10 Essential Things to Know About Menopause

It has many nicknames, including “The Change,” “The Big M,” and “The Pause.” No matter what it’s called, menopause will eventually affect every person with ovaries. In the U.S., about 1.3 million people will reach menopause annually.

Although menopause is a natural part of aging, many are not prepared for it. The first signs of perimenopause can be surprising, as some people expect it to occur later in life. To help you prepare for menopause, here are 10 essential things to know.

1.Menopause Occurs in Three Stages

Menopause doesn’t take place all at once. The transition is gradual over several years and is divided into three stages:

• Perimenopause is when the ovaries begin to produce less estrogen. Signs of perimenopause include irregular periods, hot flashes, and mood swings.
• Menopause is when menstrual periods stop and the ovaries no longer release eggs.
• Postmenopause is when symptoms of menopause start to decrease, but some symptoms may continue indefinitely. In postmenopause there is increased risk for other health conditions brought on by reduced estrogen levels, such as osteoporosis.

2. Causes of Menopause

Menopause naturally occurs when the ovaries make less estrogen and progesterone, the hormones that control menstruation. Eventually, the ovaries stop releasing eggs and the menstrual cycle ceases.

Menopause can also happen because of surgery to remove the ovaries, chemotherapy, and radiation therapy to certain parts of the body, such as the pelvis and abdomen.

3. When to Expect Menopause

Natural menopause usually occurs between ages 45 and 55, with the average age in the U.S. being 51. However, symptoms can begin up to 10 years before. People in their late 30s can experience the first signs of perimenopause, and it’s not unusual for people in their 40s to have symptoms.

4. How to Know You’re in Menopause

If you’ve gone 12 consecutive months without a menstrual period, you have reached menopause.

5. Common Symptoms of Perimenopause

• There are more than 30 symptoms of perimenopause. The most common include:
• Irregular or skipped periods
• Hot flashes
• Night sweats
• Vaginal dryness and itching
• More frequent or urgent urination
• Difficulty sleeping (insomnia)
• Anxiety, irritability, mood swings, or depression
• Dry skin, eyes, or mouth
• Worsening of premenstrual syndrome symptoms
• Breast tenderness

6. Lesser-Known Symptoms

In addition to the traditional symptoms like hot flashes, perimenopause has some lesser-known symptoms caused by changes in hormone levels. They include:

• Loss of sexual interest
• Facial hair growth
• Pain during intercourse
• Panic attacks
• Unusual dreams
• Urinary tract infections
• Bloating and gas
• Indigestion
• Headaches
• Difficulty concentrating or memory lapses
• Joint and muscle aches
• Weight gain
• Hair loss or thinning

7. Treatments for Perimenopausal and Menopausal Symptoms

There are many treatments available for symptoms. They include hormone therapy for people experiencing menopause after age 45, and hormone replacement therapy for those who have symptoms at an earlier age (in their 30s and early 40s).

Hormone therapy may include taking estrogen, which is available in several forms like patches, pills, and creams. A health care provider may also prescribe progesterone to go along with estrogen. If you are interested in hormone therapy, talk with your provider about its risks and benefits and whether it is right for you.

There are also non-hormonal treatments available, including lifestyle changes such as getting more exercise, and using medications that do not have hormones. Talk with your provider to learn more about non-hormonal treatments.

8. Health Risks Associated with Menopause

With low estrogen levels brought about by menopause, there’s an increased risk of several other health problems, including osteoporosis and cardiovascular disease. To prevent osteoporosis—a disease that makes bones thin and brittle—your provider may want you to have a bone density scan and take supplements like calcium and vitamin D. To prevent cardiovascular disease, your provider may recommend dietary changes, increased physical activity, and hormone therapy.

Another possible health issue caused by menopause and perimenopause is loss of bladder control, also known as urinary incontinence. Tissues of the vagina and urethra change during menopause, which can result in sudden urges to urinate or urine leakage. Treatments may include vaginal estrogen, prescription medications, and pelvic floor exercises to strengthen the muscles supporting the bladder and urethra. Check out our blog article on how physical therapy can help ease pelvic floor disorders.

9. How to Stay Healthy After Menopause

Eating a balanced diet is important, especially with sources of calcium and vitamin D to prevent osteoporosis. Read more about ways to get vitamin D.  

A regular exercise routine that includes walking can help keep your bones strong. Resistance training will also help strengthen your muscles and bones. Check out our blog article on building strength without lifting weights.

If you don’t already do so, getting in the habit of scheduling annual wellness visits and recommended preventive screenings will help you find problems early, when they are easier to treat.

10. When to Contact Your Provider

For many, the symptoms of perimenopause are often mild. However, up to 30% of people going through perimenopause experience severe symptoms that can affect their quality of life. If your symptoms are bothering you or interfering in your daily activities, it’s time to contact your health care provider to discuss treatments.

To learn more about hormone decline in men, check out our blog article on “manopause.”