As health-care practitioners, we see the following scenario play out in our
practice a few times a week: 48-year old female presents with chief concerns
of hot flashes, night sweats, irritability, xerosis, dry eyes, vaginal atrophy, dyspareunia, sleep dysfunction, mood swings, an irregular menstrual cycle, and memory concerns.
You run some blood chemistries, and everything is unremarkable besides decreasing estrogen and progesterone, with an increase in FSH. This woman clearly is in the throes of perimenopause. She’s hesitant to start hormone or biological hormone replacement therapy because of what she has heard and read online about side effects and risks of prolonged
hormone replacement.
You begin to comb the Rolodex of treatment options that actually work and have a very low side effect profile and minimal if any long-term risks, but you can’t think of any that work quite as well as hormones.
This article will discuss the definition of menopause, clinical signs and
symptoms, long-term consequences of estrogen deficiency, conventional
treatments, and finally, evidence-based, nonhormonal approaches.