Perimenopause and menopause in Marrakech

Perimenopause is the transition period, with irregular periods. Menopause is confirmed after twelve months without periods.

Hot flushes, night sweats, sleep problems, mood changes, vaginal dryness, pain during sex, urinary problems. Their intensity varies greatly from one woman to another.

It reviews your symptoms, your personal and family history and your general health. Tests (blood tests, mammography, ultrasound) are requested as needed.

Lifestyle advice, non-hormonal treatments, local treatments for vaginal dryness, and menopausal hormone therapy when it is indicated. Benefits and risks are discussed with you before any decision.

Menopause is also the time to review the health of your breasts, cervix, bones and heart, with suitable follow-up.

Perimenopause covers the years before periods stop: cycles become irregular, shorter or further apart, sometimes with marked symptoms. Menopause is diagnosed after twelve consecutive months without a period, on average around 50, most often between 45 and 55.

After menopause, the fall in hormones has long-term effects on bones, heart and intimate tissues, hence the value of follow-up.

Hot flushes, night sweats and frequent waking are the most troublesome symptoms. Simple measures help: wearing layers, airing the bedroom, limiting alcohol, spices and caffeine in the evening, keeping regular sleep hours and being physically active.

When these measures are not enough, treatments exist. The choice is made with the doctor according to the intensity of symptoms and your history.

Menopausal hormone therapy is effective against hot flushes and intimate dryness. It is not for everyone: it is not advised with a history of certain hormone-dependent cancers, thrombosis or certain conditions, and its duration and route (patch, gel or tablet) are discussed.

The principle is to offer the lowest effective dose for the time needed, with regular review. An informed decision means talking to the doctor, without fear or preconceived ideas.

If you do not wish to or cannot take hormones, there are alternatives: lifestyle measures, non-hormonal medicines on prescription, vaginal moisturisers and lubricants, and approaches that help manage stress and sleep.

Be careful with so-called "natural" products sold for menopause: their effectiveness varies, their composition is sometimes uncertain and they are not risk-free. Always ask for advice.

Menopause speeds up bone loss. Depending on your age and risk factors, the doctor may suggest tests, a bone density scan, a suitable intake of calcium and vitamin D and advice on physical activity.

Cardiovascular risk also rises: blood pressure, cholesterol, blood sugar and weight should be monitored, as well as stopping smoking. Breast and cervical screening continue according to recommendations.

Dryness, burning and pain during intercourse are common and can be treated: moisturisers, lubricants, local treatments, pelvic floor rehabilitation. Many women do not dare to talk about it, yet these problems are not inevitable.

The consultation is a confidential, judgement-free space to raise this subject like any other.

Any bleeding after menopause must be explained: consult without delay.