The most important things to know about menopause
This years' long transition can come with uncomfortable symptoms — but understanding what’s happening in your body and getting the right care can make all the difference.
File menopause under women’s experiences that no one really talks about, right next to periods and miscarriages. (You might have learned about hot flushes through pop culture osmosis, but that’s pretty much the extent of our collective education on the topic).
There's still a long way to go in dispelling the misconceptions, understanding the truly effective treatment options, and demystifying the rarely discussed aspects of this phase of life. Yet it’s important to talk about, since it will affect everyone with ovaries, and can impact our bodies in major ways.
What’s happening biologically during menopause?
The simple bio backstory: People assigned female at birth have a finite number of eggs, and once you run out, your body responds by reducing your production of estrogen. This then triggers a hormonal rollercoaster that impacts parts of a woman's body well beyond the reproductive system, since estrogen also helps us focus, keeps skin moisturised, and regulates metabolism, among many other roles. Eventually, the estrogen wind-down process ends and 12 months go by without having a period — which means a woman is considered to be in menopause. In the U.S., the average age for this is 51.
Common menopause symptoms
Since estrogen controls so many other functions in our bodies outside of our reproductive system, a drop in estrogen can cause symptoms including:
acne
dry, thin skin
facial hair growth
fatigue
higher blood pressure
higher cholesterol
hormonal weight gain, especially in the belly
hot flushes
increased risk of dementia
increased risk of heart disease
irritability and mood swings
loss of bone density
night sweats
pain with sex
trouble sleeping
vaginal dryness
How do I know if I’m in menopause?
If you’re not sure where you are in the transition, but you’re experiencing bothersome symptoms, such as these, talk with your doctor. Unfortunately, there’s not a single test that can reveal exactly where you are on the journey. Blood tests are thought to be unreliable since there are such major variations in hormones from day to day. “We could do the same test two days in a row and get completely different results,” says Dr. Stephanie Faubion, M.D., the director for the Centre for Women's Health at the Mayo Clinic, medical director for The Menopause Society, and member of the WeightWatchers Scientific Advisory Board.
What if I’m on birth control?
Being on hormonal birth control (including the ring, oral pills, or hormonal IUDs such as Mirena, or other IUDs) won't delay menopause. But your cycle isn’t going to be able to give you much information about where you are in the menopause process, and the hormones from birth control may stop symptoms. “You can’t use the marker of bleeding or not to tell if you are menopausal. All bets are off because of the hormonal manipulation,” says Faubion.
What are the stages of menopause?
The transition is less like a lightswitch instantly flicking on or off and more like a dimmer, since it can stretch over the course of years. You may also experience different issues at each stage. The stages include:
Premenopause. Also called “late reproductive stage,” this is when a woman has regular monthly periods (even if the cycle varies by up to seven days).
Perimenopause. This is the stage when the difference in your period cycle is greater than seven days or a period is completely missed.
Postmenopause. Once a woman hasn't had a period for 12 months, they're officially in menopause (also called postmenopause).
What are the treatments for menopause?
The goal with treatment isn’t to hold off going through menopause, but to address symptoms with treatments, with advice from your healthcare provider, that may help women feel better as their bodies adjust. Doctors can prescribe medication options that may vary depending on symptoms and stage. They include:
Birth control for pre- and perimenopause. A low-dose oral contraceptive pill can help with symptoms like hot flushes, or an IUD that has a progestin can help with heavy periods.
Menopause hormone therapy (MHT), more commonly known as hormone replacement therapy, for perimenopause and menopause. MHT is a common option for treating symptoms of menopause with estrogen and progesterone; it’s typically delivered through a stick-on patch.
Oral contraceptive pills and MHTs are two of several treatment options available for managing menopause symptoms. It is important to consult with a doctor to determine if medicines such as oral contraceptive pills, MHTs or other prescription medicines are appropriate for you.
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