or patch (rather than pill form) is the safest route to go since oral estrogen can increase inflammation and risk of clot formation. [goop.com]
- Shivering
I actually felt a shiver of excitement at the prospect of getting back on track. I used to struggle with body confidence but am now super proud of the way I look. [refinery29.com]
Studies suggest that these women have a narrower zone of temperature regulation, and therefore smaller changes in core body temperature produce compensatory responses such as vasodilation, sweating, and shivering [ 23 ]. [intechopen.com]
- Heat Intolerance
For this reason, serum TSH should be checked in all suspected perimenopausal cases with heat intolerance and disturbed sleep to determine the cause! [amboss.com]
Musculoskeletal
- Fracture
For an average 50-year-old woman, the lifetime risk of a forearm fracture is 16%, of a spine fracture is 15.6%, of a hip fracture is 17.5% and of any osteoporotic fracture is more than 40%.[ 52 ] Fractures can lead to chronic pain and spinal deformity [ncbi.nlm.nih.gov]
Unfortunately, osteoporosis and similar conditions often go undiagnosed until an unexpected fracture occurs. That’s why perimenopausal and menopausal women (aged 31 to 50) should consume 1200 mg of calcium each day. [flo.health]
A limitation of this large trial was that serum levels of estradiol were above those associated with meaningful outcomes in other studies such as vasomotor symptom reduction and fracture prevention, and the study lacked power to exclude small treatment [practicalneurology.com]
Regular exercise has been shown to reduce hip fracture risk in older women and to strengthen bone density. Get enough sleep. Try to keep a consistent sleep schedule. [mayoclinic.org]
Skin
- Increased Sweating
Irregular menses (which gradually decrease in frequency) → complete amenorrhea Autonomic symptoms Increased sweating, hot flashes, and heat intolerance Vertigo Headache Mental symptoms Impaired sleep ( insomnia and/or night sweats) Depressed mood or mood [amboss.com]
- Alopecia
Jill Grunewald, FMCHC, author of the best selling Essential Thyroid Cookbook, and creator of the Reversing Alopecia program "There simply is not enough quality information available to women on perimenopause. Thankfully, Dr. [amazon.com]
Neurologic
- Dizziness
Hot flushes and irregular periods are the primary clues, but how many thirty- or fortysomething women have not experienced at least one of the following: fatigue, weight gain, migraines, insomnia, joint aches, skin problems, breast tenderness, dizziness [theguardian.com]
Here are a few of those symptoms: Hot flashes (which can include sweating, tingling, electrical sensations, flushing from the extremities up through the torso and head, nausea, dizzy spells, etc.) [medium.com]
But if you’ve got period changes and any of the following list, it could be hormonal: sleeplessness, emotional upheaval, joint pain, loss of libido, weight gain, anger, irritability, low mood, poor concentration, memory problems, anxiety, dizziness, irritability [redonline.co.uk]
In the first nights of taking progesterone, you can feel dizziness or "drunk" if you are awakened within an hour or two of taking it. [cemcor.ubc.ca]
It can reduce the number and severity of hot flashes. footnote 5 Possible side effects include sleepiness, dizziness, and swelling. Other Treatment Many women have turned to alternative medicine for menopause symptom relief. [healthlinkbc.ca]
- Memory Impairment
Although cognitive impairment has been shown to occur during perimenopause, 1 this is not routinely incorporated into assessments of memory and other cognitive impairments of women in this stage of life. [practicalneurology.com]
Workup
Serum
- Estrogen Decreased
Estrogen decrease during perimenopause can lead to flushing, mood changes, and in some studies, mild cognitive changes (eg, mild memory loss, verbal fluency impairment, and slowed psychomotor speed). [practicalneurology.com]
Once you enter perimenopause, your estrogen levels start to decrease. As estrogen decreases, it throws off the balance with progesterone, another hormone produces by the ovaries. [my.clevelandclinic.org]
Treatment
It does not need treatment, but treatment can help lessen symptoms. Treatment includes hormones, antidepressants, and lifestyle changes. [hopkinsmedicine.org]
It does not need treatment, but treatment can help ease symptoms. Treatment includes hormones, antidepressants, and lifestyle changes. [healthlibrary.brighamandwomens.org]
Treatments such as black cohosh and soy. To learn more, see Other Treatment. Home Treatment A healthy lifestyle may help you manage menopause symptoms. [healthy.kaiserpermanente.org]
Treatment can decrease pain related to sex and relieve vaginal dryness. Your healthcare provider will discuss the risks and benefits of perimenopause treatment with you and recommend the best option based on your needs. [my.clevelandclinic.org]
Prognosis
Outlook / Prognosis Are there any health risks associated with perimenopause? There are health risks associated with menopause, which happens right after perimenopause. Estrogen plays an important role in preserving your bones. [my.clevelandclinic.org]
Etiology
[…] vasomotor symptoms (i.e., hot flashes) Clonidine and/or gabapentin References: [3] [11] [12] [13] [14] Disorders related with cessation of menstruation Premature menopause ( menopause precox ) Definition : : cessation of periods before the age of 40 Etiology [amboss.com]
[…] lead patients and physicians to think another cognitive disorder is present, leading to a misdiagnosis. 11 Similarly, if symptoms of a menopause-related cognitive impairment persist past the transition or significantly interfere with function, another etiology [practicalneurology.com]
Epidemiology
Its multidisciplinary membership of 2,000 leaders in the field--including clinical and basic science experts from medicine, nursing, sociology, psychology, nutrition, anthropology, epidemiology, pharmacy, and education--makes NAMS uniquely qualified to [eurekalert.org]
Clinical and epidemiological data on women in perimenopause are limited, and what data there are come primarily from Caucasian populations. [ncbi.nlm.nih.gov]
Epidemiology of women and depression. J Affect Disord. 2003 Mar. 74(1):5-13. [Medline]. Klaiber EL, Broverman DM, Vogel W, Kobayashi Y. Estrogen therapy for severe persistent depressions in women. Arch Gen Psychiatry. 1979 May. 36(5):550-4. [medscape.com]
Repeated epidemiological studies throughout the world show that depression and anxiety prevalence rates are approximately 2:1 for women to men. [intechopen.com]
Pathophysiology
The data collected may also be linked with data from other perimenopausal depression protocols (e.g., DNA, psychophysiology tests, treatment studies, etc.) for the purposes of better understanding the diagnosis, pathophysiology, and treatment response [clinicaltrials.gov]
Postmenopause : : the time period beginning 12 months after the last menstrual period References: [1] [2] [3] [4] [5] Pathophysiology ↓ Ovarian function → ↓ estrogen and progesterone levels → loss of negative feedback to the gonadotropic hormones → ↑ [amboss.com]
[…] cumulative prevalence of 85% for vasomotor symptoms.26 Vasomotor symptoms cause a substantial amount of distress and reduction in health-related quality of life (HRQOL).27 Despite their high prevalence, surprisingly little is understood about their exact pathophysiology [ncbi.nlm.nih.gov]
Prevention
Some studies claim they reduce hot flashes, prevent osteoporosis, treat acne, and promote cardiovascular health. Research on their ability to fight other perimenopausal symptoms, however, has been inconclusive. [flo.health]
Preventive Services Task Force (2017). Hormone therapy for the primary prevention of chronic conditions in postmenopausal women: U.S. Preventive Services Task Force recommendation statement. JAMA, 318(22): 2224–2233. DOI: 10.1001/jama.2017.18261. [healthy.kaiserpermanente.org]
Preventive Services Task Force[ 46 ] and the Canadian Task Force on Preventive Health Care[ 47 ]) decided that HT, especially taken in this regimen, does not fit the profile of a compound for the prevention of diseases and have thus changed their recommendations [ncbi.nlm.nih.gov]
Perimenopause seems to be the preventative health buzzword du jour with two guides to be released in November to help young women understand their next "life change." [independent.co.uk]
They act by preventing the ovary from releasing its own estrogen and progesterone. They also work to inhibit ovulation, thus preventing pregnancy. [medicinenet.com]