Perimenopause Specialist

Park Avenue Women's Center

OB-GYNs located in Yorkville, Upper East Side, New York, NY

Many women are taken by surprise when they have hot flashes or experience other symptoms of estrogen deficiency. When this happens to you, Dr. Gila Leiter, Dr. Shari Leipzig, and Dr. Douglas Moss at Park Avenue Women’s Center in New York City are available to help you through this natural transition before menopause. If you’ve experienced symptoms or have questions, call their Yorkville, Upper East Sideoffice or book an appointment online.

Perimenopause Q & A

What is perimenopause?

Perimenopause occurs in the years before you reach menopause, your final menstrual stage. Since the age of menopause varies for each woman, you can’t predict when perimenopause will start. Most women, however, begin moving toward menopause in their 40s.


What happens to your periods during perimenopause?

During perimenopause, your levels of estrogen begin to fluctuate, rising and falling unevenly. These hormonal changes affect your menstrual cycles, but the impact is different for each woman. Your periods may be shorter, longer, lighter, or heavier and you may occasionally skip periods.

If your periods become persistently longer or you notice changes in the interval between periods, either shorter or longer, you may be in perimenopause. Once you start to skip periods, perimenopause is in full swing. When you don’t have any periods for 12 consecutive months, you’ve reached your menopause, which was your final period.


What other symptoms occur during perimenopause?

Many women aren’t prepared for perimenopause and may not realize initially what is happening to them. You can begin to have all the classic symptoms of menopause and still be menstruating regularly.

During perimenopause you may develop mild to severe symptoms that include:

  • Hot flashes
  • Night sweats
  • Sleep problems
  • Bouts of anxiety or depression
  • Mood swings
  • Low sex drive
  • Decreased natural lubrication
  • Painful intercourse
  • Urinary frequency or urgency
  • Urinary tract or vaginal infections


As estrogen levels decline, you’re also at risk for developing osteoporosis, high cholesterol, urinary incontinence (leakage), and vaginal atrophy. Vaginal atrophy and urinary incontinence occur when low estrogen causes drying, thinning, and loss of elasticity in the tissues lining the vagina, urethra (a tube that carries urine away from your body), and bladder.


Can you get pregnant during perimenopause?

Irregular periods reflect sporadic ovulation. Your fertility is decreasing because you don’t release an egg every month, but you can still get pregnant in those months when you do ovulate. Your risk of having a miscarriage also increases.

The irregular nature of ovulation during perimenopause makes it impossible to know when you may be fertile, so be sure to use birth control if you don’t want to get pregnant. Birth control is recommended until 12 months pass without a period.


How is perimenopause care approached?

The team at Park Avenue Women’s Center takes a holistic approach to perimenopause. After evaluating your overall health and hormone levels, they take time to talk with you, teaching you about what happens during perimenopause and the overall effect on your body due to changing hormones.

Strategies to relieve your perimenopausal symptoms may include:

  • Nutrition counseling to prevent osteoporosis and heart disease
  • Natural alternatives to alleviate symptoms
  • Stress management techniques
  • Exercise recommendations
  • Hormone replacement therapy
  • Vaginal lubricants or vaginal estrogen to ease dryness
  • MonaLisa Touch® laser treatment to restore vaginal tissues


To get relief from perimenopause symptoms, call Park Avenue Women’s Center or book an appointment online today.