What is menopause?
Simply put, menopause occurs when a person stops having a menstrual cycle. While it is often associated with aging, Dr. Linus Chuang, M.D., MPH, MS, FACOG, FASCO, clinical professor and network chair for the Department of Obstetrics and Gynecology at Nuvance Health, notes that it can actually occur at any age, as a result of hormonal imbalance that cause the ovaries to produce less estrogen. The U.S. National Library of Medicine notes that menopause most frequently occurs after the age of 45. Menopause is made up of three stages, all of which can be included in the term. Women commonly use the term menopause to describe perimenopause, menopause, and post-menopause, for which all three stages are a part of the menopause transition,” explains Dr. Tara K. Iyer, M.D., senior clinical fellow in specialized women’s health at Cleveland Clinic. Menopause is not a disease or diagnosis, but a natural-occurring bodily process that manifests with symptoms. A woman is expected to be in menopause when she has gone 12 months without menstrual bleeding.” Most often when we think of menopause, we are thinking of the earliest stages, known as perimenopause. According to Dr. Kelly Culwell, M.D.—known professionally as “Dr. Lady Doctor”—a board-certified OB-GYN and a previous medical officer for the World Health Organization in Geneva, Switzerland, perimenopause is the time leading up to menopause and can begin as early as ten years before actual menopause occurs. This is where you’ll see the earliest signs and symptoms, including the hot flashes and mood changes that menopause is known for.
What are the common signs and symptoms of menopause?
People can expect both physical and emotional symptoms of menopause, with the earliest beginning to occur during the perimenopausal period. According to Dr. Culwell, physical signs and symptoms of menopause—that begin during perimenopause—include:
Hot flashes Night sweats Weight gain (especially around the belly) Mood changes/irritability, dry skinVaginal dryness/pain with intercourseDifficulty sleeping
Dr. Chuang adds that it is not uncommon to experience irregular periods in the time leading up to losing the period completely as estrogen levels begin to reduce. “When women start having menopause, they may have premenstrual symptoms such as cramping and heavy bleeding,” he adds. “Headaches are reported to be more common in menopausal women. Some women may suffer from depression-related symptoms during or before the month of their last menstrual periods.” According to Dr. Culwell, emotional changes that occur during the early stages of menopause include:
IrritabilityDepression or difficulty with concentrationExacerbated emotional impacts due to lack of sleep
Are there any complications of menopause?
Not every person will experience complications due to menopause, but according to Dr. Chuang, the lack of estrogen can lead to complications including:
Bone loss or osteoporosisCardiovascular diseaseVulvovaginal atrophyPainful intercourse Urinary incontinence Behavioral and mood changes CataractsMetabolic changes
Dr. Iyer adds that besides these physiological complications, menopause may also negatively affect a person’s relationships and career. This can often be the result of the common symptoms of menopause. “Hot flashes, mood and sleep disturbances, and ‘brain fog’ (difficulties with memory and concentration) may affect a woman’s ability to work, which may have a downstream career, and thus, financial consequences,” explains Dr. Iyer. “The sexual dysfunction, mood changes and self-esteem/body image changes many women experience with menopause may also adversely impact romantic relationships for both women and their partners.”
Are there treatment options for menopause?
Because menopause is a natural process, there is no “cure” for the process as a whole; however, many negative symptoms and complications can be treated. Should you be experiencing what you believe to be perimenopause, it can be helpful to see a doctor to go over what to expect and have a care plan in place should your daily life become negatively affected by menopause. “Treatments include hormonal treatment—with estrogen and/or progesterone—that can be taken orally, via a patch or gel or vaginally depending on your preference and your symptoms,” explains Dr. Culwell. “There are non-hormonal treatments for many of the symptoms, including antidepressants, which can help with mood changes or sleep problems, or vaginal moisturizers for vaginal dryness. There are also alternative or complementary treatments that can also be helpful including acupuncture, meditation, exercise and nutritional changes.” Complementary treatments often work to keep your general health intact, but things such as the exercise and nutritional changes that Culwell mentions have a greater purpose: injury prevention. As menopause can result in low bone density, preventing injury is often a priority and can be remedied by movement and exercise. “A big myth is that since menopause leads to lower bone density and muscle atrophy due to lack of estrogen, there is not much women can do to reduce injury to the body,” acknowledges Dr. Michelle Andoy, PT, DPT, an Austin-based physical therapist at ResilientRx. “However, women can do a lot in reducing risk for injury. Resistance training naturally stimulates bone growth and helps prevent osteoporosis. Also, eating foods rich in protein, vitamin D, and calcium are beneficial for building stronger bones and muscles.”
Can you prepare your body for menopause?
There is no formula to determine when menopause will occur. However, Dr. Tiffany Cochran, M.D., senior clinical fellow in specialized women’s health at Cleveland Clinic, notes that there are some factors that can influence when it occurs, including:
Race/ethnicitySocioeconomic statusGenetics History of medically-treated depression or seizure disorderHistory of chemotherapy or pelvic radiationHistory of gynecologic surgery
While you can’t stop menopause from happening, the complementary treatments prescribed can actually be used to help prepare for the onset of menopause. Not only is bone density affected, but Dr. Andoy adds that muscle atrophy and changes in metabolism are also possible in terms of bodily changes. “Woman can prepare for the effects of menopause by getting more movement and exercise— with emphasis on resistance training/ weight training to stimulate bone and muscle growth—consuming nutrient-dense foods, practicing meditation and mindfulness to manage stress, using lubricant during sex, consulting with a menopause specialist/doctor if hormone therapies or estrogen creams are a good fit for you to combat symptoms, and seeking help from a physical therapist to improve mobility, strength and function,” adds Dr. Andoy. While we can’t pinpoint exactly when menopause is going to happen, we know that it will. Taking these steps early can help alleviate some of the common symptoms and help strengthen your whole body. Dr. Andoy adds that the body relies on hormones—such as estrogen—to strengthen systems such as the bones and brain, so focusing on whole health early on is ideal.
When should you see a doctor about menopause?
If you want to verify that you are in fact experiencing menopause, it is advisable to seek care of a doctor. Otherwise, Dr. Chuang stresses that should you experience symptoms that affect your daily life—emotionally, physically or mentally—you should see a doctor. Next up, check out this list of resources we have compiled that get real about menopause.
Sources
Dr. Kelly Culwell, MD—known professionally as “Dr. Lady Doctor”—a board-certified OB-GYN and a previous medical officer for the World Health Organization in Geneva, SwitzerlandDr. Linus Chuang, M.D., MPH, MS, FACOG, FASCO, clinical professor and network chair for the Department of Obstetrics and Gynecology at Nuvance HealthMedlinePlus, U.S. National Library of Medicine, “Menopause.”Dr. Michelle Andoy, PT, DPT, an Austin-based physical therapist at ResilientRxDr. Tara K. Iyer, M.D., senior clinical fellow in specialized women’s health at Cleveland ClinicDr. Tiffany Cochran, M.D., senior clinical fellow in specialized women’s health at Cleveland Clinic
