8 Must-Know Truths About Menopause

It’s not only about hot flashes and mood swings. This part of aging is different for everyone.

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Menopause occurs when your period stops permanently because your ovaries cease to produce estrogen and progesterone. The transition is confirmed when you haven’t had menstrual bleeding for 12 consecutive months. Some women fear menopause because of accompanying symptoms like hot flashes, vaginal dryness, sleep problems and decreased sex drive. But there is some good news: there are effective ways to relieve symptoms.

Christine Hunter, MD, an OBGYN at Summerville Medical Center in Charleston, South Carolina, shares eight things women should know about this important part of aging.

Medically reviewed in December 2019.

No two women will have the same experience

2 / 9 No two women will have the same experience

As with pregnancy and menstruation, no two women will experience menopause at the same time with the same symptoms. Likewise, no two sets of treatments will work the same way, either.

“Your symptoms may be different from your neighbor’s,” says Dr. Hunter, “and what works in one person may not work in another.” You may not have the same experience that your mom did either, because treatments for symptoms are evolving. “Just in the last few years,” Hunter notes, “things have changed drastically when it comes to available treatments.”

While it can be helpful to talk through the ins and outs of the menopause experience with friends and family, just remember that it’s unlikely your experiences will be identical.

The cause of menopause onset varies

3 / 9 The cause of menopause onset varies

Menopause is most often a natural process and the average age of menopause onset is 52. That said, it’s also common for women to experience the changes prematurely after surgeries like hysterectomies (removal of the uterus) and oophorectomies (removal of the ovaries). Chemotherapy or radiation to treat certain cancers may damage the ovaries and decrease the production of ovarian hormones, bringing about early menopause. Other causes of early onset menopause include:

  • Smoking
  • Certain health conditions like autoimmune diseases (such as rheumatoid arthritis), thyroid disease, HIV/AIDS or chronic fatigue syndrome
  • Chromosomal abnormalities

Although it’s common for early onset menopause to occur in conjunction with these procedures or health conditions, menopause can also arrive early for no apparent reason.

Perimenopause can bring major symptoms, too

4 / 9 Perimenopause can bring major symptoms, too

Natural menopause is a consecutive year without a period, but you may experience changes in your period well before that. This stage is called perimenopause, or menopausal transition.

“Some people may skip a few periods here and there, then have a period, then have three in a row, then skip three months,” Hunter explains. “During the time they’re not having regular periods, they can have symptoms of menopause.”

Estrogen levels rise and fall irregularly during perimenopause and that’s why your periods may be shorter or longer. You may notice symptoms that are associated with menopause during this time, such as hot flashes, sleep issues and vaginal dryness. Heavy or prolonged bleeding may be a sign you’re going through perimenopause, too. Perimenopause occurs at different ages but can start as early as your mid-thirties. On average, it lasts up to four years until you enter menopause.

You can relieve menopause symptoms

5 / 9 You can relieve menopause symptoms

Menopause can bring a slew of not-so-enjoyable symptoms like night sweats, sleeping problems, vaginal dryness, mood swings, hair loss and trouble concentrating. And if you’re wondering what the most common symptom is, it’s hot flashes, by far—experienced by up to 80 percent of women.

Treatment options aren’t going to stop menopause, but they can help relieve some of the symptoms. For women who are still having periods or going through perimenopause, low-dose hormonal birth control may help. Hunter notes that the most common treatment for menopausal symptoms in most women is hormone therapy.

“With hormone therapy,” she explains, “you’ll get prescriptions for two or three hormones that are usually produced by the ovaries—estrogen, progesterone and testosterone.” Different types of hormone therapy are recommended depending on certain factors. For example, women without a uterus are typically prescribed estrogen only, while those with a uterus usually take estrogen and progestin.

Although major health organizations like the American College of Obstetricians and Gynecologists (ACOG) and the North American Menopause Society say that hormone therapy is safe for most women, there are some risks. Talk with your OBGYN about the risks and the benefits. Some methods, for example, slightly increase the risk of uterine cancer, breast cancer, heart attack, stroke or gallbladder disease.

Some doctors may also recommend herbal remedies such as red clover, dong quai, vitamin E and black cohosh. “ACOG studies show they’re not necessarily effective, but I think they are worth a shot for some women who don’t want to use typical hormone replacement therapy,” says Hunter. Talk to your gynecologist before taking any supplements, since some of them present safety concerns for certain people.

It may affect your bone and heart health

6 / 9 It may affect your bone and heart health

Post-menopausal women may have an increased risk for certain health conditions like osteoporosis and heart disease. But why?

Estrogen, the hormone that your ovaries normally produce, helps build strong bones. When your ovaries stop producing that hormone, you may have some bone loss.

“Women who are already at risk for bone loss, like those who smoke, have thyroid disease or are on the thinner side don’t have as much bone density to start out with so their risk is higher,” says Hunter. If you’ve gone through menopause, aim to get 1,200 milligrams of calcium per day. Foods like raw tofu, low-fat yogurt, milk, leafy green vegetables and fortified cereals are great sources of calcium.

Post-menopausal women are also at increased risk for heart disease. “As your estrogen levels drop, your risk for heart disease is going to go up,” says Hunter. Estrogen helps keep blood vessels flexible and encourages proper blood flow. During menopause, it’s also possible that rising blood pressure and LDL (“bad”) cholesterol levels play a role in heart disease risk.

Researchers are working to learn more about the connection between menopause and heart disease, but in the meantime, a healthy diet and regular exercise will help keep your ticker strong. The American Heart Association recommends eating a diet rich in fruits, vegetables, whole grains, low-fat dairy products, fish, lean meat and nuts and limiting your intake of red meat and sugary foods and drinks.

Irregular bleeding is a red flag

7 / 9 Irregular bleeding is a red flag

Whether or not you’re around the age of menopause onset, irregular bleeding warrants a doctor visit. “Any type of increased bleeding is something that needs to be checked out,” says Hunter.

Monitoring heavy bleeding is especially important if you think you’re going through menopause. “As our hormone levels decrease, our bleeding should decrease,” Hunter says. If your periods are very heavy—they last more than seven days, you soak through one or more tampons or pads per hour or your menstrual flow’s blood clots are bigger than a quarter—see your healthcare provider.

You should also visit the doctor if your period is occurring more than every three weeks. Heavy periods or too frequent periods may signal a larger health issue like fibroids (non-cancerous growths that develop from uterine tissue), polyps (non-cancerous growths of tissue similar to the endometrium that grow on the uterine wall or endometrial surface), endometriosis (endometrium tissue that grows somewhere outside of the uterus) or uterine cancers.

There are some positive benefits of menopause

8 / 9 There are some positive benefits of menopause

While there are certainly some not-so-pleasant side effects of “the big M,” there are some potential positives. After all, menopause is a time of aging and change, which means you can look forward to a developed sense of confidence and appreciate the life experience you’ve earned. You can even use this opportunity to set new goals for the next chapters of your life. Focusing your attention away from some of the symptoms and instead toward some of the positives might help change your perspective.

First, it may help to set aside any negativity you’ve heard about the transition. It may also help to keep a gratitude journal. Try writing down three things you’re grateful for every night.

Next, it’s important that you take care of yourself. While you may not feel your best every day, make sure to squeeze in some time for things that make you feel happy and relaxed. That could simply mean meeting a friend for a morning yoga class, winding down at night with a warm bath or treating yourself to a blowout, just because.

Lastly, remember to stay connected to loved ones. Although your friends or family members may not be experiencing the same changes you are, try to connect with someone else who is. Talking with those who’ve gone through or are going through what you are can help put your mind at ease. Not to mention, having a strong social network may help you live longer.

It’s okay (and safe) to seek help

9 / 9 It’s okay (and safe) to seek help

“I don’t want women to suffer from menopause symptoms because they are afraid of something,” says Hunter. Many women shy away from seeing their doctor for fear that hormone therapies will cause breast cancer or other issues.

“Breast cancer is so prevalent in our society that the risk alone from hormone replacement therapy is small compared to the baseline risk of breast cancer,” Hunter says.

Quality of life is very important, so Hunter urges that women talk with their gynecologists when perimenopause and menopause happen.

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