Mood swings, sleep problems, sudden fatigue, night sweats, and difficulty concentrating. Many women attribute these symptoms to stress, a hectic lifestyle, or simply years.
But their cause can sometimes be perimenopause – a transitional period that precedes menopause and during which significant hormonal changes occur.In 2026, the health of middle-aged women becomes one of the most important topics of medical wellness. Instead of an approach according to which unpleasant symptoms simply have to be accepted, more and more experts emphasize the importance of individual assessment and appropriate treatment.
What has changed and what new opportunities are available to women?
1. Perimenopause may start earlier than you expect
Perimenopause most often begins during the forties, but in some women, changes can occur earlier.
During this period, estrogen and progesterone levels can fluctuate significantly, affecting the menstrual cycle, sleep, mood, and other bodily functions. Common symptoms include hot flashes, night sweats, irregular periods, vaginal dryness, and sleep disturbances.In some women, symptoms are mild, while others significantly impair daily functioning. Menopause is officially confirmed after 12 consecutive months without menstruation, if there is no other cause for its absence.
It is important to know that perimenopause in women over 45 can often be recognized based on symptoms and cycle changes, without extensive hormonal testing.
2. Hormone therapy is back in the spotlight
Hormone therapy has been the subject of much debate in recent decades due to efficacy and safety issues. Today, its application is based on an individual benefit-risk assessment. For many women, menopausal hormone therapy is the most effective form of treatment.Therapy may include estrogen in the form of tablets, patches, gel or spray, while women who still have a uterus are generally given an appropriate progestogen to protect the lining of the uterus.
The choice depends on age, symptoms, personal and family history, and possible contraindications. Of particular importance is the fact that hormone therapy is not a universal solution for every woman, but it is also not something that should be automatically avoided.The latest expert guidelines emphasize informed decision-making and individualization of treatment.
3. What if a woman does not want or cannot use hormones?
One of the more interesting changes in the modern treatment of menopausal symptoms is the development of non-hormonal therapies. Certain drugs that act to regulate body temperature can relieve hot flashes without the use of estrogen. Recent approaches include neurokinin receptor antagonists, developed to target the mechanisms associated with vasomotor symptoms.
An example is fezolinetant, the use of which requires medical evaluation and monitoring of liver function due to possible serious side effects. The availability of individual medicines varies from country to country.In addition to medications, cognitive-behavioral therapy tailored to menopause can help certain women manage symptoms and their impact on sleep and quality of life.
4. Muscle, bone, and metabolism become a new priority
Changes during perimenopause are not only related to the reproductive system. Decrease in estrogen levels is associated with accelerated bone loss, and body composition and fat distribution may change during middle age. That is why modern preventive programs increasingly emphasize the preservation of muscle strength, bone health and cardiometabolic health.
Regular strength training, adequate protein intake, quality nutrition and physical activity are important parts of this approach.In women at increased risk of osteoporosis, the doctor may recommend measuring bone mineral density. The goal is not only to alleviate current symptoms, but to preserve health and independence in later decades of life.
5. Personalized checkups – the new generation of preventive medicine
One of the most prominent trends in medical wellness is the development of programs that combine different areas of health care. Instead of focusing solely on hormonal changes, such programs may include gynecological examinations, cardiovascular risk assessment, bone health screening, and lifestyle counseling.
However, a personalized approach does not mean that every woman needs dozens of laboratory analyses. The usefulness of each test depends on symptoms, age and health risk factors.
Quality preventive care implies targeted examinations, a clear interpretation of the findings and recommendations that have real medical value.
6. Where in Croatia to find specialized care for perimenopause?
The trend of personalized care for women is also present in Croatia.
St. Catherine Specialty Hospital – Zagreb
One concrete example is the Special Hospital of St. Catherine, who introduced special physical examination programs for perimenopausal and menopausal women. The institution offers four inspection packages under the names START, BASIC, PLUS and PREMIUM.
Depending on the chosen programme, examinations may include laboratory and hormonal analyses, gynaecological examination, bone density assessment and cardiovascular diagnostics.Assoc. Prof. Ivana Erceg Ivkošić, specialist in gynecology and obstetrics and subspecialist in gynecological endocrinology, human reproduction and menopausal medicine. The hospital also provides information on hormone therapy options and an individual approach to menopausal problems.
This example shows how specialized programs focused on the needs of women during hormonal changes are also being developed in Croatia. Before contracting the program, it is useful to check what the specific package includes and which examinations are medically justified for an individual.
**7. Should every woman be treated for perimenopausal symptoms?**Not necessarily. Perimenopause is a natural life process, not a disease. If the symptoms are mild and do not significantly affect the quality of life, appropriate lifestyle habits and regular health care are often sufficient.
However, women who have pronounced hot flashes, prolonged insomnia, mood problems or other unpleasant symptoms should not automatically accept them as an inevitable part of aging.It is especially important to seek medical advice for unusually heavy bleeding, bleeding after menopause or symptoms that cannot be clearly explained by hormonal changes. Expert assessment can help distinguish perimenopausal symptoms from other health conditions.
The future of women's health begins with a better understanding of menopause
Perimenopause and menopause are increasingly recognized as important periods for the long-term preservation of women's health.
The development of new therapies, personalized preventive examinations and better professional guidelines enables an approach that takes into account individual needs, health risks and life circumstances.The most important change is not just in new medicines and technologies, but in the fact that women's health in middle age is finally receiving more attention.
Explore gynecology, integrative medicine, and medical wellness providers on ** Energy Clinic * * and learn about modern approaches to health and quality