What to expect during menopause

What happens when a woman goes through menopause?

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What happens when a woman goes through menopause?

The traditional changes we think of as “menopause” happen when the ovaries no longer produce high levels of hormones. The ovaries are the reproductive glands that store eggs and release them into the fallopian tubes. They also produce the female hormones estrogen and progesterone as well as testosterone. Together, estrogen and progesterone control menstruation. Estrogen also influences how the body uses calcium and maintains cholesterol levels in the blood.

What to expect during menopause

Menopause usually starts between the ages of 40 and 58 years in developed countries, where the average age is 51 years. For some, it will occur earlier due to a medical condition or treatment, such as the removal of the ovaries.

Around the time of menopause, many females experience physical symptoms such as hot flashes, night sweats, vaginal dryness, and a reduced sex drive. It can also lead to anxiety, changes in mood, and a reduced sex drive.

These symptoms may start before menstruation ends, and they can last for several years. The impact on a person’s quality of life can range from mild to severe. However, there are ways of managing these symptoms.

Each person will experience menopause differently. Many have full, active lives throughout the transition and afterward, and some feel relieved by no longer having to deal with menstruation or birth control.

Maintaining a healthful diet and getting regular exercise can help a person feel better and boost their overall health in the long term. For those who experience menopause symptoms, treatments and support are available.

What is menopause?

Menopause is the stage of life that follows the end of the menstrual cycles. Each person may experience menopause differently.

It can last for several years, and there are three stages:

Perimenopause is the transitional time that starts before menopause and includes the 12 months that follow a person’s last period.

Menopause starts either 12 months after the last period or when menstruation has stopped for a clinical reason, such as the removal of the ovaries.

Postmen pause refers to the years after menopause, although it can be difficult to know when menopause finished and postmen pause starts.

Signs and symptoms

Around menopause, various physical and mental changes can occur, causing symptoms. Some of these start before menopause, and some continue after it.

The changes involved in perimenopause and menopause include:

Lower fertility

As a female approaches the end of the reproductive stage, but before menopause begins, estrogen levels start to fall. This reduces the chances of becoming pregnant.

Irregular menstruation

The first sign that menopause is approaching is usually periods occurring less regularly. They may come more or less frequently than usual, and they may be heavier or lighter.

Anyone who has concerns about menstrual changes should see a doctor, as these changes can also indicate pregnancy or some health issues.

Vaginal dryness and discomfort

Vaginal dryness, itching, and discomfort may start during perimenopause and continue into menopause. A person with any of these symptoms may experience chafing and discomfort during vaginal sex. Also, if the skin breaks, this can increase the risk of infection.

Atrophic vaginitis, which involves thinning, drying, and inflammation of the vaginal wall, can sometimes occur during menopause.

Various moisturizers, lubricants, and medications can relieve vaginal dryness and associated issues.

Hot flashes

Hot flashes are common around the time of menopause. They cause a person to feel a sudden sensation of heat in the upper body. The sensation may start in the face, neck, or chest and progress upward or downward.

A hot flash can also cause:

  • sweating
  • red patches to form on the skin

Some people experience night sweats and cold flashes, or chills, in addition to or instead of hot flashes.

Hot flashes usually occur in the first year after menstruation ends, but they can continue for up to 14 years after menopause.

What does a hot flash feel like? Find out here.

Sleep disturbances

Sleep problems can arise during menopause, and they may stem from:

  • anxiety
  • night sweats
  • an increased need to urinate

Getting plenty of exercise and avoiding heavy meals before bedtime can help with managing these issues, but if they persist, contact a healthcare provider.

Click here for some tips on how to get better sleep.

Emotional changes

Depression, anxiety, and low mood are common during menopause. It is not unusual to experience times of irritability and crying spells.

Hormonal changes and sleep disturbances can contribute to these issues. Also, a person’s feelings about menopause may come into play. For example, distress about low libido or the end of fertility can contribute to depression during menopause.

While feelings of sadness, irritability, and tiredness are common during menopause, they do not necessarily indicate depression. However, anyone who experiences a low mood for 2 weeks or longer should see a doctor, who will be able to advise about the best course of action.

Trouble focusing and learning

In the lead-up to menopause two-thirds of women may have difficulty with concentration and memory.

Keeping physically and mentally active, following a healthful diet, and maintaining an active social life can help with these issues. For example, some people benefit from finding a new hobby or joining a club or a local activity.

Physical changes

Various physical changes can develop around the time of menopause.

People may experience:

  • a buildup of fat around the abdomen
  • weight gain
  • changes in hair color, texture, and volume
  • breast reduction and tenderness
  • urinary incontinence

However, the link between these changes and menopause is not always clear. Some may occur independently at the same time as the transition, and age and lifestyle can also play a role.

Increased risk of some health conditions

After menopause, the risk of certain health issues appears to increase. Menopause does not cause these conditions, but the hormonal changes involved may play some role.

osteoporosis: This is a long-term condition in which bone strength and density decrease. A doctor may recommend taking vitamin D supplements and eating more calcium-rich foods to maintain bone strength.

Find out more about osteoporosis treatments.

Cardiovascular disease: The American Heart Association (AHA) note that, while a decline in estrogen due to menopause may increase the risk of cardiovascular disease, taking hormone therapy will not reduce this risk.

Breast cancer: Some types of breast cancer are more likely to develop after menopause. Menopause does not cause Trusted Source breast cancer, but hormonal changes involved appear to increase the risk.

LGBTQIA+ and menopause

Most information about menopause describes the experiences of cisgender, heterosexual women. However, menopause can affect anyone who is born with ovaries.

A person who transitions to male but who retains their ovaries may experience menopause when their ovaries stop producing eggs.

If a person starts taking supplementary testosterone as part of their transition, they may experience menopause symptoms then. Also, menopause symptoms can develop when a person undergoes surgery to remove their ovaries.

When transitioning involves any of these experiences, the symptoms of menopause will be the same as those of cisgender women.

However, transgender people can face additional difficulties, depending on the attitude of their medical team. It is essential that transgender people have access to healthcare providers who understand their needs and can address them effectively.

Treatment

Menopause is not a health problem but a natural transition. However, it can involve unwanted physical and mental changes.

Anyone who has concerns about these changes should seek medical advice. A doctor may recommend one or more of the following:

Hormone therapy

This treatment helps balance the body’s hormone levels by providing supplemental estrogen and a synthetic version of the hormone progesterone.

Hormone therapy comes in various forms, including skin patches and topical creams. It can help reduce the occurrence of hot flashes and other menopause symptoms.

However, using it may increase the risk of developing certain diseases and health conditions.

A person should not use hormone therapy if they have risk factors for the following health problems, or if they have a personal or family history of these issues:

  • heart disease
  • blood clots
  • high levels of triglycerides in the blood
  • gallbladder disease
  • liver disease
  • stroke
  • breast cancer

It is important to discuss the possible benefits and risks of hormone therapy with a doctor before deciding to use it.

Other treatments

A person may find that the following can also help relieve symptoms:

  • over-the-counter gels and other products for vaginal dryness
  • prescription pills, creams, and rings for vaginal dryness
  • low-dose hormonal birth control pills for hot flashes, vaginal dryness, and mood changes
  • low-dose antidepressants for hot flashes, even among people who do not have depression

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