In some cases, there may be excessive bleeding during the regular periods. Hormonal changes and psychosocial stress associated with adjustment to the aging process and perceived losses can lead to emotional instability, irritability and depression. The woman may associate cessation of menstruation with loss of femininity, sexual attractiveness or desire, and role of potential parent, even though she may not want to have more children. Alternatives to hormonal replacement include limitation of foods high in saturated fat and nitrites and avoiding red meat, coffee, tea, chocolate, colas and alcohol. Vitamins E and D, vitamins of the B complex, calcium and magnesium may be prescribed by some physicians.
Regular exercise is especially important during the perimenopausal years and after.
Exercise stimulates the production of endorphins which increase one's sense of well-being, improve circulation and help to prevent osteoporosis. The manner in which a woman reacts to the changes taking place during the perimenopause depends to a great extent on her feelings of self-esteem. Knowing what to expect and being able to get some control over what is happening to her can significantly improve her physical and mental health during this time.