Falling estrogen levels during perimenopause and a lack of estrogen after menopause may lead to vaginal dryness. This makes the wall of the vagina thinner. It can be painful to have sex. A doctor may prescribe synthetic hormones or bioidentical hormones to combat these and other symptoms related to menopause. It's important to take progesterone along with estrogen to decrease certain risks of hormone therapy. Some women are not advised to take it because of an increased risk of heart attack, stroke, blood clots, gall bladder disease, breast cancer, and endometrial cancer. Hormone therapy may be associated with side effects that include headaches, breast tenderness, swelling, mood changes, vaginal bleeding, and nausea.
Most women’s periods come every 21 to 35 days. If yours doesn’t arrive around the same time every month, or you skip some months, it might mean that you have too much or too little of certain hormones (estrogen and progesterone). If you’re in your 40s or early 50s -- the reason can be perimenopause -- the time before menopause. But irregular periods can be a symptom of health problems like polycystic ovarian syndrome (PCOS). Talk to your doctor.