Managing common problems in perimenopausal women.

The perimenopause can be a time of many changes in the lives of women. Uncomfortable, nuisance, and sometimes serious symptoms and medical problems often accompany it. Some of these problems include concerns about fertility or contraception (or both), hot flashes, sleep disturbances, urogenital changes, and abnormal uterine bleeding. Common treatment options for perimenopausal problems include hormone replacement therapy with estrogen and progestins and surgical modes of therapy. In addition, many women will notice a change in their health during the perimenopausal years and a strategy for screening and health maintenance needs to be established.