Perimenopause: What are the benefits of Hormone Replacement Therapy, where to get it? Doctor explains

'Perimenopause' is not an unfamiliar term to women anymore, thanks to health experts talking about it in recent years. However, many women are not yet equipped to understand whether their bodies are going through the phase, when it starts, what exactly its symptoms are and most importantly, how to get help. Dr Raju Nair, Chief IVF Specialist at Mitera Hospital, Kottayam, explains what perimenopause means and how to get help to handle the phase. 

What is perimenopause
A woman's femininity is based on two hormones - estrogen and progesterone. They are created in the body in the ovaries during ovulation. Over time, the number of eggs in the ovaries reduces, and the ovulation gradually stops. This phase is called menopause, says Dr Raju. Perimenopause is the phase of transition towards menopause. At that time, women's bodies will undergo many changes. When estrogen levels are reduced, there will be many psychological impacts on women's lives, alongside physical effects like hot flashes and a reduction in bone density. It will go on till menstruation comes to a stop," the doctor says. 

When does perimenopause start
Perimenopause can start two to three years before the menopause or even earlier. That said, its onset can differ in the case of different women, says Dr Raju. 

It's not a disease, but...
While perimenopause is not a disease but a transitional phase, the decision on whether a person requires medical care to handle it depends on the individual, Dr Raju says. "Many women consider it a normal phase of life and move on, accepting the reality. However, some find it tough to cope when it affects the quality of their life. In such cases, options like Hormone Replacement Therapy can help," he says.

What is Hormone Replacement Therapy?
Hormone Replacement Therapy or HRT is simply the process of replacing the hormones that are reducing in a woman's body, to relieve menopausal symptoms. They can start it from the perimenopausal stage and even continue it in the menopausal stage, according to Dr Raju. 

Is HRT costly?
According to Dr Raju, HRT is quite affordable, and a woman can visit any gynaecologist to undergo the therapy. "The gynaecologist will also team up with an endocrinologist and counsellor for the HRT," he says. He says that, more than the availability of the service, awareness and acceptance levels are the hindrances to women availing themselves of the service. He narrates an experience. "When I was studying in Pune around 20 years ago, menopausal clinics and societies were already very active there. However, even now, people are just starting to understand it. Even in facilities where the services are available, very few people use them. This is because many people don't know its health benefits and don't have enough awareness of it," he says, adding that while the possibility of breast cancer is often quoted as a risk element of HRT, there are methods to handle it efficiently.