1. Mood Changes
Some women find that hormone fluctuations in perimenopause create a feeling of being out of control. Reports of increased irritability, anxiety, fatigue, and blue moods are not uncommon. Relaxation and stress-reduction techniques, including deep-breathing exercises and massage, a healthy lifestyle (good nutrition and daily exercise), and enjoyable, self-nurturing activities may all be helpful. Some women try to treat their menopause symptoms with over-the-counter products such as St. John’s wort or vitamin B6.
Discussing mood issues with your healthcare provider can help you identify the cause, assess for severe depression, and decide on the most appropriate intervention. For depression, prescription antidepressant medications may be indicated to correct a chemical imbalance. Although several weeks are usually needed to experience the full effect of one of these drugs, many women show a marked improvement with these medications with relatively few side effects. Some antidepressants have also been found to treat hot flashes. Antidepressant therapy is most effective when combined with counseling or psychotherapy.
2. Urinary Incontinence
While it is defined as the persistent, involuntary loss of urine, most women would say urinary incontinence is an unfortunate, unwelcome, unwanted annoyance. Luckily, there are strategies to help improve the various forms of incontinence without medication or surgery. Try drinking adequate water to keep urine diluted (clear and pale yellow), and avoid foods or beverages with a high acid or caffeine content, which may irritate the bladder lining. These include grapefruit, oranges, tomatoes, coffee, and caffeine-containing soft drinks. Also, try Kegel exercises to strengthen your pelvic floor muscles and reduce incontinence episodes.
3. Night Sweats
To get relief from night sweats (hot flashes that occur during sleep), try different strategies to stay cool while you sleep:
- Dress in light nightclothes.
- Use layered bedding that can easily be removed during the night.
- Or, try wicking materials for both.
- Cool down with an electric fan.
- Sip cool water throughout the night.
- Keep a frozen cold pack under your pillow and turn over the pillow often so that your head is always resting on a cool surface, or put a cold pack on your feet.
4. Trouble Falling Asleep
Establish a regular sleep schedule and sleep routine:
- Wake up and go to bed at consistent times, even on weekends.
- Relax and wind down before sleep by reading a book, listening to music, or taking a leisurely bath.
- Try snacking on a bowl of cereal or peanut butter on toast before bedtime.
- Milk and peanuts contain tryptophan, which helps the body relax.
- A cup of chamomile tea may also do the trick.
- Keep bedroom light, noise, and temperature at a comfortable level -- dark, quiet, and cool are conditions that support sleep.
- Use the bedroom only for sleep and sex.
- Avoid caffeine and alcohol late in the day.
5. Sexual Discomfort
Menopause contributes to sexual function changes through the decreases in ovarian hormone production and may lead to vaginal dryness and a decline in sexual function. To counteract these changes, try:
- Vaginal lubricants: Available without a prescription, these products decrease friction and ease intercourse when the vagina is dry. Only water-soluble products should be used because oil-based products such as vaseline may actually increase irritation. Only products designed for the vagina should be used; avoid hand creams and lotions containing alcohol and perfumes, which may irritate tender tissue. (Examples of available vaginal lubricants include Astroglide, Moist Again, and Silk-E.)
- Vaginal moisturizers: Also available without a prescription, these products improve or maintain vaginal moisture in women with mild vaginal atrophy (when tissues of the vulva and the lining of the vagina become thin, dry, less elastic, and less lubricated as a result of estrogen loss). They also help keep vaginal pH low, which ensures a healthy vaginal environment. (Examples include Replens and K-Y Long-lasting Vaginal Moisturizer.) These products can be used on a regular basis and offer a more lasting effect than vaginal lubricants.
- Regular sexual stimulation: Last but certainly not least, women can maintain vaginal health through regular sexual activity, which promotes blood flow to the genital area.