Menopause will affect every woman at some point in her life but the transition, known as perimenopause, can be just as difficult for some women. It’s at this time in a woman's life when she starts to feel some of the effects of menopause usually in the late 40's to early 50's. "Sometimes before menopause they go into a menopause transition, where the hormones are no longer as efficiently communicating with other organs, other glands, so that ovulation is not every month, it's kind of a hit or miss." Doctor Castillon says it's the lower production of hormones that will typically cause changes in the body to happen and these changes can cause uncomfortable symptoms for women. "Hot flashes, night sweats, insomnia, irritability, those kind of things depending on how sporadic their production of estrogen is." Symptoms can also include depression and anxiety and can sometimes be incredibly difficult for a woman to deal with. "Some women have such severe symptoms that it interferes with their jobs, it interferes with their relationships and their marriages, and those are the women who we counsel with the possibility of hormone replacement therapy." Over the years there's been a certain risk associated with hormone replacement therapy, but Doctor Castillon says the treatment can work for many women but close monitoring by a doctor is important. "Their use is very popular now, but I think that women need to understand that they need to be followed by a physical regardless of what kind of hormones they're using." The most dangerous risks associated with lengthy hormone replacement therapy in the past, included cardiovascular disease and breast cancer. Doctor Castillon says being educated about treatment options is the best thing a patient can do. Diet and exercise can sometimes help with milder symptoms, but it's best to consult your doctor to find the right treatment for you.