So you’ve heard a little bit about menopause, and you’re wondering — do I need to brace for impact?
The good news is that many people go through menopause without noticing very many changes at all. The other good news is that, if you do have symptoms, there are lots of treatments to help.
Here’s a peek at what to expect and how you can start preparing for menopause
Before there’s menopause, there’s perimenopause
A lot of what you hear about menopause is really about perimenopause — the time before menopause when your hormone levels start to fluctuate, your cycle becomes less regular, and eventually, your periods stop altogether.
Perimenopause can start as early as your 30s or as late as your 50s, but for most women, the first signs appear in their mid-40s. On average, this transition phase lasts about four years, but there is a lot of variation between women. Once you’ve gone a full year without a period, you’ve reached menopause.
Preparing for menopause: The most common signs of perimenopause
While each person experiences perimenopause differently, these are the most common things you might notice:
Changes in your menstrual cycle
For many people, the first sign of perimenopause is irregular periods. Your cycle might become longer or shorter, and your periods may be lighter or heavier. You may skip periods. Eventually, periods stop.
About 75 percent of women experience hot flashes around the time of menopause. When a hot flash happens, your face and body suddenly feel hot and you may sweat or develop red blotches. Hot flashes vary in intensity and duration — they can last 30 seconds or up to 10 minutes — and they can happen anytime. When hot flashes happen at night, they’re called night sweats.
For most women (about 80 percent), the hot-flash phase lasts two years or less. But it’s not uncommon to have an occasional hot flash later, even after menopause.
Studies show that up to 23 percent of women have mood changes during and after perimenopause. Changing hormones and sleep disruptions can contribute to mood swings or a lower mood for some people. Menopause also happens at a time when life can be packed with stressors — from aging parents to children getting ready to leave home and careers in full swing.
There’s no simple way to untangle exactly what causes any one person’s mood changes. If you’re concerned about your mood — and especially if you have symptoms of depression — please talk to your healthcare provider for support.
Nighttime hot flashes, mood changes, and major life events can all make it harder to sleep well. Managing the things that keep you from sleeping (like stress and hot flashes) and building healthy sleep habits, can help.
Estrogen helps keep the vagina elastic and moisturized. As estrogen levels fluctuate, some women notice vaginal dryness and discomfort during sex. An over-the-counter lubricant can make a huge difference.
As menopause approaches, some women find that they need to urinate more often, or notice that they leak some urine when laughing or sneezing.
With hormonal shifts, some women develop more facial hair. The hair on the scalp may become thinner.
Some people have weight gain around menopause, especially in the stomach, hips, and thighs. This can be related to menopause, but it’s also just easier to gain weight as we age.
Taking care of yourself during perimenopause and beyond
If you notice perimenopause symptoms that bother you, there are lots of approaches to help. Some lifestyle adjustments, like eating well, exercising regularly, or sleeping with a fan and dressing in layers can bring relief. There are also some proven natural remedies (keep in mind that some “natural” treatments make big promises and don’t deliver — so always check with your healthcare provider first). Many women also opt for hormone therapy to ease symptoms and reduce health risks.
If the changes around menopause are frustrating or uncomfortable for you, talk to your healthcare provider. You can work together to find an approach that matches your symptoms, preferences, and lifestyle.
Approaching menopause in an anti-aging world
Menopause might be happening in your body, but it also happens in a society that has a lot to say about aging. Flip open any fashion magazine and you’re likely to be bombarded with images of very young women and ads for anti-aging miracle cures. It’s easy to internalize the message that aging is a problem to manage or hide. And from there, it’s not far to feeling like menopause is embarrassing or shameful.
If those negative messages have seeped in, it may be worth considering some other perspectives. In study after study, researchers have found that menopause has a lot of good sides. Here are just a few examples:
- The Massachusetts Women’s Health Study of 2,565 middle-aged women found that most were either relieved or neutral about the end of their cycles.
- In a review of studies about body image, a researcher discovered a trend: while menopausal women tended to judge themselves negatively if they were asked about their appearance, open-ended questions showed that women overall were highly satisfied with their lives.
- In a smaller study of Australian women at middle-age, respondents reported some sadness about aging, but the more notable finding was greater confidence and wisdom, more self-awareness, and higher feelings of self-worth.
It’s normal to have complicated feelings, and some worry, about menopause and getting older. But please remember that menopause is a natural process, and there are lots of ways to think about it – and many options for treatments if you need them.
Reviewed by the Ovia Health Clinical Team
- “Perimenopause.” Cleveland Clinic. Cleveland Clinic. October 5, 2021. https://my.clevelandclinic.org/health/diseases/21608-perimenopause.
- “Introduction to Menopause.” Johns Hopkins Medicine. Johns Hopkins Medicine. https://www.hopkinsmedicine.org/health/conditions-and-diseases/introduction-to-menopause.
- “Depression, Mood Swings, Anxiety.” North American Menopause Society. North American Menopause Society. https://www.menopause.org/for-women/sexual-health-menopause-online/causes-of-sexual-problems/depression-mood-swings-anxiety.
- Tori DeAngelis. “Menopause, the makeover.” American Psychological Association. American Psychological Association. March 2010. https://www.apa.org/monitor/2010/03/menopause.