Menopause and Perimenopause

What it is

Perimenopause is the transition phase between reproductive and non-reproductive life, and menopause corresponds to the last menstrual period. During this time, declining hormone levels can cause hot flashes, night sweats, changes in sleep and mood, vaginal dryness, decreased libido, and changes in the skin, bones and metabolism. Gynecological follow-up assesses each woman's symptoms and risks to recommend the most appropriate care, which may include hormone therapy, non-hormonal alternatives, treatments for intimate health, osteoporosis prevention, and lifestyle guidance.

Most common symptoms

• Hot flashes and night sweats
• Irregular periods that become spaced out until they stop
• Insomnia or poor-quality sleep
• Mood changes, irritability and anxiety
• Vaginal dryness, pain during intercourse and decreased libido
• Fatigue, difficulty concentrating and memory lapses
• Weight gain, joint pain and changes in the skin and hair

Causes and risk factors

• Natural decline in ovarian function, usually between ages 45 and 55
• Progressive drop in estrogen and progesterone levels
• Surgical removal of the ovaries, chemotherapy or radiotherapy
• Family history of menopause at a similar age
• Smoking, which tends to bring on menopause earlier

How it is diagnosed

The diagnosis of perimenopause is clinical, based on age, the pattern of periods and the symptoms reported. During the consultation, your gynecologist assesses the severity of the complaints, personal and family history, and cardiovascular, bone and breast cancer risk factors. Hormone level testing is useful in specific situations, such as symptoms before age 45 or after the uterus has been removed. Routine tests, such as mammography, ultrasound, a metabolic panel and a bone density scan, complement the assessment according to age and history.

How we treat it at Femi Saúde

Care during perimenopause is individualized and based on weighing the risks and benefits of each option. The gynecology team at Femi Saúde guides lifestyle changes, such as physical activity, diet and sleep hygiene, and discusses hormone therapy, which usually relieves hot flashes and night sweats when there are no contraindications. Non-hormonal alternatives are offered for those who cannot or do not wish to use hormones. For intimate health, vaginal estrogen, moisturizers, intimate CO₂ laser and radiofrequency are options depending on the case, along with attention to osteoporosis prevention and periodic follow-up.

What we offer