**What is Menopause?**
Menopause marks the permanent end of a woman’s menstrual cycle, either occurring naturally or being medically induced. Natural menopause is when a woman hasn’t had a period for 12 consecutive months. Induced menopause happens when both ovaries are surgically removed or periods stop due to chemotherapy. Induced menopause often triggers more abrupt hormonal changes and can lead to more intense symptoms compared to natural menopause. It’s important to discuss this thoroughly before undergoing ovary removal, especially if it isn’t medically necessary. On average, natural menopause begins at around 51 years old in Western countries. However, if it happens before the age of 40, it’s called premature menopause, which affects about 1% of women.
**What Causes Menopause?**
Menopause occurs due to a decline in estrogen levels and other hormonal changes. Here’s an interesting fact: women are born with all the follicles (or eggs) they’ll ever have—about 1 to 2 million. This number starts declining while they’re still in the womb. By the time menopause arrives, only a few hundred to a few thousand follicles remain. As the body senses fewer follicles, it ramps up hormone production, such as Follicle Stimulating Hormone (FSH), in an attempt to stimulate the ovaries. This hormonal activity contributes to many of the symptoms women experience during the lead-up to menopause, although the process is more complex than this simplified explanation.
**What is Perimenopause?**
Perimenopause is the transitional phase leading up to menopause, beginning when hormone levels start to fluctuate and ending with the final menstrual period. During this stage, women may experience irregular cycles (such as heavier or skipped periods), hot flashes, vaginal dryness, and trouble sleeping. These disruptive symptoms can understandably affect mood and, in some cases, lead to irritability or depression.
**Symptoms of Menopause and Perimenopause**
Symptoms of menopause and perimenopause can vary widely from person to person. Some women experience just one symptom, while others may deal with several at once, with different levels of severity.
The most common and talked-about symptom is the hot flash. These can range from a slight warm sensation to intense heat, causing women to stop what they’re doing, shed layers of clothing, and seek relief by sitting in front of a fan or opening a window. Hot flashes often cause flushed skin on the face, neck, or chest, along with an overwhelming sense of heat, heart palpitations, and sweating. They can be especially bothersome at night, leading to night sweats and disrupted sleep. The frequency and intensity of hot flashes are highly individual—they can last just a few seconds or several minutes and persist on average for four to five years, but in some cases, they continue for decades.
Although the exact cause of hot flashes isn’t fully understood, they seem to occur when lower estrogen levels confuse the hypothalamus, the brain’s temperature regulation center, into thinking the body is too hot. This mistake can trigger an overreaction, like an increased heart rate, blood vessel dilation (causing flushing), and sweating.
Other menopause-related symptoms overlap with aging, such as vaginal dryness, which can make sex uncomfortable, insomnia, early waking, and urinary incontinence when sneezing or coughing.
**Managing Symptoms**
Many clinical studies are ongoing to find better ways to manage menopause symptoms, particularly hot flashes, so treatments are evolving. In the meantime, there are several proven steps that can help, starting with simple lifestyle changes. The first step is to consult your healthcare provider to confirm your symptoms are due to menopause and not another medical issue.
Once menopause is confirmed, here are several strategies that can ease symptoms:
– Cut back on caffeine, alcohol, and spicy foods.
– Exercise regularly to maintain a healthy weight.
– Practice stress-reduction techniques.
– Wear layers of clothing that can be easily removed during a hot flash.
These small adjustments can make a noticeable difference and are easy to integrate into daily routines.
There are also over-the-counter supplements that some women use to ease mild symptoms, but these should always be discussed with a healthcare provider first. Even “natural” products can have side effects or interact with other medications. Common options include:
– **Evening Primrose Oil**: Might help with hot flashes due to its gamma-linolenic acid (GLA) content.
– **Black Cohosh**: Often used for hot flashes but is not recommended for women with liver issues.
– **Flaxseed and Flaxseed Oil**: May relieve mild symptoms.
Phytoestrogen extracts, like soy and red clover, have shown mixed results in studies and may offer minimal symptom relief. However, women with a history of estrogen-positive breast or uterine cancer must consult their doctor before using these supplements.
Additionally, Vitamin D and calcium are important for maintaining bone health and preventing osteoporosis as estrogen levels drop.
**Final Thoughts**
Every woman who lives long enough will go through menopause, but the experience—and the severity of symptoms—varies greatly. The key to navigating this phase successfully is open communication with your healthcare provider. If your symptoms become disruptive or your periods become irregular, don’t wait. A collaborative approach with your doctor can help you develop a personalized plan to manage symptoms effectively. Menopause is not something you need to face alone—there are options and strategies to support you through this transition.