Although not necessarily fun, it’s something every woman must come to terms with at some point in her lifetime: The transition — commonly known as menopause — that signals the end of the reproductive years. True menopause occurs when your menstrual period has stopped entirely for 12 months, with 51 being the average age of menopause onset in the U.S.

Perimenopause, on the other hand, signals the period (pun not intended) of time before menopause where women may notice changes in their monthly cycles — irregular periods, heavier or lighter flow, change in duration, etc. With these changes may come a slew of other symptoms, including headaches or joint pain, hot flashes, mood swings, sleep issues, and vaginal dryness.

These not-so-fun symptoms are typically a result of fluctuating hormone levels, but the good news is this: These symptoms don’t have to rule your life — in fact, they can be managed. Here at Beaches OBGYN, we have a few options that can help relieve the symptoms of menopause and perimenopause: In addition to SSRIs (which can help with mood swings) and birth control pills (which can help stabilize hormone levels), we offer both traditional hormone therapy (HRT) and BioTe pellet hormone replacement therapy (BHRT).

Traditional Hormone Replacement Therapy

The hormonal changes experienced during perimenopause and menopause are often caused by declining estrogen levels, a vital hormone used in reproduction. The two main types of estrogen HRT are:

Systemic estrogen therapy. This can come in pill, skin patch, gel, cream, or spray form and contains a higher dose of estrogen that is released into the bloodstream and absorbed into the organs and tissues where it is needed.

Low-dose or local estrogen therapy. This can come in cream, tablet, or ring form and has a lower dose of estrogen, used to treat vaginal dryness.

If you have never had a hysterectomy and still have a uterus, you will also likely need progesterone or progestin (similar to progesterone), because estrogen alone when not balanced with progesterone can thicken the uterine lining, increasing the risk of endometrial cancer.

BioTe Hormone Replacement Therapy

BioTe is a method of bioidentical hormone replacement therapy that uses plant-based pellets, which are molecularly similar to human hormones. The pellet contains a custom-made compound of estrogen, progesterone, and/or testosterone based on the patient’s needs and is inserted via a small incision near the upper buttocks. It dissolves and takes effect within four to six weeks after insertion, providing a consistent release of hormones. Because they are custom-made, some women may benefit from the nonstandard doses found in compounded BHRT.

Make an appointment with your provider to learn more and discuss which option might be right for you.