Perimenopause, Menopause and Beyond
‘When will menopause happen’ and ‘how bad will it be’ are questions we get a LOT as people go through their 40s. While we can’t say exactly what it will be like for YOU, we can give you an idea of what to expect and provide you with options for managing disruptive symptoms—if you have them.
Care that changes with you
Perimenopause—the transitional phase before menopause—typically begins in your 40s and can last anywhere from a few months to several years as your ovaries gradually produce less estrogen. About one to two years before menopause, that drop in estrogen becomes more sudden, and this is when many people experience the most intense symptoms.
Estrogen levels can swing from day to day, causing symptoms like hot flashes, night sweats, vaginal dryness, vulvar changes, headaches and shifts in libido—plus many more (there more than 30 commonly associated with perimenopause). The impact on your mood, memory and concentration is real; it’s a direct result of estrogen’s role in brain function, and it’s not in your head.
Until your periods stop completely, you can still get pregnant, so birth control is still important during this time. Once you’ve gone 12 months without a period, you’ve reached menopause. But that doesn’t mean symptoms stop. Estrogen production continues to decline, and you may notice longer-term changes in your skin, metabolism, weight distribution or bone strength.
A note: For a small few, menopause may arrive between the ages of 40 and 45, known as early-onset menopause. When it happens before age 40, it’s known as premature ovarian insufficiency.
There’s no single test to “diagnose” perimenopause. Hormone levels can fluctuate daily and don’t always give the full picture. That’s why your personal experience with symptoms and health history matters most. Only you know when you feel “off” or “different.”
You should consider making an appointment if symptoms are interfering with your quality of life, or even if you’re just unsure what’s going on. Talking to a provider can help you make sense of the changes and decide if treatment makes sense for you.
The goal of treatment is twofold: to provide relief from disruptive symptoms now, and to set you up for a healthy future by protecting your bone, heart and brain health for years to come.
Many people bring up perimenopause-related symptoms at their wellness visit—and that’s a great place to start. Be sure to track your cycles and symptoms in a calendar ahead of time, noting how often you bleed, how long it lasts and what symptoms you experience.
You and your provider will talk through your symptoms, treatment goals and any health concerns that could affect your options. Depending on your needs, we might begin symptom management that same day or schedule a follow-up to finalize or adjust your plan. Your treatment plan may include:
- Hormone therapy: Menopause Hormone Therapy (MHT) is the most effective way to relieve hot flashes, night sweats and vaginal dryness. While you may have heard about past safety concerns, decades of research have shown that for most healthy people starting within 10 years of menopause, the benefits of MHT (including long-term protection for your bones) often outweigh the risks. In some cases, testosterone may be an option for specific concerns like postmenopausal low libido.
- Non-hormonal medications: These may help manage symptoms like sleep disruption, mood swings or hot flashes.
- Lifestyle support: Nutrition, regular movement and stress-reduction strategies all play a role in how you feel—now and long term.
WHA has many certified nurse-midwives and OB/GYNs who are passionate about and trained in perimenopause care, who are dedicated to helping you feel more like, well, you.
Perimenopause and menopause services
WHA’s physicians, nurse-midwives and nurse practitioners can help you address symptoms that are disrupting your life with the following approaches:
- Lifestyle modifications to promote energy and a sense of wellbeing
- Non-hormonal medications to address specific symptoms.
- Systemic and/or topical hormone therapy
- Complementary approaches and the science behind them
Office Locations
- Bridgeview, (503) 274-4800
1130 NW 22nd Avenue, Suite 520, Portland, 97210 - Gateway, (503) 734-3800
10566 SE Washington Street, Portland, 97216 - Hillsboro, (503) 840-3400
7431 NE Evergreen Parkway, Suite 100, Hillsboro, 97124 - Newberg, (503) 538-2698
1003 Providence Drive, Suite 340, Newberg, 97132 - Oregon City, (503) 657-1071
1500 Division Street, Oregon City, 97045 - Peterkort North, (503) 734-3700
9701 SW Barnes Road, Suite 200, Portland, 97225 - Tabor, (503) 249-5454
5050 NE Hoyt Street, Suite 230, Portland, 97213 - Tualatin, (503) 692-1242
19250 SW 65th Avenue, Suite 300, Tualatin, 97062 - Northwest Gynecology Center – Peterkort, (503) 734-3535
9701 SW Barnes Road, Suite 150, Portland, 97225 - Northwest Gynecology Center – Tualatin, (503) 855-1600
19250 SW 65th Avenue, Suite 325, Tualatin, 97062
Welcoming New Patients
We are happy to begin discussing symptoms related to perimenopause and menopause during your wellness visit, if you are due for one—but be aware that a follow-up gynecology visit may be necessary to address your symptoms and begin treating them. If you are not due for a wellness visit, schedule a gynecology appointment to get started.
Accepted Insurance
We participate in most insurance plans that serve the Portland area, including specific plans offered by the companies listed below (1). If you don’t see your insurance company on this list, please call our clinic and we’ll be happy to help you. Call your health plan directly to verify participation, benefits and any referral requirements before scheduling.
Please note:
- The insurances we are able to accept can change without warning. Contact your insurance company to verify your coverage and benefits.
- We are able to accept the Medicare Advantage Plans associated with these health plans, unless they are PFFS (Physician Fee for Service) plans.
- We cannot accept Kaiser or OHSU OHP plans (among other OHP plans outside the areas our offices serve).
- We cannot accept the Regence BCBS OHSU or PeaceHealth network plans.