Perimenopause, in plain words

An FDA pathway for bringing a moderate-risk medical device to market. It is named after a section of US law. The maker shows that the device is substantially equivalent to one already sold legally, and the FDA then clears it. Clearance is not the same as FDA approval, which needs more evidence. Many personal lubricants, vaginal moisturizers and menstrual cups are 510(k)-cleared. Each clearance number starts with K and can be checked in the FDA's public database.

Read the guide →Source: FDA. Premarket Notification 510(k)

The actual chance that something will happen to a person or group over a set time. It is usually given as a count, such as cases per 1,000 or 10,000 women per year. Absolute risk shows how much a treatment really changes the odds. A risk can rise by a large percentage and still be small if the event is rare. That is why hormone therapy risks are best read in absolute numbers, alongside relative risk.

Read the guide →Source: NCI Dictionary of Cancer Terms. Absolute risk

A condition in which tissue like the lining of the uterus grows into the muscle wall of the uterus. The uterus can become thicker and larger. It can cause heavy, long or painful periods, but many women with it have no symptoms. When bleeding gets heavier in perimenopause, clinicians look for it along with fibroids and polyps. Ultrasound or MRI can help find it. Symptoms usually go away after menopause.

Read the guide →Source: MedlinePlus. Adenomyosis

A hormone made by small follicles in the ovaries. Its level reflects how many follicles are left. AMH falls steadily with age and becomes very low as menopause nears. It can help estimate how close the final period is, especially in the late 40s and early 50s. It cannot diagnose perimenopause on its own. The FDA says AMH results should not be used to decide when to stop birth control or to judge fertility.

Read the guide →Source: MedlinePlus. Anti-Müllerian Hormone Test

Surgery to remove both ovaries. The fallopian tubes are often removed at the same time (bilateral salpingo-oophorectomy), and sometimes the uterus too. Done before natural menopause, it causes surgical menopause right away, because the ovaries make most of a woman's estrogen until then. Removing only the uterus, only the tubes, or one ovary usually does not cause menopause. If healthy ovaries may be removed before 50, ask whether they really need to come out.

Read the guide →Source: NCI Dictionary of Cancer Terms. Oophorectomy

Hormones with the same chemical structure as the ones the ovaries make, mainly estradiol and progesterone. The Menopause Society says the term was invented by marketers and has no clear scientific meaning. FDA-approved estradiol products and micronized progesterone capsules are bioidentical, and they are tested for dose and safety. Custom-mixed 'bioidentical' creams, troches and pellets are not FDA-approved. They contain the same hormones and carry the same risks, without the same quality checks.

Read the guide →Source: The Menopause Society. MenoNote: Bioidentical Hormone Therapy, Custom Compounded versus Government Approved

The FDA's strongest safety warning. It sits in a box at the top of a prescription drug's label and flags serious or life-threatening risks. In November 2025, the FDA asked makers of menopausal hormone therapy to remove heart disease, breast cancer and probable dementia from the box. The endometrial cancer warning stays on systemic estrogen-alone products. Fezolinetant and ospemifene also carry boxed warnings.

Read the guide →Source: FDA. FDA Requests Labeling Changes Related to Safety Information to Clarify the Benefit/Risk Considerations for Menopausal Hormone Therapies

An everyday term, not a medical diagnosis, for thinking changes many women notice in perimenopause. Examples include losing words, forgetting why you walked into a room, losing your train of thought and struggling to focus. Studies suggest the changes are real but usually mild and temporary. Swinging estrogen, poor sleep, hot flashes and mood changes all play a part. Thyroid disease, low iron, sleep apnea and depression should be ruled out.

Read the guide →Source: Office on Women's Health. Menopause symptoms and relief

A registered nurse with graduate training in midwifery and national certification. Despite the name, CNMs do not only care for pregnancy and birth. They also provide gynecologic checkups, birth control, primary care and menopause care, and they can order tests and prescribe medicines. How independently they work depends on state law. A CNM can be a good place to start perimenopause care, especially if you already see one.

Read the guide →Source: MedlinePlus. Certified nurse-midwife

A short, structured treatment for long-lasting insomnia, usually about six sessions. It can be done in person, by phone or video, or through a guided digital program. It combines sleep restriction, stimulus control, work on the thoughts that keep you awake, relaxation and better sleep habits. A sleep diary guides changes each week. US sleep guidelines call it the first-line treatment for chronic insomnia. It works in perimenopause even when night sweats continue.

Read the guide →Source: National Institute on Aging. Sleep Problems and Menopause: What Can I Do?

Hormone products mixed by a pharmacy from a custom recipe, such as creams, gels, troches, capsules and implanted pellets. They are often sold as 'bioidentical.' Compounded drugs are not FDA-approved, so the FDA does not check their safety, effectiveness or quality before use. The dose can vary from batch to batch, and progesterone creams may not protect the uterus. ACOG and The Menopause Society recommend FDA-approved hormone therapy instead.

Read the guide →Source: FDA. Compounding and the FDA: Questions and Answers

A quick, low-radiation X-ray test that measures bone density, usually at the hip and lower spine. Results come as a T-score, and sometimes a Z-score. They are used to diagnose osteopenia and osteoporosis and, with tools such as FRAX, to estimate the chance of a fracture. The USPSTF advises screening for women 65 and older. It also advises screening younger postmenopausal women whose risk assessment shows higher risk.

Read the guide →Source: MedlinePlus. Bone mineral density test

Menopause, meaning the final period, that happens between ages 40 and 45. Before 40, it is called premature menopause or premature ovarian insufficiency. Early menopause can happen on its own or after surgery, chemotherapy or radiation. Smoking is linked to an earlier menopause. More years with low estrogen raise long-term risks to bones and heart. That is why clinicians treat early loss of ovarian function more actively than menopause at the usual age.

Read the guide →Source: Office on Women's Health. Early or premature menopause

A non-hormonal prescription capsule for moderate to severe hot flashes and night sweats caused by menopause. The FDA approved it in October 2025. It is taken once a day at bedtime. It blocks two brain receptors, neurokinin 1 and neurokinin 3, that help trigger hot flashes. This is the same pathway fezolinetant targets. In trials it cut hot flashes more than placebo and improved sleep scores. As the newest option, it has the least long-term data.

Read the guide →Source: MedlinePlus. Elinzanetant

An office test that removes a small sample of the uterine lining (endometrium) through a thin tube passed through the cervix. The sample is checked under a microscope for overgrowth or cancer. It can cause brief cramping. ACOG recommends it as a first test for heavy or irregular bleeding after age 45, or earlier with risk factors such as obesity. It is also used to check bleeding after menopause.

Read the guide →Source: MedlinePlus. Endometrial biopsy

An overgrowth of the lining of the uterus (endometrium). It is usually caused by estrogen that is not balanced by enough progesterone. It can happen in perimenopause, when skipped ovulations mean less progesterone. It can also happen in women with a uterus who take estrogen without a progestogen. Some types, called atypical hyperplasia, can lead to cancer. Abnormal bleeding is the usual sign. It is diagnosed with a biopsy and often treated with a progestin.

Read the guide →Source: ACOG. Endometrial Hyperplasia (FAQ)

The main and strongest estrogen the ovaries make during the reproductive years. In perimenopause, estradiol swings widely and can even run higher than before. On average it does not fall steeply until about two years before the final period. So one blood test cannot confirm or rule out perimenopause. Estradiol is also the estrogen in most patches, gels, sprays and vaginal products, and in many hormone therapy pills.

Read the guide →Source: MedlinePlus. Estrogen Levels Test

A group of hormones made mainly by the ovaries before menopause. They control the menstrual cycle and also act on the brain, bones, blood vessels, skin, bladder and vagina. The main types are estradiol, estrone and estriol. In perimenopause, estrogen does not drop in a straight line. It spikes and crashes, and those swings drive many symptoms. After menopause, levels stay low, which speeds bone loss and causes vaginal and urinary changes.

Read the guide →Source: NCI Dictionary of Cancer Terms. Estrogen

A once-daily, non-hormonal pill for moderate to severe hot flashes and night sweats caused by menopause. The FDA approved it in May 2023. It blocks the neurokinin 3 (NK3) receptor in the brain. This calms nerve cells that become overactive as estrogen falls and set off hot flashes. It carries a boxed warning for rare but serious liver injury. Liver blood tests are needed before starting and at set times during the first nine months.

Read the guide →Source: MedlinePlus. Fezolinetant

A hormone made by the pituitary gland that tells the ovaries to grow follicles. As the supply of follicles shrinks, the ovaries make less inhibin B, and FSH rises to push harder. In perimenopause, FSH swings from month to month, so one normal result does not rule out perimenopause. After 45, diagnosis is usually based on age, cycle changes and symptoms. FSH testing matters most before 40, to check for premature ovarian insufficiency.

Read the guide →Source: MedlinePlus. Follicle-Stimulating Hormone (FSH) Levels Test

A low-cost generic medicine approved for seizures and nerve pain. It also reduces hot flashes and night sweats. It is not FDA-approved for menopause, so it is prescribed off-label, but The Menopause Society recommends it based on strong evidence. Drowsiness and dizziness are common, especially in the first week. That is why a bedtime dose is often used when night sweats disrupt sleep. It is not a hormone and needs no routine blood tests.

Read the guide →Source: MedlinePlus. Gabapentin

The medical name for vaginal, vulvar and urinary changes caused by falling estrogen. It was adopted in 2014. Symptoms include dryness, burning, irritation, pain with sex, urgent or burning urination and repeat urinary tract infections. GSM can begin in perimenopause and usually gets worse without treatment. Lubricants and moisturizers are first-line options. Low-dose vaginal estrogen has the strongest evidence. GSM replaced the older terms vaginal atrophy and vulvovaginal atrophy.

Read the guide →Source: The Menopause Society. Menopause Glossary

A blood test that shows your average blood sugar over the past two to three months. An A1C below 5.7% is normal. From 5.7% to 6.4% is prediabetes, and 6.5% or higher is diabetes, usually confirmed with a second test. Diabetes risk rises in the 40s and 50s, mostly with age, weight and changes in body composition. That makes A1C a common midlife screening test. Some health conditions can make results less accurate.

Read the guide →Source: MedlinePlus. Hemoglobin A1C (HbA1c) Test

A sudden wave of heat, usually in the chest, neck and face. It often comes with sweating, flushing and a faster heartbeat, lasts one to five minutes and may leave you chilled. It happens when the brain's temperature comfort zone narrows, so a small rise in body temperature sets off the full cooling response. Hot flashes often start in perimenopause and can last for years after the final period. Hormone therapy is the most effective treatment.

Read the guide →Source: National Institute on Aging. Hot Flashes: What Can I Do?

A hormone made by developing follicles in the ovaries. It tells the pituitary gland to hold back FSH. As the number of follicles falls with age, the ovaries make less inhibin B. This is one reason FSH rises in the years before menopause. Inhibin B is measured mainly in research and some fertility workups. It is not a routine test for perimenopause, which is diagnosed from age, cycle changes and symptoms.

Read the guide →

Trouble falling asleep, staying asleep or waking too early, with daytime effects such as tiredness, irritability or poor focus. It becomes more common in perimenopause. Night sweats, shifting hormones and mood changes all play a part. The typical pattern is waking in the second half of the night. Habits like going to bed early, lying in or napping can keep it going. CBT-I is the first-line treatment; sleeping pills have weaker evidence.

Read the guide →Source: MedlinePlus. Insomnia

A blood test that measures total cholesterol, LDL ('bad') cholesterol, HDL ('good') cholesterol and triglycerides. Non-HDL cholesterol is calculated from these. LDL rises fastest in the year before and the year after the final period. A baseline test in your 40s helps you see that change. Your results are combined with other risk factors to decide whether lifestyle changes alone or a statin is the right step.

Read the guide →Source: MedlinePlus. Cholesterol Levels

A hormone made by the pituitary gland. It triggers ovulation each cycle and helps the ovary make progesterone afterward. The sharp rise in LH just before ovulation is what home ovulation tests detect. Like FSH, LH tends to rise and swing during the menopause transition as the ovaries respond less. It is not used on its own to diagnose perimenopause, and one result says little during the transition.

Read the guide →Source: MedlinePlus. Luteinizing Hormone (LH) Levels Test

Treatment with estrogen to relieve symptoms caused by falling ovarian hormones. Women who still have a uterus also take a progestogen. It is the most effective treatment for hot flashes and night sweats, and it prevents the bone loss of early menopause. It comes as pills, patches, gels, sprays and vaginal products. For healthy women with bothersome symptoms who are under 60 or within 10 years of menopause, US guidelines say the benefits outweigh the risks.

Read the guide →Source: ACOG. Hormone Therapy for Menopause (FAQ)

The research term for the years when periods change on the way to the final period. Under the STRAW+10 system, it starts when cycle length begins to vary by 7 days or more. It ends at the final menstrual period. Its late stage is marked by gaps of 60 days or more. Perimenopause covers the same years plus the first 12 months after the final period, so the terms are often used interchangeably.

Read the guide →Source: National Institute on Aging. What Is Menopause?

The point when periods stop for good. It is confirmed after 12 months in a row with no period or spotting. Menopause is a single date, known only looking back, not a phase. The average age in the US is about 51 to 52. Most symptoms people call 'menopause' start in perimenopause, the years before, and many continue into postmenopause. Menopause can also happen suddenly if both ovaries are removed.

Read the guide →Source: ACOG. The Menopause Years (FAQ)

A credential from The Menopause Society for licensed clinicians who pass its exam on menopause care. It replaced the older NCMP title. It must be renewed every three years, by retaking the exam or through continuing education. Doctors, nurse practitioners, physician assistants, nurse-midwives, nurses and pharmacists can earn it. It shows focused menopause training, but it is not a license or a specialty. A clinician's license decides what they can prescribe.

Read the guide →Source: The Menopause Society. Certification Examination: How to Earn an MSCP Credential

A study that combines the results of several earlier studies on the same question. The goal is a more precise overall answer. A meta-analysis of well-run randomized trials is usually stronger evidence than any single trial. But it is only as good as the studies it pools: combining small, biased or very different studies can mislead. It is often part of a systematic review, such as a Cochrane review, which first searches for every relevant study.

Read the guide →Source: NCI Dictionary of Cancer Terms. Meta-analysis

Progesterone that is chemically identical to the hormone the ovaries make. It is ground into fine particles so it can be absorbed from a capsule. In hormone therapy, it protects the lining of the uterus from the overgrowth that estrogen alone would cause, and it is FDA-approved for that use. It is taken at bedtime because it can make you drowsy. The capsules contain peanut oil, so people with a peanut allergy should not take them.

Read the guide →Source: MedlinePlus. Progesterone

A unique 10-digit number that the federal Centers for Medicare & Medicaid Services gives to US health care providers. Providers who bill insurance electronically must have one, so most practicing clinicians do. Anyone can look up a clinician's NPI, listed specialty and practice address in the free NPPES NPI Registry. An NPI shows that a provider is enrolled. It does not show license status or quality; your state licensing board shows that.

Read the guide →Source: CMS. National Provider Identifier Standard (NPI)

Hot flashes that happen during sleep. They often wake you damp or drenched and then chilled. Together with daytime hot flashes, they are called vasomotor symptoms. They are a leading cause of broken sleep in perimenopause, especially in the lighter second half of the night. Alcohol, sleep apnea, an overactive thyroid, some medicines and, rarely, infections or cancers can also cause night sweats. Sweats with fever or weight loss need a checkup.

Read the guide →Source: NCI Dictionary of Cancer Terms. Night sweats

The American National Standard for testing and certifying dietary supplements. The independent group NSF uses it. Certification means NSF reviewed the formula, checked that the label matches what is inside, and tested for contaminants such as lead and mercury. NSF also audits the factory every year. NSF Certified for Sport adds testing for substances banned in sport. Like other quality marks, it does not show that a supplement works or is right for you.

Read the guide →Source: NSF. Product and Ingredient Certification (NSF/ANSI 173)

A doctor (MD or DO) trained in obstetrics, which covers pregnancy and birth, and gynecology, which covers the reproductive organs. OB-GYNs check abnormal bleeding, do procedures such as biopsies and hysterectomies, and prescribe hormone and non-hormonal treatments. That makes them the most common starting point for perimenopause care. Menopause training varies from one OB-GYN to another, so it is worth asking how many patients in this stage they see.

Read the guide →Source: MedlinePlus. Types of health care providers

Using an FDA-approved drug for a condition, dose or group of patients that is not listed on its label. It is legal and common. In menopause care, gabapentin, most SSRIs and SNRIs, oxybutynin and testosterone for women are used off-label. That means the dose for that use came from independent studies rather than FDA review. It is fair to ask your clinician what evidence supports an off-label choice.

Read the guide →Source: FDA. Understanding Unapproved Use of Approved Drugs "Off Label"

A once-daily prescription pill for painful sex and vaginal dryness caused by menopause. It is not estrogen, but it acts like estrogen on vaginal tissue. It belongs to a drug class called selective estrogen receptor modulators (SERMs). It suits women who prefer a pill or cannot use a vaginal product. Side effects can include hot flashes and vaginal discharge. Its label carries a boxed warning about endometrial cancer, stroke and blood clots.

Read the guide →Source: MedlinePlus. Ospemifene

Bone density that is lower than a healthy young adult's but not low enough to be called osteoporosis. On a DEXA scan, that means a T-score between -1.0 and -2.5. It is common after menopause. It is a signal to look at your overall fracture risk, often with the FRAX tool, not an automatic reason for medicine. Strength and impact training, enough calcium and vitamin D, and preventing falls help protect bone.

Read the guide →Source: NCI Dictionary of Cancer Terms. Osteopenia

A disease in which bones lose density and strength and break more easily, sometimes from a minor fall. It is diagnosed when a DEXA scan T-score is -2.5 or lower, and a hip or spine fracture from a minor fall also points to it. Bone loss speeds up from about a year before the final period to about two years after it, because estrogen helps balance bone breakdown and rebuilding. Estrogen is FDA-approved to prevent it.

Read the guide →Source: National Institute on Aging. Osteoporosis

Sudden, strong urges to urinate that are hard to put off, often with more trips to the bathroom by day and at night. When urine leaks before you reach the toilet, it is called urgency (urge) incontinence. This differs from stress incontinence, which is leaking with a cough or lift, and many women have both. Bladder training, pelvic floor physical therapy and medicines can help. A UTI or genitourinary syndrome of menopause can also cause urgency.

Read the guide →Source: MedlinePlus. Urge incontinence

The years before menopause when the ovaries make estrogen and progesterone less predictably. Periods change, and symptoms such as hot flashes, poor sleep, mood changes and brain fog can begin. It most often starts in the mid-40s, usually lasts four to eight years, and ends 12 months after the final period. It is diagnosed from age, cycle changes and symptoms; blood tests are usually not needed. Pregnancy is still possible until menopause is confirmed.

Read the guide →Source: The Menopause Society. Perimenopause

The rest of life after menopause is confirmed by 12 months without a period. FSH keeps rising and estradiol keeps falling for about two years after the final period, then levels settle. Hot flashes often continue into this stage. Bone loss stays fast for about two years, and vaginal and urinary changes tend to get worse without treatment. Any vaginal bleeding after menopause is not normal and should be checked by a clinician.

Read the guide →Source: NCI Dictionary of Cancer Terms. Postmenopausal

Loss of normal ovarian function before age 40. It causes irregular or missed periods, low estrogen and menopause-like symptoms. Unlike menopause, it is not always permanent: periods can come back, and some women get pregnant. Diagnosis is based on four or more months of irregular or missing periods plus an FSH level in the menopausal range, after ruling out pregnancy. Hormone therapy is advised until at least the usual age of menopause to protect bones, heart and brain.

Read the guide →Source: NICHD. About Primary Ovarian Insufficiency (POI)

A hormone the ovary makes after ovulation. It prepares the lining of the uterus each cycle, and when it falls, the lining sheds as a period. It also has a calming, sleep-supporting effect. In perimenopause, progesterone often falls first, because cycles without ovulation make little of it. This helps explain early changes in sleep and mood and heavier, less predictable bleeding. In hormone therapy, a progestogen protects the uterus from estrogen.

Read the guide →Source: MedlinePlus. Progesterone Test

A lab-made compound designed to act like progesterone, with a changed chemical structure. Examples include medroxyprogesterone acetate, norethindrone and levonorgestrel. Progestins are used in birth control pills, hormonal IUDs and some hormone therapy, where they protect the lining of the uterus. The Women's Health Initiative tested a progestin. Observational studies suggest some progestins may carry more breast cancer and blood clot risk than micronized progesterone.

Read the guide →Source: The Menopause Society. Menopause Glossary

The umbrella term for any hormone that acts like progesterone. It includes both micronized progesterone and lab-made progestins. Women with a uterus who take estrogen need a progestogen to keep the lining of the uterus from overgrowing. Women who have had a hysterectomy usually do not. It can be taken daily (continuous) or for 10 to 14 days a month (cyclic), combined with estrogen in a patch or pill, or supplied by a hormonal IUD.

Read the guide →Source: The Menopause Society. Menopause Glossary

A study that assigns people by chance to different groups, such as a treatment or a placebo. Because the groups start out alike, differences in results can be credited to the treatment. When neither participants nor researchers know who got what, the trial is double-blind. RCTs are the strongest single type of study for testing whether a treatment works. The Women's Health Initiative hormone studies were RCTs. Hot flash trials often show large placebo effects.

Read the guide →Source: NCI Dictionary of Cancer Terms. Randomized clinical trial

A comparison of how likely an outcome is in one group versus another, shown as a ratio. A relative risk of 1.0 means no difference. A value of 1.26 means 26% higher, and 0.75 means 25% lower. On its own, relative risk can make a rare harm sound large, so read it with absolute risk, the actual number of extra cases. Hazard ratios and odds ratios, common in hormone therapy studies, are read the same way.

Read the guide →Source: NCI Dictionary of Cancer Terms. Relative risk

The loss of muscle mass, strength and function that comes with aging. Muscle loss becomes noticeable around age 50, and in women it speeds up during the menopause transition. Strength fades even faster than muscle size. This raises the risk of falls, fractures and losing independence later in life. Strength training is the most reliable way to slow it, along with enough protein. Hormone therapy has not been shown to prevent it.

Read the guide →Source: NCI Dictionary of Cancer Terms. Sarcopenia

A type of antidepressant that increases the amount of serotonin available in the brain. At low doses, some SSRIs also ease hot flashes, whether or not you are depressed. In trials they cut about one to two more hot flashes a day than placebo. Paroxetine 7.5 mg (Brisdelle) is FDA-approved for hot flashes. Escitalopram and citalopram are used off-label. Paroxetine and fluoxetine should be avoided with tamoxifen because they block its activation.

Read the guide →Source: NCI Dictionary of Cancer Terms. Selective serotonin reuptake inhibitor

A type of antidepressant that increases available serotonin and norepinephrine in the brain. Venlafaxine and desvenlafaxine reduce hot flashes in trials and are prescribed off-label for this use. They make sense when low mood or anxiety comes with hot flashes. They are also among the safer choices for women taking tamoxifen. Nausea, dry mouth and constipation are common side effects. They should be tapered, not stopped suddenly.

Read the guide →Source: NCI Dictionary of Cancer Terms. Serotonin-norepinephrine reuptake inhibitor

A disorder in which the upper airway narrows or closes again and again during sleep, so breathing stops and restarts many times a night. The most common type is obstructive sleep apnea. Risk rises after menopause. In women it often shows up as insomnia, tiredness, morning headaches and low mood rather than loud snoring, so it is easy to blame on perimenopause. A sleep study diagnoses it, and CPAP is the standard treatment.

Read the guide →Source: MedlinePlus. Obstructive sleep apnea - adults

Short for Stages of Reproductive Aging Workshop + 10, a staging system published in 2012. Researchers and clinicians use it to stage reproductive aging by period patterns rather than by age or blood tests. The early menopausal transition (stage -2) starts when cycle length varies by 7 days or more. The late transition (stage -1) starts with gaps of 60 days or more between periods. Postmenopause is divided into early and late stages.

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Leaking urine when pressure on the bladder rises suddenly, such as with a cough, sneeze, laugh, jump or heavy lift. It happens when the pelvic floor muscles and tissues that support the urethra weaken. Childbirth, extra weight and aging all contribute, and it is common in the 40s and 50s. Pelvic floor muscle training is the first-line treatment. Pessaries, vaginal inserts, bulking injections and sling surgery are options if more help is needed.

Read the guide →Source: MedlinePlus. Stress urinary incontinence

Menopause caused by surgery that removes both ovaries before natural menopause. Until then, the ovaries make most of a woman's estrogen and much of her testosterone, so hormone levels drop within days. Symptoms can start suddenly. Women who lose their ovaries young and do not take estrogen face higher long-term risks to heart, bones and brain. Hormone therapy until at least the usual age of menopause is usually advised. Removing only the uterus does not cause it.

Read the guide →Source: NCI Dictionary of Cancer Terms. Surgical menopause

Estrogen in a form that raises levels throughout the body: pills, skin patches, gels, sprays and some higher-dose vaginal rings. It treats hot flashes, night sweats and vaginal symptoms, and it helps prevent bone loss. Women with a uterus need a progestogen with it. Local estrogen is different. Low-dose vaginal creams, tablets, inserts and rings act mainly on vaginal and urinary tissue. They do not treat hot flashes or need a progestogen.

Read the guide →Source: ACOG. Hormone Therapy for Menopause (FAQ)

The number a DEXA bone density scan uses to compare your bone density with a healthy young adult's. A T-score of -1.0 or higher is normal. Between -1.0 and -2.5 is osteopenia, or low bone mass. A score of -2.5 or lower is osteoporosis. The more negative the number, the thinner the bone. Adults between 20 and 50 usually get a Z-score instead, which compares them with people their own age.

Read the guide →Source: The Menopause Society. Menopause Glossary

A hormone women make in smaller amounts than men, in the ovaries and adrenal glands. Levels fall slowly with age rather than dropping at menopause, but they fall quickly if both ovaries are removed. No testosterone product is FDA-approved for women in the US. The only evidence-based use is for postmenopausal women with distressing low sexual desire (HSDD), at doses kept in the normal female range. A blood level alone cannot diagnose low desire.

Read the guide →Source: The Menopause Society. Menopause Glossary

Estrogen absorbed through the skin from a patch, gel or spray instead of swallowed as a pill. Transdermal means through the skin. Because it skips a first pass through the liver, transdermal estradiol has little effect on clotting proteins. Large observational studies show no rise in blood clots with it, unlike oral estrogen. It relieves hot flashes as well as pills do and is usually preferred for women with a higher risk of clots.

Read the guide →Source: The Menopause Society. Menopause Glossary

An imaging test in which a slim ultrasound probe is placed in the vagina to get close-up pictures of the uterus, its lining and the ovaries. It is a standard test for heavy or irregular bleeding. It looks for fibroids, polyps and a thickened lining. After menopause, a lining of 4 mm or less makes endometrial cancer very unlikely. Bleeding that continues or comes back still needs a tissue sample.

Read the guide →Source: MedlinePlus. Transvaginal ultrasound

A quality mark from US Pharmacopeia (USP), an independent standards group, for dietary supplements that pass its testing program. It means the product contains the listed ingredients in the stated amounts and has no harmful levels of certain contaminants. It also means the product was made under FDA good manufacturing practices and will break down properly in the body. It does not mean the supplement works or is right for you. You can confirm products in USP's online finder.

Read the guide →Source: USP. USP Verified Mark

Noncancerous growths of muscle tissue in or on the wall of the uterus. They are common in the 40s. They can cause heavy or long periods, pelvic pressure, frequent urination and anemia, though many cause no symptoms. In perimenopause, clinicians check for fibroids when bleeding gets heavier, usually with a pelvic ultrasound. Fibroids often shrink after menopause, when estrogen levels fall.

Read the guide →Source: ACOG. Uterine Fibroids (FAQ)

An older term for thinning, drying and loss of stretch in the vaginal lining caused by low estrogen. It leads to dryness, burning, itching and pain with sex. In 2014, The Menopause Society and other groups adopted a broader term, genitourinary syndrome of menopause (GSM). The new name also covers urinary symptoms and drops the negative word atrophy. Lubricants, vaginal moisturizers and low-dose vaginal estrogen are the main treatments.

Read the guide →Source: NCI Dictionary of Cancer Terms. Vaginal atrophy

Low-dose estrogen placed in the vagina as a cream, tablet, insert or ring. It is also called local estrogen. It treats genitourinary syndrome of menopause, including dryness, irritation, pain with sex and some urinary symptoms, and it can help prevent repeat UTIs. Very little reaches the bloodstream, so it does not treat hot flashes or require a progestogen. It has the strongest evidence of any GSM treatment and a reassuring long-term safety record.

Read the guide →Source: MedlinePlus. Estrogen Vaginal

The medical name for hot flashes and night sweats together. Vasomotor refers to changes in the width of blood vessels. During a hot flash, vessels in the skin widen, causing the rush of heat and flushing. These are the most reported symptoms of the menopause transition and often begin in perimenopause. In a large US study, frequent symptoms lasted a median of 7.4 years. FDA approvals and trials measure moderate to severe vasomotor symptoms.

Read the guide →Source: FDA. FDA Approves Novel Drug to Treat Moderate to Severe Hot Flashes Caused by Menopause

A set of large US government-funded studies. Its hormone trials enrolled 27,347 postmenopausal women aged 50 to 79, with an average age of 63. In 2002, the estrogen-plus-progestin trial was stopped early because of more breast cancers, strokes, heart attacks and clots, and hormone therapy use collapsed. Later analyses showed the risks were concentrated in older women. Hormone therapy did not change overall death rates, and estrogen alone lowered breast cancer risk.

Read the guide →Source: NHLBI. Women's Health Initiative (WHI)

A registered nurse with a graduate degree and national board certification as a nurse practitioner in women's health. WHNPs focus on gynecologic, reproductive and midlife care. They diagnose conditions, order tests and prescribe medicines, including hormone and non-hormonal menopause treatments. How independently they work depends on state law. Many focus on perimenopause and menopause, and their visits are often longer than a doctor's.

Read the guide →Source: MedlinePlus. Nurse practitioner (NP)