Keep in mind that some of these symptoms may be caused by medical issues other than menopause. A woman is not considered fully menopausal until she has not had a period for 12 consecutive months, which usually doesn’t occur until the early 50s in most normal circumstances (i.e., normal if there are no mitigating factors like surgery to remove the ovaries and/or uterus, chemotherapy or radiation treatments that bring an earlier onset).

While many women do not experience or even notice the hot flashes and other subtle changes related to perimenopause, the issues for some will gradually grow more obvious, including hot flashes that redden the skin and are extremely uncomfortable.

Sometimes doctors will use a combination of estrogen and progestin, a synthetic form of the estrogen-related hormone progesterone. These can be combined in women who still have a uterus. However, progestin will stop cell growth in the uterus, which may, in some women, lead to uterine cancer.

Problems with Hormones

While estrogen is an effective treatment, studies by the National Institutes of Health have noted problems with estrogen and other hormone therapy. There are increased risks of certain health problems, and those who are already frail or have an undetected underlying condition are particularly at risk.

A study done by the Women’s Health Institute looked at the use of estrogen plus progestin in women who still had a uterus, comparing its use in women who did not have a uterus. The groups were further divided into those receiving estrogen therapy and those who received a placebo.

The results were alarming. The hormone-medicated groups were found to have an increased risk of blood clots, heart attack, breast cancer and stroke compared to the placebo group, while the estrogen plus progestin medication also had an increased risk of breast cancer and heart attack.