Every beginning has an end. Menopause is the moment in a woman’s life where ovulation ends. While it may be a natural biological process for a woman, it causes uncomfortable symptoms that disrupt her sleep, lower energy, and affect emotional health. Here is an overview of menopause, including the management of menopausal and perimenopausal symptoms.

What is Menopause?

As you reach the age of 35-40 years old, the number of eggs left in your ovaries decreases more rapidly, making your ovulation less regular until it stops completely. If you haven’t had any menstrual period for 12 consecutive months, you’ll know that menopause has already occurred. 

Menopause is the final menstrual period where you have released your last remaining unfertilized egg. This means you can no longer get pregnant naturally as your menstrual cycle has come to an end.

When Does Menopause Occur and How Long Does It Last?

The onset of menopause varies between women, but it usually begins around 45-55 years of age. Some could have them before they even reach 40, while others could have them as late as 60 years old. For example, the average age for onset of menopause for an American Woman is 51 years old. 

Most women start to manifest menopause symptoms about 4 years before their last period. These symptoms often continue for another 4 years from their last period. Some women may experience menopause symptoms a decade earlier than when menopause occurs, and 1 in 10 women may experience these symptoms for up to 12 years following their last period. 

Several factors such as genetics and ovary health may help determine when you will begin menopause. When your hormones begin to change in preparation for menopause, it is called perimenopause, and it can last anywhere from a few months to several years. Perimenopause begins in many women in their late 40s, but other women may skip this phase and enter menopause suddenly. 

The Three Stages of Menopause

The process of menopause happens slowly over three stages:

Perimenopause 

During this stage, the ovaries are beginning to run out of eggs that are causing erratic hormonal changes, particularly estrogen. The pituitary gland produces higher levels of follicle-stimulating hormone (FSH) and luteinizing hormone (LH) to keep the ovaries producing eggs and estrogen levels normal. 

During this time, ovulation may occur twice in a cycle, or may not occur at all. As a result, your menstrual cycle becomes irregular, late, or you may completely skip one or more periods. 

Menopause  

This stage is defined as your final menstrual period. But because periods can be very irregular and onset can be months apart as you approach menopause, you will realize you had your final period when you haven’t had any periods for 12 months.

Postmenopause

This stage refers to the years after the onset of menopause. Menopausal symptoms are experienced at this time, and how long they last vary from woman to woman.

What are the Symptoms of Menopause?

Menopause experience is unique to every woman. Sudden onset of menopause usually has more severe symptoms. The severity and duration of symptoms tend to increase with conditions that impact the health of the ovary, such as cancer and hysterectomy, along with certain lifestyle choices like smoking. 

Perimenopause, menopause, and postmenopause have generally the same symptoms, aside from menstruation changes. The most common signs of perimenopause include:

• Less frequent menstruation
• Heavier or lighter periods than normally experienced
• Vasomotor symptoms (hot flashes, night sweats, flushing)

Hot flashes are experienced by about 75 percent of women during menopause.

Other common symptoms of menopause are the following:

• Aches and pain
• Crawling or itching sensation under the skin
• Forgetfulness
• Headaches
• Irritability
• Lack of self-esteem
• Reduced sex drive (libido)
• Tiredness
• Difficulty sleeping
• Frequent urination
• Vaginal dryness
• Discomfort with sexual intercourse

Long-term Health Risks with Menopause

When a woman has undergone menopause, there’s a decrease in their  female hormones that may lead to certain complications such as:

• Weakening of bones (osteoporosis) and an increased risk of fractures. 
• Increased risk for heart or blood vessel diseases.
• Development of mood disorders
• Occurrence of psychosexual dysfunction

How is Menopause Diagnosed?

Knowing when your period is your last period can be difficult. If you miss your periods for a few months and experience all those symptoms of menopause listed above, you are probably entering the perimenopausal stage. If it has been 12 months since your last period, menopause has occurred. 

However, sometimes your lack of bleeding may be caused by other reasons. If you are younger than 45 years, don’t have the typical symptoms of menopause, or have other symptoms unrelated to menopause, then you should seek medical attention. 

Treatment of Perimenopausal Symptoms

If your symptoms are severe and are affecting your quality of life, treatment may be necessary. Depending on your symptoms and medical history, appropriate treatment and management options include:          

Hormone Therapy

Systemic estrogen therapy, which comes in many forms, including pills, skin patches, spray, gel, and cream, is still the most effective treatment option for relieving hot flashes and night sweats. Your doctor may recommend estrogen in the lowest dose to provide you with symptom relief, depending on your medical history.  systemic estrogen may prevent bone loss and osteoporosis associated with menopause. 

Vaginal Estrogen

This treatment releases just a small amount of estrogen by administering it directly to the vagina using a vaginal tablet, ring, or cream. As estrogen is absorbed by the vaginal tissue, it helps relieve vaginal dryness, discomfort in sexual intercourse, and some urinary symptoms. 

Antidepressants

Certain antidepressants may reduce menopausal hot flashes. These medications belong to the class known as selective serotonin reuptake inhibitors (SSRIs). The treatment is useful for women who can’t take estrogen for health reasons or who require antidepressants for mood disorders. 

Gabapentin (Neurontin)

Gabapentin is an approved treatment for seizures, but it is also an effective remedy for hot flashes. This drug is useful for women who have migraines and can’t use estrogen for health reasons.  

Additional treatment for perimenopause symptoms include:

• Combined oral contraceptive pill (OCP)
• Progestin-releasing intra-uterine device (Mirena) for heavy bleeding
• Natural therapies (consult an accredited naturopath)

Note: If you are sexually active, contraception can still be important, as an egg is still released in around 1 in 3 cycles, and sometimes twice in a cycle during perimenopause. So, if you don’t intend to become pregnant, it is important to discuss this with your doctor.        

Home Remedies and Lifestyle Changes

There are natural ways to reduce minor-to-moderate menopausal symptoms through home remedies and lifestyle changes. Here are some at-home tips you can use to manage symptoms of menopause:

Keep Cool and Stay Comfortable

• To manage hot flashes, dress in loose, layered clothing, especially at night or during warm weather. 
• Reduce chances of night sweats by keeping your bedroom cool and avoiding heavy blankets at night. If night sweats persist, consider using a waterproof sheet and placing them under the beddings to protect your mattress. 
• A portable fan can also help you cool down whenever you’re feeling flushed. 

Exercise and Weight Management

Manage your weight through a plant-based diet. Here is an article on the best diet to lose weight.

Also, make it a habit to exercise moderately for 20 to 30 minutes a day. This can help:

• Increase energy
• Promote better sleep quality
• Improve mood
• Promote your general well-being

Communicate Your Needs

If you have any feelings of depression, anxiety, sadness, isolation, insomnia, and identity changes, you should talk to a therapist or psychologist. Sometimes, talking about these things make you feel better.

If you don’t want to talk to a professional, you can always go to your friends and family for comfort. They should understand how you are feeling to know how they can help you. 

Supplement Your Diet

Taking supplements like calcium, magnesium, and vitamin D can be helpful in reducing your risk for osteoporosis as well as improving energy levels and sleep. Consult your doctor about supplements suitable for your individual health needs. 

Practice Relaxation Techniques

Improve your mood and relieve stress by practicing relaxation techniques, such as:

• Yoga
• Box breathing
• Meditation

Manage Sleep Issues

Manage your insomnia by applying changes to your sleeping and dietary habits. Over-the-counter (OTC) sleep medications may help temporarily, but if you regularly have trouble sleeping, it’s best to consult your doctor for more appropriate treatment. Learn more about addressing sleep issues from another YHF article about insomnia. 

Quit Smoking and Limit Alcohol Use

Quitting smoking and avoiding exposure to secondhand smoke can be beneficial as exposure to cigarettes can make your symptoms worse. Also, limiting your alcohol intake is advised to keep your symptoms from getting worse. Heavy drinking during menopause increases risks for health concerns.

Other Remedies

Some limited studies have supported the use of herbal or natural treatments for menopause symptoms. Herbal remedies and natural supplements that may help limit symptoms of menopause are the following:

• Soy
• Vitamin E
• Isoflavone
• Melatonin
• Flax seed
• Black cohosh

Warning: While these supplements are among the commonly used natural treatments to control menopausal symptoms, it’s important to note that research in determining their effectiveness is still ongoing. 

Summing It Up

Menopause marks the end of fertility and the start of a new chapter in a woman’s life. They will no longer have menstrual periods. Adjusting to these changes might be difficult for some women. Menopause may be a natural stage of aging, but that doesn’t take away the discomfort and distress that it causes.

Treatments such as hormone therapy, vaginal estrogen, antidepressants, gabapentin, home remedies, and lifestyle changes mentioned in the article may be beneficial and ease the transition. What treatment is best for you will depend on your symptoms and individual health condition. 

Nonetheless, women’s health should be taken seriously and, while menopause is expected, no woman should suffer because of it. Knowing how to manage these symptoms can help improve a woman’s outlook and enable them to embrace this stage in their life. With every end comes a new beginning.