Menopause is a natural event that every woman goes through as she transitions out of fertility.  While the years leading up to menopause (known as perimenopause) can be uncomfortable, someone at iTherapy can help.

Signs of Menopause

Officially, menopause is defined as the final menstrual period and confirmed only when a woman has missed periods for 12 consecutive months.  On average, menopause occurs around age 51, though perimenopause (the years before the final menstrual period) can last six years or more. Perimenopause is caused by the changing, often erratic, hormone levels such as estrogen. Other things that can trigger menopause include: chemotherapy, radiation therapy, primary ovarian insufficiency (caused by genetic factors or autoimmune disease), hysterectomy and bilateral oophorectomy (removal of uterus and ovaries)

Symptoms of Perimenopause

  • Irregular menstrual periods
  • Hot flashes
  • Mood swings
  • Feelings of sadness or loss
  • Low sex-drive
  • Low energy
  • Loss of breast fullness
  • Vaginal dryness
  • Thinning hair
  • Increase abdominal fat
  • Decreased fertility


There is no medical treatment for menopause, but several actions or medications can relieve symptoms.

To Reduce Hot Flashes

  • Use hormone therapy such as estrogen
  • Take a low-dose antidepressant such as: Celexa, Effexor, Paxil, Prozac, Sarafem and Zoloft.
  • Take Clonidine ( a pill or patch typically used to treat high blood pressure) to reduce the frequency of hot flashes. However, unpleasant side effects are common.
  • Try to identify possible triggers such as spicy foods, alcohol, hot beverages that my induce hot flashes and avoid those triggers.
  • Try relaxation techniques, such as yoga, deep breathing, guided imagery and meditation.

To Minimize Sleep Disturbances

  • Avoid caffeine
  • Exercise during the day, but not right before bedtime.
  • Try relaxation techniques, such as yoga, deep breathing, guided imagery and meditation
  • Administer vaginal estrogen in the form of a vaginal tablet, ring or cream
  • Use over-the-counter water-based vaginal lubricants (Astroglide, K-Y) or moisturizers (Replens, Vagisil).

To Improve Osteoporosis

  • Use Bisphosphonates such as Actonel, Boniva, Fosamax
  • Use Selective estrogen receptor modulators (SERMs) such as Evista
  • Exercise regularly- at least 30 minutes of moderate-intensity activity daily.
  • Don’t smoke. Smoking may also increase hot flashes.

Post Menopause Medical Conditions

Sometimes, chronic medical conditions can develop after menopause, but there are steps you can take to mitigate those conditions.

To Prevent Cardiovascular Disease

  • Stop smoking
  • Reduce high blood pressure
  • Get regular aerobic exercise
  • Eat healthy diet that includes whole grains, fruits and vegetables

For Preventing Osteoporosis:

  • Get adequate calcium and vitamin D (1200-1500 mg daily of calcium; 800 IU vitamin D daily)
  • Exercise regularly- at least 30 minutes of moderate-intensity activity daily, such as walking/running
  • Urinary incontinence
  • Strengthen your pelvic floor through exercises, such as Kegel exercises
  • Weight gain
  • Reduce caloric intake by 200-400 calories daily
  • Increase exercise and get regular aerobic exercise

If you are experiencing signs of menopause and need help, contact one of our iTherapy counselors to discuss your concerns.