Menopause / Perimenopause

What is Menopause / Perimenopause?

Menopause is the normal transition in a woman’s life when her menstrual periods end, typically in her late 40s to early 50s. The ovaries are no longer releasing eggs and have also dramatically slowed hormone production. Perimenopause is the stage leading up to full menopause, as the ovaries gradually make less and less estrogen. Perimenopause usually starts in a woman’s 40s but can start as early as her 30s. A woman will still get periods during this time and can still get pregnant. While the average length of perimenopause is four years, it may vary from a few months to as long as ten years.

In females of any age, surgery or damage to the ovaries can initiate menopause more suddenly.

Menopause and Perimenopause Symptoms

Menopause and Perimenopause have a wide range of symptoms. No two women experience this transition the same way. You may have varying degrees of symptoms for varying lengths of time. For example, more than two-thirds of North American women get hot flashes, but some experience them for only a year or two, while others may have them for over a decade.
The most common early symptoms of perimenopause
  • Worsening premenstrual symptoms
  • Irregular periods
  • Heavier or lighter periods
  • Breast tenderness
As you approach, and transition into, menopause
  • Hot flashes – A brief sensation of heat that comes on suddenly, sometimes with facial flushing and sweating. Triggers may include hot weather, caffeine, nicotine, alcohol, spicy foods, tight clothing, and stress.
  • Night sweats
  • Trouble sleeping
  • Bladder control problems – Including leakage when coughing or sneezing, urgency, or increasing frequency.
  • Vaginal dryness – Which can cause discomfort during sex.
  • Dry skin
  • Emotional changes – Such as depression, anxiety, lack of motivation, irritability, and anger.
  • Facial hair growth
  • Difficulty concentrating and minor memory problems
  • Lower sex drive
  • Bone loss
  • Other symptoms – Some women experience headaches, rapid heartbeat, joint and muscle aches, weight gain, or hair loss.

Causes of Menopause / Perimenopause

Menopause is not a disease. It’s a natural process; however, if your menopausal journey is affecting your daily life, there is no need to suffer from its symptoms.

You are born with all the eggs you will ever have. As a baby, you probably started with 1-3 million eggs, but they expire over time. At menopause, you may have only 10,000 remaining, and these eggs may not be as healthy as they once were. Meanwhile, as your ovaries age, they produce less of the hormones estrogen and progesterone, the two key hormones controlling the female reproductive system. This natural decline in hormone production — especially estrogen — signals an end to fertility that can affect your overall health.

Estrogen affects many parts of the body besides the uterus, including the blood vessels, heart, bone, breasts, urinary system, skin, and brain. Healthy estrogen levels keep your organs and systems functioning at their best, so its decline is at the root of many menopause symptoms. During menopause, the ovaries also decrease their production of testosterone — a hormone involved with sex drive.


Your doctor will likely be able to diagnose perimenopause from your symptoms. While there are blood tests to measure hormone levels, they are often inconclusive because your hormone levels are fluctuating widely during this time.

The first step in diagnosing menopause is a discussion with your doctor about your menstrual cycle. If you’ve gone a full year without a period, you’re typically considered to have gone through menopause. For many women, testing isn’t necessary. A blood test is available that measures levels of follicle-stimulating hormone (FSH) — a hormone produced by the pituitary gland that is a key player in preparing your body for pregnancy. However, this test can be misleading, especially early in menopause when your hormone levels are still rising and falling irregularly.

If you think you may be experiencing symptoms of Menopause / Perimenopause and your periods have been irregular or have stopped, talk to your doctor. There are other conditions that can cause some of these effects, which your health care provider may want to rule out.

Menopause / Perimenopause Treatments

If your symptoms are mild or short-lived, you may not need additional therapy. However, if you do, hormone replacement can address uncomfortable symptoms of menopause and perimenopause.

Some hormones that may be prescribed for you include different forms of estrogen: estradiol, estriol, or biest, a combination of the two.  Progesterone, testosterone, pregnenolone, and DHEA may also be recommended based on your menopausal symptoms.



How Belmar Can Help

Belmar compounds bioidentical hormones in a variety of dosage forms, strengths and combinations to help you feel more like yourself again. Dosage forms include injectable pellets, regular and sublingual tablets, and blended creams. We also dispense other medications that target specific issues like hair loss, dry skin, or low sex drive. We’re focused on ensuring your doctor has the right medication available to fit your specific needs so you can enjoy the best health and lifestyle possible.

If you are going through perimenopause or menopause, or are concerned about any of the symptoms on this page, contact us for more information and start a conversation with your doctor. Together, you can decide if a compounded prescription might be a good treatment for you.

Contact Belmar Pharma Solutions

If you're a patient, we're here to help you fill prescriptions or provide you with the information you need to work with your doctor to help decide if a compounded prescription might be a good therapy for you.

Prescribers, for a complete formulary or access to our clinical resources, fill out the form below. If you are new to compounding, you may also find our page on How to Write a Compounding Prescription

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