Perimenopause is the transitional phase from a woman's reproductive years to menopause. Symptoms during this time can impact a woman's physical and mental health, as well as her sex life. Dr. Nguyen Thi Quy Khoa, Deputy Head of Obstetrics and Gynecology at Tam Anh General Hospital in TP HCM, explains that perimenopause is caused by decreased activity in the brain-pituitary-ovarian axis, leading to an imbalance in three key hormones: estrogen, progesterone, and testosterone.

Perimenopause can last for several months or even years. Dr. Khoa offers advice on managing symptoms and protecting overall health during this time.

Calcium and vitamin D supplementation

Perimenopausal women are at increased risk of osteoporosis due to declining estrogen levels. This affects calcium absorption and bone formation, weakening bones. Many women in perimenopause and menopause are at risk of decreased height, hunchback, and spinal curvature.

Women can supplement with about 1,000 mg of calcium daily, increasing to 1,200 mg after menopause, not exceeding 2,000 mg. The recommended daily intake of vitamin D for perimenopausal women is around 15 micrograms (600 IU), increasing to about 20 micrograms (800 IU) after menopause.

Women can obtain vitamin D through sun exposure, diet, or supplements. For medications or supplements, consult a doctor and follow the dosage instructions. Avoid exceeding the recommended dose to prevent potential toxicity.

A doctor consults a woman in her 40s about perimenopause treatment. Photo illustration: Tam Anh General Hospital

Antidepressants

Certain antidepressants can help stabilize mood and reduce hot flashes. Consult a doctor before using these medications. Women with severe perimenopausal symptoms may require hormone therapy.

Hormone therapy

Lower estrogen levels in perimenopausal women can lead to vasomotor symptoms like hot flashes, excessive sweating, hair loss, and dry skin. Dr. Khoa notes that estrogen supplementation is an effective way to alleviate these symptoms. However, women should consult a doctor for appropriate evaluation and prescription. Hormone therapy is not suitable for individuals with coronary artery disease, breast cancer, endometrial cancer, stroke or venous thrombosis, liver disease, or unexplained vaginal bleeding.

Phytoestrogen supplements

Phytoestrogens are plant-derived compounds with estrogen-like properties. Supplementing with phytoestrogens can help reduce hot flashes, prevent osteoporosis, treat acne, and improve cardiovascular health. However, consult a doctor for guidance. High doses of phytoestrogens can cause side effects, affecting the ovaries and increasing the risk of certain cancers.

Dr. Khoa cautions against self-treating perimenopause symptoms, as this can increase the risk of heart attack, blood clots, endometrial hyperplasia, breast cancer, and stroke. Most perimenopausal symptoms are mild to moderate and may subside over time. Intervention is typically necessary only for those experiencing severe symptoms that negatively impact work, relationships, and daily life.

Diem Thuy