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A woman’s reproductive system undergoes several changes over their lifetime, and their hormones undergo massive shifts each time.
With menopause, women go through a multi-stage transformation where each set brings unique changes, challenges, and considerations.
Join us as we discuss the stages of menopause and provide valuable insights into the symptoms and the best proper management strategies for each phase.
Understanding Menopause and Its Stages
What is Menopause?
For most, menopause starts between the ages of 45 and 55. However, it can begin much earlier.
Regardless of when it starts, menopause marks the end of a woman’s child-bearing years - after this year, they can no longer reproduce naturally. However, what most don’t know is that the onset of menopause can take years, and the post-menopause years are a separate journey altogether.
The Three Stages of Menopause
There are three main categories of menopause: perimenopause, menopause, and postmenopause.
Adult women in and near their golden years need to understand the different stages of menopause.
Perimenopause: The Transition Phase
Definition and Timeline
The changes to a woman’s body and mood happen before their menopausal years begin.
Perimenopause, sometimes called pre-menopause, typically happens up to five years before menopause, and it can last anywhere from a few months up to ten years. During perimenopause, a woman’s body starts producing less estrogen and progesterone.
As hormone levels drop, women will experience physical and emotional changes, such as:
Common Symptoms
Irregular Periods
Just how difficult the menstrual cycle becomes differs from woman to woman, but in general, perimenopause may have the following impact on a woman’s period:
- Longer or shorter cycles
- Heavier or lighter flow
- Skipped periods
- Spotting
Hot Flashes and Night Sweats
Hot flashes, or night sweats when they happen at night, are an intense warmth that’s usually felt on the face, neck, and chest.
During an attack, your skin will look as if you’re blushing. It can also cause intense sweating and rapid beating of your heart. Afterward, you might start feeling chilly as your body loses heat.
In North America, as many as 75% of perimenopausal women experience hot flashes.
Mood Swings
The fluctuating hormone levels significantly impact a woman’s mood as well.
The most common mood-related symptoms reported are:
- Mood swings
- Irritability
- Anxiety
- Brain fog
- Fatigue
- Depression
The sleep disturbances often caused by perimenopause can exacerbate these symptoms.
Hormonal Changes During Perimenopause
These are the hormones and shifts responsible for perimenopausal symptoms:
- Gradual decline of estrogen levels
- The body starts producing less progesterone
- Increased follicle-stimulating hormones (FSH) as the body attempts to stimulate egg production
Management Strategies
Lifestyle Adjustments
Perimenopausal symptoms may feel overwhelming to deal with, but there are lifestyle changes you can implement to help manage them better:
- Regular exercise
- Stress management
- Maintaining a consistent sleep schedule
- Dress in multiple relaxed and comfortable layers
- Avoid consuming too much alcohol, caffeine, and spicy foods
Dietary Changes
Feeding your body the right kind of nutrients and minerals can also help you fight off perimenopausal symptoms:
- Vitamin D and calcium for better bone health
- Add more phytoestrogen-rich foods into your diet
- Flax seeds
- Soybeans
- Dried fruits
- Sesame seeds
- Garlic
- Peaches
- Berries
- Tofu
- Broccoli
- Brussel sprouts
- Drink plenty of water and fluids
- Stay away from alcohol, sugar, and processed food
Medical Treatments
In severe cases, perimenopausal women may need professional help and medication.
For example, low-dose birth control pills can help regulate hormone levels, making the decrease more gradual instead of sudden. Antidepressants can also help combat hot flashes and night sweats. Finally, hormone therapy can help with symptoms like vaginal discomfort and dryness.
As menopause is a personal experience, healthcare experts will base their treatment on an individual’s health profile and symptoms.
Menopause: The Official Phase
Definition and Timeline
Officially, menopause happens when a woman hasn’t had a menstrual period for 12 consecutive months - the sign that their fertility and menstruation have ended. However, menopausal experience varies wildly amongst women. Some go through it with no symptoms, while others experience all of them, sometimes simultaneously!
Common Symptoms
During menopause, many perimenopause symptoms will continue and intensify, but it also brings new changes.
Cessation of Menstruation
Outside of pregnancy and certain medical conditions, the complete stop of menstruation, otherwise known as amenorrhea, is the first symptom of menopause.
Vaginal Dryness
Changes to the woman’s reproductive system come with the decline in estrogen levels.
Vaginal dryness can make intercourse feel more painful and uncomfortable, causing menopausal women to have intimacy problems in their marriage. In addition to this, vaginal dryness can increase one’s risk for urinary tract infections.
Sleep Disturbances
As night sweats become more frequent, menopausal women might find it more difficult to sleep at night, affecting their mood and overall disposition.
Hormonal Changes During Menopause
During menopause, the swings in hormonal levels become more drastic as estrogen production drops significantly while testosterone levels also decline.
This hormonal balance is the primary reason for the symptoms and health concerns linked with menopause.
Management Strategies
Hormone Replacement Therapy (HRT)
HRT is a proven treatment for menopausal symptoms. It’s particularly effective against symptoms like vaginal dryness and hot flashes. But it’s not a perfect solution. It carries certain risks.
Before considering HRT, you should discuss your current situation and goals with your healthcare provider.
Non-Hormonal Treatments
Non-hormonal alternatives exist for those who can’t or prefer not to use HRT for menopause:
- Gabapentin or clonidine for hot flashes and night sweats
- Topical vaginal creams, lubricants, and moisturizers for dryness
- Antidepressants or selective serotonin reuptake inhibitors (SSRIs) can treat hot flashes and night sweats
Lifestyle Adjustments
Continuing the lifestyle changes you’ve already made from perimenopause will have a similarly positive effect:
- Add weight-bearing and strength training to your exercise routine for better bone health and muscle health
- Practice good sleep hygiene
- Add more calcium-rich foods to your diet
- Minimize stressors and learn how to manage stress better
Postmenopause: Life After Menopause
Definition and Timeline
Whereas menopause starts when you’ve not had a menstrual cycle for twelve straight months, life after menopause, or postmenopause, only begins a year after menopause begins.
Now, estrogen, progesterone, and testosterone levels are at their lowest throughout your life.
Common Symptoms and Health Concerns
Bone Density Loss
The lower estrogen levels accelerate bone loss, affecting bone density and putting women at risk of osteoporosis and fractures.
During this time, women may experience frequent back pain and decreased height.
Cardiovascular Health
Lower estrogen levels increase the likelihood of cholesterol build-up on artery walls, increasing blood pressure and putting postmenopausal women at an increased risk of cardiovascular disease.
Other risk factors include the distribution of visceral fat, or belly fat, and heightened cholesterol levels.
Continued Hormonal Changes
Despite the more stable hormone levels, these symptoms will usually persist:
- Hot flashes and night sweats
- Vaginal dryness
- Loss of skin elasticity
- Thinning hair
Long-Term Health Management
Regular Health Screenings
Bone density scans, mammograms, colonoscopies, and cardiovascular risk assessments are important for postmenopausal women.
These regular health screenings can help catch osteoporosis, heart disease, and even ovarian cancer early to help you and your healthcare provider come up with an appropriate treatment plan.
Nutrition and Exercise
A healthy lifestyle takes precedence as you grow older. For menopausal women, it’s even more critical.
Estrogen deficiency affects muscle mass and strength, which you can offset by weight-bearing and strength-training exercises. Paired with a healthy diet with the right amount of calcium and vitamin D for bone health, you’ll reduce your risk for chronic diseases, even ones that aren’t related to menopause.
Managing Chronic Conditions
What makes menopause more challenging is managing other age-related conditions. For better management, work closely with your healthcare provider and closely monitor your blood pressure and cholesterol levels.
Comparative Overview of Symptoms
Perimenopause vs. Menopause vs. Postmenopause
Symptom Frequency
- Perimenopause: Symptoms can be irregular and unpredictable
- Menopause: Symptoms may be more consistent but often peak in intensity
- Postmenopause: Many symptoms decrease, but some may persist
Intensity of Symptoms
- Perimenopause: Symptoms can vary significantly in intensity
- Menopause: Often the peak of symptom intensity for many women
- Postmenopause: Symptoms generally decrease in intensity over time
Duration of Symptoms
- Perimenopause: Can last 4-8 years on average
- Menopause: Officially lasts 12 months (the time without a period)
- Postmenopause: Lasts for the remainder of a woman's life, with some symptoms potentially persisting for years
Emotional and Psychological Aspects
Coping with Mood Changes
The emotional rollercoaster associated with menopause is perhaps one of the more difficult symptoms to adjust to, but you can minimize its impact on your life by doing the following:
- Keep a symptom diary as an outlet for stress and to help you keep track of your mood swings
- Practicing mindfulness and meditation, as well as other stress-reduction techniques
- Consider cognitive-behavioral therapy to help you cope with anxiety and stress
Seeking Support and Counseling
This transitional period can feel isolating for postmenopausal women. Support groups and online communities like Reverse Health can feel incredibly empowering for women going through this period.
Couples going through a rough patch should seek individual or couples counseling to address current and prepare for upcoming changes to their relationship.
Finally, do seek help from your family and friends. Reach out to them and let them know how you’re feeling.
Maintaining Mental Well-being
Your mental health plays a crucial role as you go through menopause. But, as your responsibilities grow at this age, it can be difficult to achieve balance.
Here are ways you can prioritize your mental health during menopause:
- Find a new hobby that brings you joy and relaxation
- Maintain your existing social connections
- Build a new support network of likeminded women
- Look for ways to stimulate your mind
Addressing Common Concerns
Weight Gain and Metabolism
The hormonal changes during menopause slow metabolism, causing weight gain in women unprepared for these changes.
Here are some ways to avoid packing on the pounds during menopause:
- Add a healthy mix of fruits, vegetables, and lean proteins to your daily diet
- Focus on increasing the intensity of your physical activity, particularly during strength training
- Seek help from a nutritionist for personalized dietary advice
Sexual Health and Intimacy
Your sexual health will transform during menopause. You must be open to this with your partner to manage expectations. For vaginal dryness, you can use lubricants and moisturizers.
Pelvic floor exercises have also been shown to help with vaginal pain and urinary incontinence, or the inability to control your bladder.
Sleep Quality and Insomnia
You can do the following to guarantee a good night’s sleep:
- Stick to a consistent sleep schedule
- Keep your sleeping environment calm, clean, and quiet
- Avoid alcohol and caffeine during the evening
- Invest in a quality mattress
Expert Advice and Resources
Consulting with Healthcare Providers
Schedule regular check-ups with your primary healthcare provider to discuss your symptoms and concerns and to stay on top of potential complications with regular health screens.
For complicated issues, ask for a referral to a menopause specialist for specialized help.
Recommended Reading and Websites
Finding sources of reliable information can help women navigate this life-changing moment.
The North American Menopause Society, the Canadian Menopause Society, the British Menopause Society, and the International Menopause Society are excellent resources for menopause information.
Joining Support Groups and Communities
Reverse Health, the first women's-only 12-week weight loss program focusing on female physiology, can help make the journey easier by providing all the information you need at this moment in your life.
You can start here the reverse.health quiz.
Also you can seek local menopause support groups and other online forums dedicated to women’s health.
Don’t forget to look up workshops and seminars on menopause and women’s wellness in and around your area.
Conclusion
Because there are multiple stages of menopause, the entire process can take decades to complete.
The good news? You should celebrate every moment. While menopause comes with certain risks and complications, it also means you’re moving on to the next stage of your life.
By following a healthy diet, exercising regularly, and modifying your lifestyle to suit your current status best, you’ll thrive in every menopause stage as you move on to a new chapter.
FAQs
How do you know what stage of menopause you are in?
To determine what stage of menopause you are in, it is important to monitor your symptoms and menstrual cycle. Perimenopause is characterized by irregular periods, hot flashes, and mood swings and can begin several years before menopause. Menopause is diagnosed after you have gone 12 consecutive months without a menstrual period. Postmenopause begins after this point, with symptoms such as hot flashes and vaginal dryness potentially continuing. Consulting with a healthcare provider can provide clarity through symptom discussion and possibly hormone level tests.
What is the biggest symptom of menopause?
The most commonly reported and noticeable symptom of menopause is hot flashes. These are sudden feelings of intense heat, often accompanied by sweating and a rapid heartbeat, which can last from a few seconds to several minutes. Hot flashes can occur during the day or as night sweats during sleep, significantly impacting quality of life.
At what stage is menopause the worst?
Many women find perimenopause to be the most challenging stage because symptoms like hot flashes, night sweats, mood swings, and irregular periods can be intense and unpredictable. The body is undergoing significant hormonal changes during this transition, making symptoms more pronounced. For some women, symptoms peak in intensity during this phase.
What to do during the menopausal stage?
During menopause, managing symptoms and maintaining overall health can be achieved through several strategies:
- Lifestyle Adjustments: Regular exercise, stress management techniques, and maintaining a consistent sleep schedule can help.
- Dietary Changes: Eating a balanced diet rich in fruits, vegetables, whole grains, and lean proteins while staying hydrated is crucial.
- Medical Treatments: Hormone Replacement Therapy (HRT) and other medications can alleviate symptoms. Consult with your healthcare provider for personalized advice.
- Support Systems: Joining support groups and seeking counseling can provide emotional support and practical advice.
What should you not do during menopause?
During menopause, there are certain practices to avoid to help manage symptoms and maintain health:
- Avoid Excessive Alcohol and Caffeine: These can exacerbate hot flashes and disrupt sleep.
- Limit Processed and Sugary Foods: These can contribute to weight gain and negatively impact mood.
- Avoid Smoking: Smoking can increase the severity of menopausal symptoms and elevate the risk of cardiovascular diseases and osteoporosis.
- Don't Ignore Symptoms: Dismissing symptoms can lead to unmanaged discomfort and health issues. Seek medical advice for effective management strategies.
- Refrain from Sedentary Lifestyle: Regular physical activity is essential for maintaining bone density, muscle mass, and overall health.
