Here are the top six symptoms women experience during the menopausal transition:

  1. Irregular periods – every woman will experience these as their bodies shift from the reproductive years (with regular periods) into menopause (with no periods). 
  2. Hot flashes and night sweats – 75% of women will experience hot flashes, usually for less than 2 years.  Hot flashes feel like a strong wave of heat travelling through the upper body and face.  When hot flashes happen at night while you are sleeping, they are called night sweats. 
  3. Insomnia and sleep difficulties – Up to 60% of women experience difficulty sleeping during the menopausal transition, including trouble falling asleep, staying asleep, and having a poor quality of sleep. Sleep problems often result from other menopausal transition symptoms, especially night sweats.
  4. Vaginal dryness – Up to 35% of women will experience vaginal dryness. This can be painful, especially during intercourse, but there are solutions.
  5. Bladder issues – Over 50% of women will experience problems with their bladders starting in the menopausal transition. Leaking urine (when you exercise or sneeze) and urinary urgency (when you can’t hold your pee) are the most frequent urinary issues. 
  6. Mood changes and mood swings – About 50% of women in the menopausal transition will experience sudden, random mood swings. You may find yourself bouncing between feeling wonderful, tearful, angry, sad, or irritable, all because of changing hormone levels. 

Visit Herstasis.com to learn more about these symptoms and how to manage them successfully. 

MYTH

Osteoporosis is a biological process of bone density loss and increased bone breakage. It is part of the natural aging process for both men and women. Strong bones depend on many factors including your genetics, how you grew during puberty, exercise levels, your diet, smoking, and alcohol consumption. Your bones are at peak strength and density around age 30.

HT including estrogen is very effective at supporting bone density and strength, especially when combined with a healthy lifestyle. As well, strength training such as weight lifting or even standing instead of sitting, plus a good diet including calcium and vitamin D3 can help maintain bone strength.

Mid-life sees many hormone changes. Those plus decreased physical activity can contribute to osteoporosis, which can affect you in your early 50’s, causing low-impact bone breaks.

You might be in menopause if you have any of the following symptoms: irregular periods, hot flashes, night sweats, sleep problems, vaginal dryness, or mood changes (and there are more). These symptoms can occur gradually or suddenly. If you think you might be in menopause, talk to your practitioner.

More on symptoms of the menopause transition

It’s a question that many women ask as they approach middle age.

Once a woman has gone 12 months without having a period, she is considered to be in menopause.

Perimenopause is the transition time before a woman is in menopause and in general begins in their mid 40s or 50s.

Perimenopause is the transition period leading up to menopause. It’s different for every woman, but usually starts in her 40s. For some women, perimenopause lasts a few years; for others, it can last up to 10 years. The symptoms of perimenopause are caused by changes in hormone levels. These changes can cause hot flashes, trouble sleeping, mood swings, and weight gain.

Menopause is the biological process, not a medical condition, that marks the end of a woman’s reproductive years. It’s diagnosed after 12 months without a menstrual period and can be confirmed with blood tests.

If you’re one of the many women experiencing symptoms of menopause, you may be wondering what relief is available. While there is no cure for menopause, there are treatments that can help relieve your symptoms.

Though these symptoms can be uncomfortable, there are solutions available. Some women find relief with over-the-counter treatments like lubricants and moisturizers. Some may need to consult with their doctor to discuss hormone therapy. Others find relief with nutritional therapy, movement therapy and mind body wellness therapy.

Menopause is a natural biological process that marks the end of a woman’s reproductive years. While most women experience menopause in their early 50s, the symptoms can last for years. For some women, menopause is a time of great transition and they feel completely comfortable with the changes. Others find the symptoms to be disruptive and long-lasting. The good news is that there are treatments available to help manage menopause symptoms.

Symptoms associated with the transition into menopause become noticeable in your mid-40s. This is typical, but some women start to experience symptoms in their 30s, while other women start noticing them in their 50s.  

The menopausal transition lasts, on average, for 7 years, but can last up to 14 years. Some women experience only one or two symptoms, while other women experience many. Not all symptoms happen at the same time, and not all symptoms will last for the entire time.

Menopause is different than perimenopause.  When you have not had a period for one full year (12 months), you have officially entered menopause.

The stage just before menopause has several names – perimenopause, the menopausal transition, or simply ‘the change’. When it starts and how long it lasts vary from woman to woman. During this transitional stage, your hormones begin to fluctuate, sometimes wildly.

The most common symptoms of perimenopause are hot flashes &  night sweats, anxiety, cognitive changes, metabolism & weight changes, mood changes & rage and insomnia & sleeping difficulties.

Learn more

There are dozens of changes and symptoms associated with menopause found in five major categories:

  1. Vasomotor [Temperature]
  2. Urogenital [Vagina and Urinary Tract]
  3. Psychological [Mental Health]
  4. Somo-Vegetative [Body]
  5. Somo-Vegatative [Head]

Some of these are temporary whereas others can be permanent. Individual women often experience a range of symptoms from each category, varying from hot flashes and night sweats to anxiety and mood swings. Clinicians pair information about a woman’s symptoms with the date of the last menstrual period to determine whether a woman is likely to be in perimenopause, also known as the menopause transition.

Learn more

MYSTERY  

Obesity research is starting to find some of these answers, but frustratingly at the moment it remains a mystery.

MYSTERY

While the obvious answer is found in gender, age and racial inequity, the study of mid-life women’s sexual and reproductive health has historically been less profitable than studying fertility. Thankfully the “menopause market” is on the rise, which will hopefully drive more dollars into the evidence-based scientific research that is so badly needed to develop more safe, effective and personalized treatments for menopausal women.

MYSTERY

Research supports the fact there is a gender difference in the way pain systems function. Studies have found that there is a higher density of nerves in women that may cause a greater sensitivity to pain. The pain itself may be at a similar level but the perception of pain is different, with women perceiving more pain than men for similar stimuli. [12]

A fascinating study on pain and sex hormones looked at a unique study group – individuals undergoing sex-change procedures. One research trial showed that 30% of men who started taking female hormones began experiencing chronic pain during their treatment. When women started taking testosterone as part of their sex-change transition, more than half reported a reduction in their chronic pain. [8] The underlying processes around how sex hormones impact pain tolerance are poorly understood at the moment. Researchers propose that testosterone somehow reduces or blocks the pain signaling pathways in the central nervous system. Conversely, estrogen reverses this and stops any blockage of pain signals so pain sensitivity appears to increase. [8] 

FALSE

Birth control pills are often used to manage menstrual blood flow and are commonly prescribed for heavy bleeding. Older versions of birth control pills did have high doses of estrogen, which increased the risk of blood clots in women over 35, however today’s birth control pills use much lower doses of estrogen and do not carry the same risks. In fact, today’s birth control pills are known to have benefits that include a lower risk of ovarian and endometrial cancer. Birth control pills are not recommended for women over 35 who smoke, have high blood pressure, or have a history of heart disease.

FALSE

Depression and anxiety have complex root causes and can happen to any person, old or young, rich or poor, large and small. From the outside, you may seem to have “all you need” and still be depressed or anxious. You may also have seemingly little, and have a high quality of life with balanced moods.

FALSE

Nope, this won’t work and is a terrible idea! Once your immune system is sensitized to an allergen, you will keep having allergic reactions when you are exposed to that allergen. Allergy shots, or immunotherapy, do desensitize you to allergens, but this must be done under the care of an allergy specialist who will control the quantity, quality and time intervals of these shots. Talk to your healthcare provider for information if you think this may be an approach you are interested in. 

FALSE

Developing allergies in adulthood is relatively common, and in fact nearly half of adults with food allergies had those allergies start in adulthood. While it is very common for adult-onset allergies to happen in your 20s and 30s, perimenopause is a time when many women start to suffer new allergies or have increasingly problematic symptoms to existing allergies. This is caused by the interactions of estrogen and progesterone with the immune system, because estrogen and progesterone bind to the parts of the immune system that trigger allergic reactions.

FALSE

Heavy smokers and drinkers, and women with nutrient deficiencies may experience hot flashes.

MYSTERY

Medical research isn’t clear on how hot flashes are triggered, but unstable and decreasing estrogen levels, plus the chemical messages of inflammation, may upset the body’s “thermostat” in the brain.

No. There is a great deal of variability in the types and severity of symptoms. Genetics may play a role, so if possible, looking at your family history can help set your expectations for your own symptoms.

1. Dennerstein L, Dudley EC, Hopper JL, et al. A prospective population-based study of menopausal symptoms. Obstet Gynecol. 2000; 96:351–358. [PubMed: 10960625]

 

Menopause is recognized to have happened after one year (12 months) without a period. You can also ask your healthcare provider to measure the blood levels of Follicle Stimulating Hormone (FSH) that rise during perimenopause and stay elevated during menopause.

1.http://www.menopause.org 2. Melmed et al.Williams Textbook of Endocrinology 14 th edition.

 

Genetic factors play a role in the timing of this transition, so if you are able, look to your family history to set expectations. Lifestyle quality and your general health will also contribute to the timing. However, there is a great deal of variability amongst women so it is impossible to predict with complete accuracy.

Make sure you have a supportive and knowledgeable healthcare provider who will give you annual health screenings who is pro- active about your concerns. Physiotherapists, psychologists, trained counselors, and nutrition experts can also help you manage your physical and emotional symptoms. http://www.menopause.org is a website that can help you connect with well- trained experts in perimenopause symptoms.

1. http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocrinology 14 th edition.

3. Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

5. Dasai and Brinton_2019 Autoimmune disease in women: endocrine transition and disease across lifespan

 

Like other stages of life, eating a balanced nutritious diet, getting adequate high quality sleep, exercising regularly and maintaining a healthy body weight are key elements to good health. As well, share your experiences with family, friends and co-workers – not only does this normalize what you are experiencing and keep you from being isolated and alone, it will give your support system the information they need to assist you. Keep track of your symptoms and share these with your health care team. Take action where you can and stay positive.

1. http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocriology 14 th edition.

3. Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

5. Dasai and Brinton_2019 Autoimmune disease in women: endocrine transition and disease across lifespan

 

For most women, transition symptoms will likely fade away within one or two years of menopause. You might also still experience insomnia, memory challenges and depression. Every woman is a little different.

1. http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocrinology 14 th edition.

3. Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

5. Dasai and Brinton_2019 Autoimmune disease in women: endocrine transition and disease across lifespan

Some women gain adipose (fat tissue) around the middle even though there is no change in diet or lifestyle. You may experience bloating in your digestive system. If you have an autoimmune disease, it may become harder to manage. Migraines, depression and breakthrough bleeding are also associated with perimenopause.

1. http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocrinology 14 th edition.

3. Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

5. Minkin_2019_Hormones, Lifestyle, and Optimizing Aging

 

Many women experience hot flashes, which are sudden surges of blood rushing to the surface of your face and torso. Other common symptoms include vaginal dryness, stress urinary incontinence (release of urine when you lift or sneeze), deep fatigue, insomnia, rapid mood swings and temporary forgetfulness.

1.http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocrinology 14 th edition.

3.Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

 

Your body enters into the late reproductive stage when it begins phasing out reproduction around age 35- 40. It may be harder to get pregnant at this stage of life. You may also experience an early or “premature” perimenopause at this time.

1.http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocrinology 14 th edition.

3.Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

5. Minkin_2019_Hormones, Lifestyle, and Optimizing Aging

 

Your reproductive hormones are the main hormones changing their levels. These include estrogen and progesterone (from your ovaries), and luteinizing hormone (LH) and follicle stimulating hormone (FSH) from your hypothalamus located in your brain. During perimenopause, estrogen levels decrease overall, but might vary between very high or very low levels. These hormonal swings may account for mood disturbances (mood swings) and hot flashes.

1.http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocrinology 14th edition.

3.Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

5. Minkin_2019_Hormones, Lifestyle, and Optimizing Aging

 

Perimenopause, or the menopause transition, is a gradual, natural transition in your reproductive system that leads to menopause. It usually happens over 7-10 years and often starts around the age of 40. During perimenopause you will experience shorter and more irregular periods. The majority of women experience some troubling physical and mental symptoms.

1.http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocrinology 14 th edition.

3.Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

5. Minkin_2019_Hormones, Lifestyle, and Optimizing Aging

 

Menopause is the day you have the last period of your life, which marks the release of your last ovarian follicle. Most of the troublesome experiences happen earlier during the perimenopause transition.

1.http://www.menopause.org

2. Melmed et al.Williams Textbook of Endocrinology 14 th edition.

3.Santoro_2016_Perimenopause: From Research to Practice

4. Allshouse et al._2018_Menstrual cycle hormone changes associated with reproductive aging and how they may relate to symptoms

5. Minkin_2019_Hormones, Lifestyle, and Optimizing Aging

 

Regular cannabis use by mid- life women in North America is fairly new and there is not much data on the safety and effectiveness of cannabis with respect to menopausal symptoms. Make sure your care provider knows about your cannabis consumption, particularly if you are using prescription medications.

You should request a bone density exam by age 65 in order to test for osteoporosis (fragile bones). If you are at risk for low- impact fractures (because of family history) or you have had a low- impact fracture, request this exam by age 50. Low impact fractures commonly occur from falls and result in breaking a wrist or fracturing a vertebrae or hip bone). These types of fractures indicate you may be developing osteoporosis. Losing height by 1.5 inches or more also suggests that you may have some osteoporosis in your spine.

Women who are low-normal or below normal weight, who smoke, drink alcohol, and have low rates of exercise are at higher risk for osteoporosis in post- menopausal life.

 

This isn’t necessarily due to menopause! During the aging process, the lens of your eye undergoes natural changes that may make it harder to adjust your focus. However, decreasing estrogen in your blood can disrupt tear and oil secretions needed for lubricating your eyes, which can make vision blurry or dry your eyes. Your optometrist or your pharmacist can help with therapies for these symptoms.

It is suggested that women see a healthcare provider specifically about menopausal transition when you start to notice that your periods are getting irregular or you start to experience symptoms.

 

Natural menopause happens when your ovaries develop and release their last follicle and egg and stop producing estrogen. Medically induced, or treatment induced, menopause happens when there is surgical removal of both ovaries (oophorectomy). Medical menopause occurs also when a severe medical issue like breast or uterine cancer has been treated or managed with chemotherapy, radiation therapy, and/or hormonal therapy.

A hysterectomy, which is the removal of the uterus, does not necessarily mean menopause – it depends if one or both ovaries were removed at the same time. However, women who undergo a hysterectomy to treat fibroids or excessive bleeding have a nearly two-fold increased risk for developing menopause early.

 

Yes! Until you have had 12 consecutive months without a period, use contraception if you don’t intend to get pregnant.

Note that women who become pregnant after age 35 have an higher risk of miscarriage, and more than half of all pregnancies after age 45 end in miscarriage.

American Society for Reproductive Medicine

 

This life stage usually lasts 7- 10 years. If you have a high BMI, you may have a longer Menopausal transition.

No, about 20% of women have mild or no symptoms, or don’t seek medical care. About 40% of women have mild to moderate symptoms and seek medical care. Another 20 % have intense symptoms and need medical care.

Generally, women who have a high BMI and chronic stress in their lives tend to have more menopausal symptoms and those symptoms last for longer periods of time. Genetics may also impact your perimenopausal symptoms. There is a good correlation between the length and intensity of your menopausal transition and your mother’s menopausal transition.

 

No! Menopause is the life stage after the reproductive years. It is marked by the end of a woman’s menstrual cycles and is recognized when a woman hasn’t had a period for 12 months.

No! Perimenopause, also known as the menopause transition, is not a disease or a hormone deficiency disorder. All women go through this transition phase later in life (although the timing of onset does vary) and many have similar symptoms.

With medical support and the appropriate treatments many unpleasant and quality of life-impacting ‘symptoms’ can be managed. Talk to your health care provider if you are bothered by the changes you are experiencing.