Menopause means the end of a woman’s fertility cycle. It is a natural process with hormonal and physiological changes. Knowing what to expect can make the transition simpler. Here are some important facts:
1. Menopause only fully happens 12 months after the last menstruation
Popular perception might be that menopause happens suddenly. The reality is more gradual. Menopause is a process and not a distinct point in time.
So, for most women, menstruation gradually subsides, rather than stopping at once. The symptoms of menopause may appear slowly, peak, and then decline gradually, as a woman moves out of her fertile years.
The earliest stage of menopause is called perimenopause. It causes irregular periods as the body transitions toward lower fertility. As menstruation ends, and fertility along with it, a woman enters postmenopause.
A small number of women have primary ovarian insufficiency (POI). This causes early menopause and means a woman produces fewer eggs than normal.
Women with POI show hormonal changes consistent with menopause, but before the age of 40. They may not experience symptoms of menopause, or their symptoms may be subtle.
2. Perimenopause is often gradual
The earliest stage of menopause, called perimenopause, causes irregular periods, as a woman moves away from fertility. Perimenopause is usually gradual. During this process, a woman may experience other changes to her body. For example, changes to skin and hair.
These alterations are part of aging and are due partly to lower levels of hormones. A woman’s genes also affect skin changes, hair thinning and graying. Regardless of the cause, these changes can be distressing. Sometimes changes are due to thyroid conditions or anemia, which are common in women of menopausal age. A doctor should be consulted if changes are noticeable or sudden.
There are medications effective for slowing the thinning of hair, and creams and shampoos may help.Women may have several, all, or occasional symptoms of perimenopause, and these can come and go.
3. The majority of women experience perimenopause symptoms
Most women experience some of the many perimenopause symptoms. Irregular periods that eventually end are not the only symptom.
Some of the most common perimenopause symptoms include:
- Hot flashes: These produce sudden hot sensations in the upper body. Some women develop red blotches, as well.
- Difficulty sleeping: This may be a standalone symptom or due to night sweats.
- Increased vaginal dryness and sensitivity: This happens because the walls of the vagina thin.
- Stress incontinence: The tendency to leak urine when exercising or sneezing. Some women struggle to hold their urine between bathroom breaks. Estrogen protects the health of the bladder and urethra, and as this hormone declines, it affects urinary function.
- Mood swings: These may be due to shifting hormone levels. Some women experience anxiety or depression during this time.
- Sex life changes: Physical changes can make sex more difficult. This can affect how women feel about sex and their romantic relationships.
- Muscle loss and fat gain: Women may lose muscle mass and gain excess weight around the waist.
- Osteoporosis: This condition, which thins the bones, makes people more vulnerable to bone fractures. Thin Caucasian women have the highest risk.
Symptoms of perimenopause occur, as hormone levels fluctuate and the body adjusts to the transition.
4. Some options that may help women manage their menopause symptoms
Hormone replacement therapy (HRT) has been a popular option for decades. Women should weigh the benefits of HRT in consultation with their doctor. Even without HRT, it is possible to reduce the discomfort of perimenopause symptoms. Some strategies include:
- therapy to help cope with physiological and emotional changes
- more exercise to promote bone health and prevent weight gain
- a balanced diet rich in protein to support muscle health and lower the risk of bone loss
- osteoporosis medications
- vaginal lubricants to help with dryness and pain
- maintaining a healthy bedtime pattern to support quality sleep
5. Infertility is the only inevitability with menopause
Myths and secrecy surround menopause. Some women believe they will be less attractive, or that sex may become painful. Others might be concerned that they will be less “feminine” or suffer memory loss.
Many women have a positive experience of menopause, however, and feel as if they gain confidence and wisdom. In reality, nothing but loss of fertility is inevitable with menopause.
Anecdotally, some women find that menopause improves their self-esteem and increases their interest in sex. After the menopause, there is no risk of pregnancy and, for some women, this may improve sex.
Every woman’s experience of menopause will vary. There is no formula that applies across the board, although reading about other women’s experience may help.
6. The body still produces hormones
It is not true that the body stops producing hormones after menopause. The adrenal glands continue to produce estrogen and progesterone, but their overall production declines.
7. Menopause can affect your relationships and lifestyle
Menopause is not just a physiological experience. It also has deep cultural meaning.
For some women, menopause means getting “old.” This can trigger many feelings. Some derive meaning and wisdom from menopause, while others may experience depression.
The cultural values and assumptions about menopause can affect how a woman feels about this natural body process. The way she reacts to this may affect her relationships and lifestyle. For example, a woman who believes menopausal weight gain is inevitable might stop exercising.
Conversely, a woman who takes joy in the wisdom she believes comes with age, might feel better about herself. She may, therefore, feel more adventurous or sexual than ever before.
As with anyone in any situation, a woman’s thoughts during the menopause affect how she feels. Women experiencing difficult feelings can talk to a doctor or therapist to address this.
8. A woman may still get a period
Women’s periods do not normally disappear suddenly. Perimenopause means irregular periods and longer cycles. Very occasionally, women experience heavier periods. Women may also experience spotting or breakthrough bleeding.
As perimenopause progresses, a woman’s period becomes less frequent, and then end. Once periods have stopped for 12 months, a woman has moved from perimenopause to menopause.
9. Women may still get pregnant
Just as a woman’s periods do not disappear at once, neither does her fertility. The beginning of menopause marks the beginning of the end of fertility. A woman may still ovulate, and the eggs may be healthy enough to produce a pregnancy. Fertility only ends when menopause is complete.
Women who do not want to get pregnant should continue using contraception until their periods have stopped for 12 months. Notably, hormonal contraceptives may alter menopause symptoms, so women should talk to a doctor first.
Condoms are still a smart option to protect from sexually transmitted infections. A water-soluble lubricant can be used if vaginal dryness is noticeable. People should avoid oily lubricants, as they can break down the condom.
10. Menopause is not a disease
Menopause is a life transition, not a disease, even though it is sometimes spoken about as such.
When perimenopause symptoms are experienced, they are often short-lived and mild. An individual may want to track her symptoms and report them to a doctor.
Menopause is also not a sign that the body is failing. Some women worry that they have started menopause too early, because of poor health or some other issue.
Most women enter the menopause around the age of 50. However, variability in either direction is normal, and not something to worry about. Healthy transition into menopause is possible.