Levels of estrogen begin to drop in the years before menopause. During this transitional time, called perimenopause, most women experience changes in their menstrual periods.

Cycles may become longer or shorter than normal, flow may get lighter or heavier, and you may begin to skip periods. These changes are normal, but others may signal a health problem, so schedule an appointment if you experience:

• Bleeding between periods
• Bleeding after sex
• Spotting
• Any bleeding after menopause

Perimenopause ends and menopause begins after you’ve missed your periods for 12 straight months — as long as there aren’t any medical reasons why you didn’t have periods. Once you reach menopause, estrogen levels stabilize at a low level.

The symptoms associated with menopause begin during perimenopause and continue after menopause. However, it’s important to remember that the experience is different for each woman. You may have a few symptoms or a lot, and they may be quite mild or severe. The classic symptoms include:

• Hot flashes and night sweats
• Vaginal dryness
• Pain during intercourse
• Frequent urination
• Urinary tract infections

Hormone replacement therapy effectively treats menopausal symptoms, including hot flashes, night sweats, and mood swings. Replacing your estrogen also relieves vaginal dryness, dry skin, and irritable bladder symptoms.

Other benefits of hormone replacement therapy include:

• Increased elasticity of blood vessels
• Lower risk of osteoporosis and fractures
• Possible improvement of glucose levels
• Possible decreased incidence of Alzheimer’s disease
• Decreased incidence of colon cancer

Short-term use of hormone replacement therapy is safe for most menopausal women, especially when it’s primarily used to relieve symptoms. It’s available in several different forms including pills taken orally, a patch placed on your skin, topical gels and creams, vaginal suppositories, and pellets.

Pellets are made by putting hormones into a tiny cylinder that’s implanted under your skin. The pellet lasts for about four months, so you don’t have to worry about taking pills or replacing patches. More importantly, you don’t have fluctuations in hormone effectiveness because the pellet constantly releases an even dose of hormone.

At Naples Women’s Center you can also receive bioidentical hormone replacement, which are synthetic hormones that are structurally identical to the hormones your body makes. Contact us if you’re seeking relief from the symptoms of menopause. Your doctor will help you decide if it’s the best treatment for you.