Women's health care during the perimenopause

To review the perimenopause, its associated symptoms, and current management options.

Published articles identified through MEDLINE (1966-2000) using the search terms perimenopause and treatment. Additional articles and books were identified from the bibliographies of the retrieved articles.

The perimenopause is the transition period from normal ovulatory cycles to menopause. It is associated with erratic fluctuations in reproductive hormone levels, often leading to irregular menstrual cycles, vasomotor symptoms, changes in mood or cognition, and sexual dysfunction. The perimenopause is an ideal time to evaluate a woman's health risks for such common chronic midlife conditions as heart disease, osteoporosis, and some cancers, and to initiate appropriate preventive health measures. Low-dose oral contraceptives and other hormonal therapies are often effective in managing perimenopausal symptoms.

The transition to menopause is an important time in the female life span that is associated with varied physical and psychological symptoms. Pharmacists should be prepared to provide education about the perimenopause and counsel women on the benefits and risks of various pharmacologic and nonpharmacologic treatments that can ease their passage through this often difficult transition. Pharmacists also are well-positioned to educate and encourage perimenopausal women to initiate lifestyle changes that can enhance their health for the rest of their lives.