Menopause is a condition almost every woman will develop as they age. However, there are stages of menopause, each with its own changes and challenges.
What is menopause?
Menopause is a natural part of aging. Your ovaries make estrogen and progesterone. These hormones allow you to menstruate, ovulate and get pregnant.
Eventually, your ovaries stop releasing eggs and stop making estrogen. Your period ends, and menopause begins.
Symptoms of menopause
Many symptoms let you know you’re in menopause and signal that your ovaries are making less estrogen. When you reach menopause, you’ll likely have one or more of the following symptoms:
- Anxiety
- Dry skin
- General aches and pains
- Hair loss or thinning
- High blood pressure
- Hot flashes and flushes
- Insomnia
- Low libido
- Mood swings
- Night sweats
- Vaginal dryness
- Weight gain
These symptoms may come and go during menopause, especially depending on the stages of menopause. Every woman’s menopause lasts for a different length of time. Some women go through a few years of menopause, while others may go through a few months of these symptoms before they ease and post-menopause comes.
If you’re a woman experiencing some of these symptoms, make an appointment with your gynecologist to discuss whether you may be starting the menopause transition.
Stages of menopause
Before menopause, you go through perimenopause. Your body begins to make less estrogen — the hormone that creates female characteristics. There’s no exact time when perimenopause happens. It usually appears between your 30s and 40s.
Once your ovaries stop releasing eggs, you’re in menopause. Menopause means you have reached the point in your life when your periods stop, and you can’t become pregnant.
Each stage has its own markers and symptoms. Understanding those can help you navigate this transitional period.
Perimenopause
Perimenopause is the stage leading up to menopause. During this time, you may have erratic periods and worse premenstrual syndrome symptoms. It typically begins in your 40s, though some women may start earlier or later.
This phase can last anywhere from a few months to a decade, with an average of about four years. The key characteristic of perimenopause is the fluctuation in hormone levels, especially estrogen and progesterone.
What to expect during perimenopause:
- Irregular periods: Your menstrual cycle may become unpredictable. You might experience shorter or longer cycles, skipped periods or heavier or lighter flow.
- Hot flashes and night sweats: These are common symptoms as your body adjusts to changes in hormone levels. You might suddenly feel a surge of heat, often followed by sweating and chills.
- Mood swings: Hormonal shifts can impact your mood, leading to feelings of irritability, anxiety or even depression.
- Sleep disturbances: Hot flashes at night can interrupt your sleep or you might wake up more often during the night.
- Decreased fertility: While you can still get pregnant during perimenopause, your fertility starts to decline. Your eggs are becoming fewer and less viable.
Menopause
Menopause is the point when you’ve gone 12 consecutive months without a period. This marks the official end of your reproductive years. The average age of menopause is 51, but it can happen earlier or later. It’s essentially a one-day milestone – your body has officially transitioned.
What to expect during menopause:
- No periods: Once you’ve passed the 12-month mark, you’ll no longer have a menstrual cycle.
- Hot flashes: Hot flashes often continue during menopause but may decrease in frequency over time. They can be unpredictable but are usually triggered by stress, hot environments or spicy foods.
- Vaginal dryness: As estrogen levels drop, vaginal tissues become thinner and less lubricated, leading to dryness. This can cause discomfort during sex or lead to urinary issues like frequent infections.
- Sleep issues: Hormonal fluctuations may continue to affect sleep even after menopause. Insomnia and poor sleep quality are common.
- Bone density loss: Estrogen plays a crucial role in maintaining bone density and its decline during menopause can lead to an increased risk of osteoporosis (thinning bones).
Post-menopausal life
After you’ve gone without a period for 12 consecutive months, you’ve reached post-menopause. This is the last stage, which lasts for the rest of your life.
Although post-menopause may not cause disruptive symptoms, the changes your body experiences during this transition can have lasting effects.
Post-menopause changes to anticipate:
- Continued hormonal changes: Although estrogen levels are lower, they do not disappear entirely. You may still experience some mild symptoms, such as hot flashes or mood changes, though they tend to be less frequent.
- Increased risk of heart disease: Lower estrogen levels increase cardiovascular risk. Your body may experience changes in cholesterol levels, raising your risk of heart disease.
- Bone health: The loss of estrogen continues to affect bone density, making fractures more likely.
- Weight changes: Many women notice changes in their body composition, particularly gaining weight around the abdomen. This is partly due to hormonal shifts, but it’s also linked to changes in metabolism.
- Sexual health: Reduced estrogen can continue to affect vaginal health, leading to dryness or discomfort during sex. You may also experience changes in libido.
Menopause diagnosis
Your symptoms let you know when you’re in menopause. You can also get a diagnosis by having blood tests to check your hormone levels.
The hormones doctors test for include follicle-stimulating hormone (FSH), estrogen/estradiol and thyroid-stimulating hormone (TSH). This checks for an underactive thyroid. During menopause, your FSH levels rise, and your estrogen levels lower.
Early or premature menopause
You may be in premature menopause if you begin menopause in your 40s. You might have inherited the condition or have an immune system disorder.
Going through chemotherapy for cancer or having your uterus or ovaries removed in surgery can cause premature menopause. Also, primary ovarian insufficiency – when your ovaries stop working before age 40 – can lead to early menopause due to lower estrogen production.
Treatments for menopause
If you have severe menopausal symptoms, there’s help. These are some of the additional treatments available and their effects:
- Antidepressants help with moodiness.
- Medications like gabapentin reduce hot flashes while blood pressure drugs help lower your blood pressure.
- Vaginal estrogen cream makes intercourse more comfortable.
- Low-dose birth control pills safely add hormones to ease symptoms.
- Hormone replacement therapy (HRT) does have risks, but it may ease most symptoms and can help prevent osteoporosis.
- Bioidentical hormone therapy, which is made to mimic your natural hormones, may be a safer option to ease symptoms.
- Physical activity is vital for maintaining bone health, managing weight and improving mood. Aim for a mix of cardio, strength training and flexibility exercises.
- Eating nutrient-rich foods, particularly those high in calcium and vitamin D, can help prevent bone loss. A diet rich in fruits, vegetables and healthy fats will also support overall well-being.
- Since stress can exacerbate menopausal symptoms, finding ways to relax – whether through meditation, yoga or simply taking time for yourself – is crucial.
- Keep up with routine medical check-ups, including mammograms, bone density tests and cholesterol screenings. Your doctor can help you manage symptoms and adjust treatments as needed.
You may be interested in alternative treatments to ease menopausal symptoms. There are herbs, supplements and oils that may help you through menopause. Calcium and vitamin D supplements can also help your bones be healthy and strong. Talk to your doctor to ensure treatments won’t interfere or interact with each other.
How we can help
While the stages of menopause are a natural part of life, they bring some significant changes to your body. Knowing the stages of menopause and working with either your primary care provider or gynecologist can improve your quality of life as you navigate the changes.
Learn about the gynecological and women’s health services we offer at Mercy Health.
