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Women's Health

Everything You’ve Ever Wanted to Know About Menopause

Your roadmap to understanding what to expect before, during, and after your change of life

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To many, it signals the end of the reproductive era. To some, it ushers in newfound freedom that liberates them from cramps, bleeding, and contraception. But for most women who are just beginning to feel the effects of the change of life, menopause can be downright mystifying — but it doesn’t have to be.

Understanding the Menopause Transition

A 2021 State of Menopause survey of 1,039 U.S. women ages 40 to 65 by Bonafide revealed that nearly half of women (45%) didn’t know the distinction between perimenopause and menopause.

Menopause is defined as the cessation of ovarian function for at least 12 months — or, in laymen’s terms, no periods for a full year. According to the National Institute on Aging, menopausal transition most often begins between ages 45 to 55 and lasts about seven years (though it can be as long as 14). 

Since it is a transition, there are two other important timeframes leading up to menopause that every woman should know about:

  1. Premenopause: when you have no symptoms of perimenopause or menopause
  2. Perimenopause: when you become symptomatic, due to a drop in estrogen

Perimenopause lasts for two to eight years, on average, says board-certified OB/GYN and menopause expert, Dr. JoAnn Richichi, DO, of Axia Women’s Health. And in the United States, the average age of menopause is 51. Of course, every woman’s timeline is different (read: You won’t necessarily follow these norms, and you might not even follow the same pattern as your mother or sisters).

Health Risks Associated With Menopause

Even though menopause affects your reproductive system, that’s not the only area it impacts. 

“Since hormones control every organ and every bodily function, as they become depleted, so do we,” says Dr. Richichi. “That decrease in hormones can decrease our overall sense of wellbeing and render us at risk for metabolic compromise.”

 She explains that as we age, we are at risk of developing high blood pressure, cardiac disease, high cholesterol, and osteoporosis. “While diet, weight management, and exercise are extremely important in maintaining a healthy lifestyle, treatments like bio-identical hormone replacement therapy can also help restore the natural hormone levels and decrease the instance of adverse metabolic conditions,” Dr. Richichi says. “The goal with this unique anti-aging modality is to optimize us and make us feel like we once did in our 30s and 40s.”

Common Menopause Symptoms

While all the following signs could be attributed to any number of health conditions (which is why it’s always wise to consult your physician), they are also often associated with menopause:

  • Hot flashes and night sweats
  • Weight changes (often gaining fat and losing muscle)
  • Insomnia or other sleep disturbances
  • Vaginal dryness/painful sex
  • Decreased libido
  • Bladder control issues
  • Mood changes
  • Difficulty concentrating, anxiety, or depression
  • Facial hair growth
  • Dry skin, eyes, or mouth
  • Headaches
  • Racing heart
  • Aches and pains

“Many of the symptoms of menopause are due, we think, to the significant fluctuations in estrogen level,” says Dr. Mary Jane Minkin, MD, clinical professor, Department of Obstetrics, Gynecology and Reproductive Sciences, Yale Medical School, pointing specifically to hot flashes, insomnia, headaches and cognitive/mood issues. “Some are just the loss of estrogen, and they get worse over time — such as vaginal dryness and bladder symptoms.”

Dr. Richichi explains that the “majority” of women have several of these aforementioned symptoms, but they aren’t necessarily a given — and all hope is certainly not lost if you do experience them. “We do not fully know why some may feel worse than others,” she says. “Of those who have a wide array of symptoms, there is no reason why, with proper help, they couldn’t lead a healthy, happy, productive, and disease-free lifestyle.”

And the key here, truly, is getting the proper help. According to the Bonafide survey, a whopping 73% of women reported they aren’t currently treating their symptoms. That’s right, nearly three-fourths of U.S. women are just “toughing it out” instead of exploring natural treatment options for menopause, filling their plates with the best foods for menopause, or talking to their doctors about hormone replacement therapy. The fact that 34% of the women surveyed hadn’t been “formally” diagnosed as menopausal by a healthcare provider may be partially to blame for suffering through their symptoms in silence.

Do I Still Need to Visit a Gynecologist After Menopause?

Yes, menopause does not mean you have a free pass from your regular visits to the gynecologist’s office. “A woman less than age 65 years of age — menopausal or not — should see a gynecologist every year for a routine checkup,” affirms Dr. Richichi. “A routine check-up is important in assessing one’s overall health and staying on top of preventative screenings. A woman 65 years or older should see a gynecologist every other year.” Of course, if a woman has gynecology-related complaints apart from the annual visit, she should not hesitate to schedule an appointment with her provider. 

For more about menopause, keep reading: