The perimenopause experience for women with spinal cord injuries

When health questions or concerns arise, nurses are often the first care providers contacted by women with spinal cord injuries (SCIs). This highlights the importance of nurses' understanding of specific health issues such as the perimenopause transition, along with understanding the symptoms and changes that women with SCI may experience throughout the conversion into menopause. Women aged 35 to 55 years old, with an SCI of any level or degree of completeness, no history of salpingo-oophorectomy or hysterectomy, and who receive care at a SCI model system in the mountain states, were mailed a questionnaire regarding symptoms associated with perimenopause, self-rated severity scores of various symptoms, and different options for treatment of the symptoms related to perimenopause. The 230 (62%) women who responded reported the following symptoms associated with perimenopause: menstrual cycle changes (60%), sleep disturbance (43%), night sweats (40%), hot flashes (39%), and decreased sex drive (38%). Subjective severity of these symptoms varied, but no significant differences were noted between women with tetraplegia and paraplegia, whether neurologically complete or incomplete. Perimenopause presents a unique challenge for women with SCI because the symptoms may mimic or mask other conditions associated with SCI, such as autonomic dysreflexia, infections, impaired temperature regulation, and spinal cord cysts. Care providers, and women with SCI, should carefully monitor their symptoms during perimenopause and the treatment plan should reflect a joint decision between the woman and her provider.