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Perimenopause Treatment - Overview

Perimenopause prescription treatments are sometimes utilized in helping women in perimenopause - the transitional years before menopause. Women who might need medications for perimenopause, including estrogen and progesterone, can use Push Health to connect with a medical provider who can prescribe hormone therapy (HRT) when appropriate to do so.

What Is Perimenopause?

Perimenopause is a complex disorder that is increasingly recognized as the cause for a variety of symptoms in women, typically starting in their early 40s and lasting 4-8 years on average. Perimenopause is characterized by symptoms such as hot flashes, mood disorders, sleep disturbances, night sweats, joint pain, cognitive symptoms, migraines, and more.

The primary treatment for perimenopause symptoms is hormone therapy, particularly using estrogen and progesterone. Treatment can begin while a woman is still having her periods.

Perimenopause Medications - Dosage and Cost

Different medications are used as part of the strategy for treating perimenopause symptoms:

  • Estradiol (bioidentical estrogen) - available as a transdermal patch, gel, spray, or oral tablet and as a low-dose vaginal cream for genitourinary symptoms
  • Progesterone (micronized) - added for women who still have a uterus to protect the endometrium
  • Combination products (e.g. Bijuva) in selected cases
  • Non-hormonal alternatives - certain antidepressants or other agents when hormones are not preferred or cannot be used

Prescription regimens and delivery methods are individualized to the patient. Transdermal estradiol is often preferred when systemic therapy is used and progesterone is added for women who still have a uterus. The medications are typically affordable as many of the medications are available in generic versions and some insurance plans may help cover costs associated with prescriptions.

Can I Buy Perimenopause Medications Online?

Hormone medications for perimenopause treatment require a prescription and are not available over the counter. Women who might need perimenopause help, however, can use Push Health to connect with a medical provider who can prescribe medications to a patient's pharmacy when appropriate to do so.

Frequently Asked Questions about Perimenopause Treatment

What is perimenopause?

Perimenopause is the transitional phase before menopause marked by fluctuating and declining estrogen and progesterone levels. Symptoms often begin years before the final menstrual period.

How long does perimenopause last?

It typically lasts 4 to 8 years although the range varies between individuals. The most intense symptoms frequently occur in the year or two before and after the final period.

What medications are used for treatment?

The primary medications used are estradiol for bothersome symptoms and progesterone (when the uterus is present). Non-hormonal options exist and are used in selected cases.

Can I start hormone therapy while still having periods?

Yes. Irregular cycles are common in perimenopause and are not a barrier to hormone therapy. Therapy can begin as soon as symptoms warrant it and the risk-benefit balance is favorable.

Do I need progesterone if I'm taking estradiol?

Progesterone is recommended in women who still have a uterus and are using systemic estrogen. Women using local estrogen should discuss this with their medical provider.

Can I get perimenopause treatment if I'm still having periods?

Yes. Many women seek and receive perimenopause treatment while still having irregular periods. Irregular cycles are a hallmark of perimenopause and are not a contraindication to treatment. A licensed provider can evaluate symptoms, confirm that perimenopause is a likely diagnosis, and prescribe appropriate treatment while a woman is still having periods.

Can I get treatment online?

Yes. Push Health offers online evaluations with licensed medical providers. Prescriptions, when appropriate, are issued electronically without an in-person visit.

Perimenopause - Lifestyle Modifications

Lifestyle and diet modifications may also be beneficial in reducing symptoms and supporting overall health. Modifications include:

  • Regular aerobic exercise and strength training
  • Sleep hygiene
  • Stress-reduction practices
  • Limiting alcohol, spicy foods, and caffeine if they trigger flashes
  • Maintaining a healthy weight
  • Smoking cessation

Perimenopause Treatment - Side Effects

Side effects of perimenopause treatments typically include breast tenderness, breakthrough or irregular bleeding, nausea, headache, and mood changes. These often settle with time or dose adjustments. Progesterone is typically required when systemic estrogen is prescribed in women with a uterus. Any treatment regimens should be reassessed periodically to confirm symptom resolution and continued need for the medications. Women with unusual bleeding, leg swelling, chest pain, sudden shortness of breath, or severe headache should get evaluated in-person as soon as possible. All other questions or concerns should be discussed with one's medical provider.

How to Get Perimenopause Treatment with Push Health

  1. Complete a health intake. Answer questions about your symptoms, menstrual history, current medications, and relevant medical history (e.g. cancer, blood clots, and cardiovascular disease).
  2. Connect with a licensed medical provider. A medical provider will review your information and evaluate which treatments might be most appropriate for your situation. Same-day consultations are available.
  3. Receive your prescription. If therapy is appropriate, your medical provider will send a prescription to a pharmacy of your choice - no office visit required.
  4. Pick up your medication or have it delivered. Generic medications are available at many retail and deliver pharmacies at affordable prices. No health insurance or subscription is required. Discuss any side effects with your medical provider.

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More Perimenopause Information

Last updated September 8, 2026. Given the evolving nature of medicine and science, this information might not be accurate and should not be construed as medical advice or diagnosis / treatment recommendations. Please consult a licensed medical provider if you have additional questions. Please call 911 immediately or go to the nearest emergency room if you believe you are experiencing a medical emergency.