Menopause

Perimenopause, menopause and postmenopause are all natural stages in your life. During perimenopause, your body makes less estrogen (that’s the hormone that regulates your menstrual cycle). Perimenopause is your body’s transition to menopause — the stage when you’ve gone 12 full months without having a period.

As estrogen levels drop, you might get hot flashes and night sweats. You may also notice other menopause symptoms like:

• Anxiety disorders and depression.
• Insomnia.
• Lack of interest in sex.
• Pain during sex.
• Vaginal dryness and vaginal atrophy.

It’s normal to experience these symptoms during your transition to menopause. It’s also normal not to experience them. You might go through menopause without ever having a hot flash or feeling different. But if you have symptoms that are affecting your life, talk with your healthcare provider. We can help you manage your symptoms to help you feel your best.

Menopause might not be your favorite topic. But we’ll talk openly with you. We’ll ask you questions to better understand your lifestyle, symptoms and goals. Then, we’ll design a personalized treatment plan just for you. We want to be sure you get the menopause relief that’s right for you.

Hormonal medications

Your specialist may recommend hormone therapy for menopause symptoms. It may seem odd, but we may prescribe birth control pills during perimenopause to help control your hormones. After menopause, there are a few different ways you can take hormone replacement therapy. We might recommend you take it:

• Internally (an inserted vaginal ring).
• Orally (in pill form).
• Through the skin (as a skin patch, topical spray or topical gel).

Since there are some risks associated with hormone replacement therapy, we’ll look at your overall health to make sure it’s a good fit for you.

Non-hormonal medications

Our experts may recommend anti-anxiety and antidepressant medications to help treat your hot flashes without using hormones. These medications can not only help with your mood and hot flashes — but they might also help you sleep better.

Over-the-counter menopause symptom relief

We don’t recommend herbal supplements to manage menopause symptoms. That’s because these supplements aren’t regulated by the U.S. Food and Drug Administration (FDA).

For vaginal dryness, we may suggest lubricants that you can buy over-the-counter (that don’t contain any hormones) to make you a little more comfortable.

Menopause support

It’s hard sometimes. Not everyone goes through menopause at the same time. Or you might not feel comfortable sharing with your friends. It sometimes can feel lonely going through symptoms on your own. To help, we offer shared medical appointments at various locations throughout Cleveland Clinic. These longer group appointments include follow-up care from your provider and support from others who are going through the same things as you.

Gynecologic Care After Menopause at Cleveland Clinic

Routine testing might be the last thing on your mind after menopause, but it’s important to still see your gynecologist for regular pelvic exams and Pap smears. Your healthcare provider will talk with you about how often you’ll need them.

Once you’ve reached menopause, you won’t have periods anymore. So if you notice any bleeding, let your provider know right away. Postmenopausal bleeding could be a sign of:

• Cervicitis.
• Cervical cancer.
• Uterine cancer.
• Uterine polyps.

Taking the Next Step

You don’t have to live with hot flashes, weight gain, mood swings, dry skin or other menopause symptoms. We can help. Our menopause experts are here to help you cool down, get a good night’s sleep — and enjoy life again.