Managing Menopause and Perimenopause

Perimenopause and menopause shouldn’t stop you from living your life to the fullest.


Menopause may be something you think of as years or even a decade away.  Yet there you are, sitting with friends at an outdoor café on a mild, breezy spring day when out of the blue you feel like a fire ignited inside of you. From your toes to the top of your head, you’re suddenly baking in the heat, your face is flushed, and tiny beads of sweat have broken out on your upper lip. Don’t panic. It’s doubtful that you are suffering from an exotic tropical fever. The more likely scenario is that you are having a hot flash, one of the most common symptoms of perimenopause. 

Menopause means that you have permanently stopped having periods. However, it can take years for your body to reach this stage and the bodily changes you experience leading up to that time is known as perimenopause. How many symptoms you’ll have and whether or not they impact your daily activities will vary for each individual. Regardless of how little or how much perimenopausal symptoms affect you, there is no reason why it should slow you down. Our providers know how to make your transition as trouble-free as possible. 

When does perimenopause begin? 

Most women will begin noticing the physical and mental changes related to decreasing estrogen levels that characterize perimenopause in their 40’s. 

How long does perimenopause last? 

Although rare, some women experience perimenopausal symptoms in their mid-30s. The length of time your symptoms last will vary just as much—a few months for some; as many as 10+ years for others. 

What’s going on with my body? Symptoms of perimenopause and menopause

Your estrogen levels are dropping and will continue to do so until they become so low that you no longer ovulate and you stop having periods. When a full year has passed since your last period, you are considered menopausal. Until that time occurs, the following symptoms generally indicate that perimenopause has likely begun:

  • Hot flashes — extremely common; 7 out of 10 women experience them
  • Irregular periods —changes in flow and length of cycle are common
  • Trouble sleeping — it’s not uncommon to wake up in the middle of the night and have difficulty falling back to sleep (until right before the alarm goes off!)
  • Night sweats
  • Exhaustion
  • Mood swings — fine one minute angry or sad the next
  • Weight gain — you’re eating and exercising like you always have and yet the scale keeps inching upward
  • Bloating
  • Less interest in sex, it’s more difficult to get aroused or climax
  • Pain or discomfort during sex due to vaginal dryness
  • Brain fog — words escape you, you go into a room and forget why you are there (more than you used to), you may have difficulty focusing and feel as if you suddenly have attention deficit order
  • Feelings of not being able to cope as well as you used to
  • Anxiety/Depression
  • Breast tenderness
  • Joint pain — estrogen helps to reduce inflammation so when levels decrease you may experience pain in your knees, hips, wrists, elbows, etc.
  • Headaches (hormonal changes can trigger migraines a few days before your period starts, even if you’ve never had them before)

If any of the symptoms above are adversely affecting your quality of life, it’s time to talk to your provider! “My patients are so different,” says Heidi Braun, MD.  “Some women prefer to manage their symptoms in a more natural way, while others want to know what medications are available. Regardless of how they want to proceed, I always advise them to get regular blood work and annual physicals. Reduced estrogen levels are a risk factor for bone loss. I typically recommend calcium, vitamin D and exercise and consider a bone density scan if I suspect bone loss is a concern after menopause. Plus, cholesterol levels can increase in perimenopausal women and we’ll want to be aware of any changes. We’ll work together to create a comprehensive treatment plan that meets your needs— one that keeps you sane and satisfied.”

How to relieve menopause symptoms

How can your ob/gyn help during menopause?

  • Hormone replacement therapy is an option available to many women which increases estrogen levels and helps alleviate uncomfortable symptoms. (available in pill form, gels, creams, or patches)
  • Vaginal creams and other treatments to help with painful intercourse and dryness
  • Antidepressants/antianxiety medications to help with mood swings (we can also recommend certified counselors and therapists)
  • Letting you know that you are not alone. You’re not going crazy.

What to do to relieve menopause symptoms? Ways to help yourself through perimenopause and menopause

  • Get plenty of exercise — it helps prevent possible weight gain, encourages better sleep, and makes you feel better.  Study after study shows that exercise is one of the best antidepressants available!  
  • Maintaining a healthy weight can have an amazingly positive effect on your life. But it can be hard to do especially during peri/menopause.  If the scale is creeping upward and your normal diet and exercise aren’t working, consider talking to our Health & Wellness team.    
  • If you drink alcohol, do so in moderation —excess alcohol can further disrupt your already interrupted sleep
  • If you smoke, consider quitting. Smoking can cause premature menopause and worsen other symptoms.
  • Limit caffeine to decrease breast tenderness and help improve sleep, and increase the amount of water you drink

Virginia Women’s Center has helped thousands of women manage and minimize their perimenopausal symptoms and we can help you. Perimenopause shouldn’t stop you from living a life you love. We’re here if you need us. Make an appointment today. 804.288.4084

Dr. Heidi Braun is a much-loved provider at our Short Pump location.  At Virginia Women’s Center, every medical decision we make—together with you—is based on what is best for you. Our goal is to educate and empower you so that you can actively manage and maintain your health, no matter where you are in your life journey. Our dedicated, knowledgeable team is here for you, from adolescence to menopause and beyond.