Menopause. It’s part of the natural life cycle, and how you view and prepare for it can impact your symptoms. It’s impossible to know in advance how it will affect you, just like all hormonal shifts throughout your life. Some people experience more symptoms than others. How you embrace it, though, can impact your happiness and health during the three stages of menopause.
Stages of menopause
Menopause is a unique journey for every woman. Some women get through the menopause transition without disruption to their life while others experience a dramatic change.
There’s a spectrum of symptoms, and the severity varies from person to person. And some women have few if any symptoms at all.
In a PeopleTweaker survey of women in all stages of menopause, some described it as relatively easy while others called it unmitigated hell. The vast majority described it as eventful or worse.
Despite the changes you’ll likely experience throughout the life cycle of menopause, 45 percent of the women in the PeopleTweaker survey found the symptoms manageable.
There are three stages of menopause.
While much of the focus is on menopause, it’s actually a small fraction of this natural transition. Menopause refers to the 12 consecutive months where your menstrual cycle ends. It’s a small period in time compared to the whole transition that can last years – including up to a decade or more.
You’ll spend the most time in the years leading up to menopause and after menopause.
That’s why it’s commonly referred to as the “menopause transition” rather than just simply menopause. Developing a game plan early, even in your 30’s and 40’s, is key to managing the transition.
The menopause transition is a journey and everyone’s experience is unique.
“We can’t change that it will happen to us. Well, we can with chemicals. But, in my way, I could not,” explained one Ph.D. respondent.
Mental fogginess was her biggest struggle, but she learned to cope.
“It made me use my humor in a different light. It also made me aware of other women who may be experiencing that and have more empathy. I’ve seen it now.”
On many days, laughter and friendships can be the best prescriptions. The comical show, “Menopause The Musical” puts a humorous spin on this life change and the sisterhood all women reach at some point in their life.
After all, it is a sisterhood. For many women in our survey, their friends offered the most guidance and support, and they leaned on them, sometimes more than on their spouse/significant other.
“I rely on my girlfriends,” one respondent explained. “Having someone who went through a similar surgery as I went through, that’s been very helpful. It’s like a pseudo support group even though it’s just the two of us.”
Perspective and preparation will help you experience menopause as part of the flow and rhythm of your life. During this new journey, you’ll learn a lot about yourself and what you can handle. You may experience things nobody told you. You’re not alone on this journey, though.
When you view menopause as a positive in your life, you’re not taking on more stress. You probably already have enough. You’re accepting menopause for what it is and can get ready to handle whatever it throws at you.
While you typically hear women say they’re in menopause as soon as the hot flashes start, it’s not always menopause. Especially when symptoms first begin in your 40’s. You’re probably just menopausal, or beginning to experience the symptoms. That’s perimenopause, the first stage of the menopause life cycle.
It’s the time leading up to your last period. It’s the end of your reproductive years.
While symptoms can come and go, when they tend to stick around, it’s likely your body’s signal of a change happening inside. Perimenopause typically hits when you’re in your mid to late ’40s and lasts about 4 years on average. However, like everything else, it can be shorter or longer.
For some, perimenopause hits early.
One PeopleTweaker survey respondent said, “I didn’t realize what was going on. But, that’s when I started with weight gain, and I started a change in menses. It went from regular to being weird, lasting much longer. It was almost like being a teenager again. Didn’t know when it was coming or how long it would last.”
In the PeopleTweaker survey, 79-percent of women had 3 or more menopausal symptoms.
You may experience:
- irregular menstrual cycle
- hot flashes
- vaginal dryness and painful sex
- mood swings
- loss of libido
- trouble sleeping
- worsening of premenstrual symptoms
Another PeopleTweaker survey respondent who is a nurse experienced headaches and mood swings.
“I’ve been kind of tearful, almost like a guilt response maybe or you feel responsible, you feel guilty. Just a kind of doom and gloom kind of thing. Noticeable to the point that my family and spouse can tell my period is coming. I’m boohooing. I’ve become very sensitive is another way to put it.”
She also described that during that time of the month, she wanted to isolate herself because she’s depressed from the terrible headaches.
“I’m not available to my family and kids as much. It’s a two to three-day thing. It’s kind of better then worse, and better then worse. It fluctuates.”
It’s difficult at home and at work, sometimes talking in front of committees and hospital boards.
“I can’t really afford to be an emotional mess in front of people. So, it affects me in that way. It’s hard to schedule when you’re doing something around your period and around your emotional response,” she said.
Menopause and your emotional health
Typically, in the U.S. at least, menopause is an un-celebrated point in the female life cycle. Anxiety and depression are also common peri-menopause symptoms and you’re more likely to get depression during menopause if you suffered from it earlier in life.
Women who experience menopause early or suddenly due to cancer treatments, surgery, or certain health conditions (such as premature ovarian failure) may also be at higher risk of depression as well as feelings of loneliness, isolation, loss, and grief.
There’s a lot of anticipation and fear surrounding menopause, especially when you begin to experience the early signs. You may wonder how much worse the symptoms will get, which may have you dreading that stage of life even more.
Fear is a powerful emotion that can lead to anger and unhappiness. So, confront your fears and emotional distress head-on by educating yourself and talking to your doctor.
If your gynecologist or PCP doesn’t bring up the issue, don’t be afraid to ask questions and start the conversation. And DO seek professional help from a mental health practitioner without hesitation. If you had diabetes, you likely wouldn’t see it as a sign of weakness and not seek medical care. How is your emotional health any different?
In menopause, you haven’t had your period for a year due to hormonal changes. Your ovaries stop making estrogen, and the production of progesterone slows. This is the official end of your reproduction and your menstrual cycle. You’ll no longer be able to have children.
Most women experience this stage of life between age 45 and 58. The average woman is 52 years old. Wondering when it’s going to happen to you? Ask your mom. That’s often a good indicator, and you may hit menopause earlier if you smoke, have specific health problems, or never had children.
Common symptoms include:
- hot flashes
- night sweats
- mood swings
- trouble sleeping which can contribute to weight gain and food cravings
- brain “fog“
- loss of libido
- vaginal dryness and painful sex
- change in metabolism, weight gain, weight distribution around your waist
- thinning hair
- dry and/or itchy skin
- generalized aches and pains
- loss of breast fullness
Many women find themselves with incomplete information. One PeopleTweaker survey respondent had a hysterectomy in her 30’s due to painful periods. So she never experienced the early symptoms. While her doctors explained a lot, she indicated, they focused mostly on hot flashes.
“… it’s not just hot flashes. And I didn’t know that. It’s the sleep disturbances. When I lie awake in bed, the pulsating, heart palpitations; I just have awful heart palpitations, the pulsating I have even up to my jaws. The most bizarre things,” she said. “So I did some research and see heart palpitations is something that seems related to menopause.”
“There are days you just feel so crazy and so out of control. And, you can see yourself and feel yourself being a little nasty or whatever, and you just can’t help yourself. That’s just a hormone thing.”
Another survey participant also experienced menopause in her early 40s. Memory loss troubled her most. “Brain fog” can be scary. However, there’s typically no reason to panic. It’s usually not an early sign of dementia or Alzheimer’s, even though it may feel that way.
“The mental fogginess was terrible, and it’s only gotten a little better afterward after I‘ve completed menopause,” she said. “…. I would go to my office and cry. Just thinking about it now brings some tears. Because I pride myself in knowing what I’m doing and doing a good job, and suddenly my brain just didn’t work like it used to. And I was going back to grad school at the time. It was terrible. It was awful,” she recalls.
“If I could go back and tell myself, ‘look you have to write this stuff down because you’re going to forget it,’ it would still be upsetting, but I think I wouldn’t have those embarrassing moments in the classroom.”
She used her humor to get through memory loss, both personally and professionally. She created a coping strategy, with sticky notes and a notebook to write everything down. Twenty-one years after her last period, she says she manages better with all her notes but doesn’t believe her brain ever went back to where it was.
Looking back, she wishes she had prepared better for this menopause symptom.
Establishing a lifestyle of healthy eating, physical activity, sufficient and good quality sleep, stress management, social connection, and engaging in mentally stimulating activities are all steps you can take early that have a positive impact on cognition.
Menopause treatment options
While many women seek relief from menopause symptoms, others suffer in silence. Help is available but it is important for you to take charge of your health and well-being if you haven’t already by this time in your life. Be ready to ask questions and persist until you get answers, which may mean learning to be assertive and moving out of your comfort zone.
When she didn’t get the help she needed medically, one PeopleTweaker survey participant took matters into her own hands. Luckily, she had an advocate in one of her doctors too. “I had to take control of it. I think my gynecologist felt so bad when I was sobbing in her office,” she said. “My primary has been, I would say, the most beneficial healthcare provider in my life, because she understands I’m not crazy…She takes matters in her own hands as well.”
Find that advocate. And, be one yourself. Being a healthcare rebel will help you get find the options that are best for you.
Though hormone therapy (pills for some, topical treatment for others) may be the most beneficial solution for some women, there are other options available. And some women cannot take hormones due to a history of breast cancer, the risk of blood clots, and the risk of stroke.
Be prepared to take the time to find a healthcare professional who is a good fit for you and to explore integrative modalities like mindfulness, meditation, guided imagery, acupuncture and herbal medicine, and yoga.
And don’t forget the importance of “lifestyle vaccines” – healthy eating, physical activity, sleep, stress management, and social connection.
Finally, post-menopause. During post-menopause or the years after, you may see fewer symptoms. However, they may not be gone completely.
The Penn Ovarian Aging Study cohort assessed women for 16 years. The study found hot flashes did not return to premenopausal levels until 9 years after the woman’s final menstrual cycle.
On average, women experienced moderate to severe hot flashes for nearly 5 years after menopause.
Additionally, you’re at a higher risk for osteoporosis and heart disease because of lower levels of estrogen.
PeopleTweaker survey respondents described their post-menopause journey as eventful to life-altering.
For one, it was liberating.
“You don’t have to worry about having periods, don’t have to worry about having tampons, don’t have to worry about pregnancy and that’s a huge freedom.”
Knowing that she’s at this point, she looks back, reflects, and uses what she experienced on her journey to help three of her colleagues who are going through menopause.
“I tell them, watch out for the brain changes. I wasn’t ready for that, and I’m telling you you’re not stupid,” she said.
Showing that empathy toward others helps can help you more than you might imagine.
Menopause sticks around for years, so be proactive and take steps early to prepare and optimize your experience.
Learning from the experience of menopause
No matter what stage of menopause you’re in, there’s help available. While the focus of menopause is often on the unwelcome side effects, look at it as a way to evolve into your future.
“With menopause, there’s a time to embrace change. And a time to defy it.”
The trick is learning which to do when. For example, genetics play a role, and you can’t change that. Your mother’s symptoms play a role, and your race can too. African-American women are more at risk for hot flashes, according to the Penn study. However, obese white women also have a significantly higher risk of getting hot flashes. And weight loss, over which you do have some control, can make a difference in some cases.
Menopause is part of the natural life cycle. Six thousand women enter menopause every day. You’ll be one of those women at some point. You can’t defy nature.
This is a marathon, not a sprint, with symptoms sometimes lasting a decade or more. Prepare for it. Mindset, physical activity, and nutrition are all important. Research treatment options in traditional medicine and integrative modalities like acupuncture and yoga.
Embrace it and prepare yourself. If you focus on self-care early in your menopause journey, you can change the severity of symptoms and, although it might be easy, you can make menopause a positive journey.
No matter what stage of menopause you’re in, there’s help available. Be a healthcare rebel and your own advocate.While the focus of menopause is often on the potential and unwelcome side effects, use menopause and the years before and after as a time to invest in you. Shifting your perspective, so you also see it as an opportunity to focus on you and your happiness, can make all the difference. You have a lot of life to live. Give yourself the best shot!
What symptoms do you struggle with most?
As a physician, healthcare executive at a Fortune 100 company, and integrative health practitioner, Z. Colette Edwards, MD, MBA knows the unique value of a holistic, whole-person approach to health and well-being. She also understands the challenges health inequities can present. Known as “The Insight Doctor,” she offers guidance and powerful tools that prepare your body, mind, and spirit for menopause, stress, and inflammatory bowel disease. Lastly, Dr. Edwards coaches individuals in the development of self-advocacy and health system navigation skills.
The foregoing information, resources, links and/or references (collectively, the “Materials”) are provided solely for informational purposes and are not intended as medical or other professional advice. No representation or warranty of any kind is made in connection with the content of the Materials. The Materials may not be current and no one should take any action based on the Materials without first consulting their healthcare professional.