Paisley Prescriptions - December 2021

Oh, Holy Night Sweats Is it Perimenopause?


December 2021 Issue
Paisley Prescriptions
Oh, Holy Night Sweats: Is it Perimenopause?

Women often think of menopause, or “the change”, as something that happens to older women, but the signs and symptoms of perimenopause can begin to affect women in their 30s. It’s important to pay attention to what your body might be telling you about your hormone levels. That’s why we asked local wellness experts to tell us more about this in-between time in women’s lives.



PYRx0721 SGHSby Lesli G. McQuigg, WHNP-BC, Southeast Georgia Physician Associates-Obstetrics & Gynecology

What is the difference between
Perimenopause and Menopause?

Perimenopause is the first stage in the end of a woman’s reproductive years. It can start eight to 10 years before menopause. Menopause is the point when a woman no longer has menstrual periods for at least 12 months.

When should I expect the onset of perimenopause, and what are some of the signs?

Every woman is different, so when you start having no periods monitor it. Women in perimenopause have at least some of these symptoms:
• Hot flashes          
• Breast tenderness    
• Worse premenstrual syndrome
• Lower sex drive     
• Fatigue        
• Mood swings
• Irregular periods    
• Trouble sleeping    
• Vaginal dryness; discomfort during sex
• Urine leakage when coughing or sneezing
• Urinary urgency (an urgent need to urinate more frequently)

Do I still need birth control during perimenopause? Can I get pregnant?
Yes and yes! Women who do not want to become pregnant still need to use an effective, safe and appropriate method of birth control until menopause is confirmed by a health care provider. Despite a decline in fertility during the perimenopause stage, women can still become pregnant.

Will perimenopause affect my sex life?
A woman’s estrogen takes a nosedive during menopause and the years leading up to it. This change has a huge impact on sexual function; it can lower desire and make it harder to become aroused.

Lesli G. McQuigg, WHNP-BC specializes in women's health at Southeast Georgia Physician Associates-Obstetrics & Gynecology; 3025 Shrine Road, Suite 190, Brunswick, Georgia

PY RX0621 BowenDiane G. Bowen, MD, Centered on Wellness and Golden Isles Center for Plastic Surgery, PC

Help! What is my body doing with these hot flashes and night sweats? What can I do?
Hot Flashes and night sweats are the most common symptom of menopause and perimenopause. Perimenopause is the timeframe before menopause when the ovaries gradually begin to produce less estrogen. In this state, a woman begins to have relatively more testosterone than estrogen and starts growing those nasty chin hairs. Hot flashes are when the blood vessels near the skin’s surface widen to cool off, making you break out in a sweat. Some women also experience rapid heart rate, or chills, too. Since we are all created differently, some women will never experience hot flashes, others have them for only a short period of time, and others have them for many years.

Your choice is to decide if you want to continue down that path of loss of libido, below the belt dryness and possibly chin hairs. If so, then know that your “sex” hormones do way more than help you in the romance department. Progesterone, estrogen and testosterone together help with quality restful sleep, mental sharpness and muscle and bone health. While doing no replacement may sound more “natural”, understand that menopause is a part of normal aging that no one tolerates in these modern times.

Bio-identical hormone replacement is a way to restore your hormonal system to more optimal balance. Many women have been on long-term birth control to deal with menstrual cycle issues, like heavy bleeding. This in turn can lead to estrogen dominance, which can be a contributing factor in breast cancer and uterine fibroids. In this case, hormone testing can help to identify imbalances in hormone production and hormone metabolism. Baseline sputum hormone testing allows for better understanding of the interplay of hormones with cortisol, your stress response hormone. If a person is under a lot of stress, good or bad, then the stress response hormone cortisol will steal supplies from the “sex hormones” and leave you low and slow. Sometimes a quality multivitamin will give your body the support that it needs to make the transition more tolerable.

There are some things you can do to make a hot flash more bearable.
• Stay Cool.
• Exercise daily.
• Estrogen. Plant estrogens, found in soy products like tofu and edamame are good options. In some cases, Bio-identical Hormone Replacement Therapy (BHRT) is needed. We suggest a consultation to determine if this is a good option for you. At Centered on Wellness we utilize blood and/or saliva to determine what your current hormone levels are and what dosage of BHRT is needed to fit your individual needs.

Supplements that can be helpful:    
• Black Cohosh: Helps reduce hot flashes
• Flaxseed or flaxseed oil: Helps to balance female hormones
• Ashwagandha: Helps control hormonal fluctuations during menopause, offering relief from symptoms like mood swings and hot flashes

Before taking any supplements, we strongly suggest you discuss them with your physician.

Is perimenopause going to put me on an emotional roller coaster? Is there anything I can do to avoid that ride?

Declining estrogen levels can make women feel like they are in a constant state of PMS. Some of the emotional changes women go through during perimenopause and menopause can include irritability, fatigue and difficulty concentrating. Unfortunately, some physicians may not take the time to diagnose underlying issues and will start a woman on mood stabilizing medicines before evaluating functional hormonal issues.

There are various non-therapeutic ways to manage these emotional changes including exercise, meditation and avoiding self-medicating with alcohol. Supplements such as Vitamin D, Ginseng and St. John’s Wort can also be very helpful with reducing mood swings.

Therapeutic treatment options start with appropriate hormonal and stress assessment testing and then nutrient optimization. With this information, the next steps could include Bio-identical Hormone Replacement Therapy (BHRT) and supplements. We encourage you to have hormone testing completed to determine where your hormone levels currently are and what specific dosage is needed to meet your individual needs.

Feeling low and slow can be a good indication that you need to have your hormone levels checked to determine what supplements, and in what quantities are needed. Remember one size does not fit all! Get off the roller coaster ride of menopause and find hormonal balance.

Diane G. Bowen, MD is the owner of Centered on Wellness and Golden Isles Center for Plastic Surgery, PC; 1015 Arthur J. Moore Drive on St. Simons Island. Website: or call 912-638-0034 or 912-634-1993

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