Menopause is a natural process in a woman’s life marking the end of her reproductive years. This process causes the ovaries to produce fewer hormones that cause menstrual periods, which leads to irregular and eventually the end of menstruation altogether. Menopause is broken down into three categories, perimenopause, or “pre” menopause, menopause, and postmenopause. Perimenopause is the time in which your body begins to move toward menopause and can range anywhere from two to eight years. During this time the levels of your reproductive hormones (estrogen and progesterone) can become imbalanced. Your menstrual cycles may lengthen or shorten, and you will begin to have menstrual cycles in which you don't ovulate. (Reminder: It's only during cycles when you do ovulate that you can become pregnant.) The length of perimenopause can vary in every woman. Most signs of upcoming menopause, such as menstrual irregularities, occur sometime in your 40s. But some women notice changes as early as their mid-30s. Menopause is reached once you have not had a menstrual period for 12 consecutive months. It is a hormonal transition associated with physical and psychosocial changes that can start in your 30s or 40s, and last into your 50s, or even 60s. You may begin to experience signs and symptoms of menopause well before your periods stop permanently. Menopause is not the end of your youth, or of your sexuality, we specialize in Hormone Replacement Therapy and have multiple options available to best relieve the signs and symptoms of menopause that you may be experiencing. Postmenopause are the years that follow menopause. This marks the time that your ovaries produce much less estrogen and progesterone, and stop releasing eggs. It is important to see your doctor during both perimenopause and postmenopause for preventive health care as well as care of medical conditions that may occur with aging. Some problems attributed to aging are unavoidable, however, others can benefit from lifestyle changes and medical treatments.

There are a wide variety of symptoms that can be associated as a result of these hormonal changes.

Some possible symptoms include:

  • Hot Flashes and Night Sweats
  • Mood Changes
  • Difficulty Sleeping
  • Changes in Sexuality
  • Vaginal Dryness
  • Heart Palpitations
  • Decreasing Fertility
  • Loss of Bone
  • Changes in Cholesterol Levels
  • Changes in Appearance

    Common Components of Hormone Replacement Therapy (HRT)


    Estrogens are a group of related hormones, each with their own specific activity. Normally circulating estrogen levels fluctuate based on a woman’s menstrual cycle. For Hormone Replacement Therapy, these hormones are often prescribed in combination to re-establish a normal balance of circulating hormone. By restoring the normal balance of hormones, many of the related symptoms of menopause disappear. The three main estrogens produced in female humans are:
    • Estrone -E1- is the primary estrogen produced after menopause
    • Estradiol -E2- is the most potent and major secretory product of the ovary, and the predominant estrogen produced before menopause.
    • Estriol -E3- causes little or no buildup of the endometrium, and is very effective in alleviating vaginal and urinary symptoms in postmenopausal women. Estriol has been shown to be clinically effective for the treatment of menopausal symptoms as well as postmenopausal problems including vaginal atrophy, dryness, painful intercourse, and various conditions of the urinary tract.

    • Is commonly prescribed for perimenopausal women to counteract the perceived higher levels of estrogen in comparison to progesterone which occurs when a woman produces smaller amounts of progesterone than normal relative to estrogen levels.
    • Used alone, or combined with estrogen, may improve bone mineral density.
    • Minimizes the risk of endometrial cancer in women who are receiving estrogen. If your uterus has not been removed or is intact, you may need to be on a progesterone.
    • May enhance the beneficial effect of estrogen on lipid and cholesterol profiles and exercise-induced myocardial ischemia in postmenopausal women (in contrast to medroxyprogesterone acetate).
    The benefits of progesterone are not limited to prevention of endometrial cancer in women who are receiving estrogen replacement. Progesterone therapy is not only needed by women who have an “intact uterus”, but is also valuable for women who have had a hysterectomy. Flushing is the most bothersome complaint of menopause, and is the most common reason women seek HRT and continue with treatment.

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