Women’s bodies go through an immense number of changes. From puberty to childbirth to perimenopause, hormones are constantly in flux, and things can feel unpredictable as your body adjusts to each new phase of life. But when you do reach “the change” — menopause — the potential symptoms can alter your life in ways you might not expect.
Menopause is a natural part of aging, and while you may feel out of control as new symptoms emerge, there are effective ways to manage them. If you’re already experiencing signs of menopause or perimenopause, now’s the time to take control and learn how to thrive during this transition.
We spoke with Dr. Karen Tang, a board-certified gynecologist, to answer common questions about menopause, including things your doctor might not tell you.
What is menopause?
“Menopause is when you go 12 months consecutively without a period, which means without the use of medications, like birth control, that prevent your period from coming each month,” Tang tells Yahoo. If your body has gone a year on its own without a cycle, you’ve likely fully transitioned into menopause.
Menopause isn’t something that happens overnight. Going 12 months without a cycle may take a long time, with perimenopause — the body’s transition into menopause — often lasting between two to eight years. Once your body has fully transitioned, you’ll no longer ovulate and will be unable to get pregnant.
Menopause can also be medically induced by a hysterectomy or surgical removal of the ovaries, according to the National Institute on Aging. “If you have surgery to remove your uterus or ovaries and are not taking hormones, you will experience symptoms of menopause immediately,” it advises.
The 3 stages of menopause
Menopause can be broken down into three stages, though Tang notes that menopause and perimenopause are typically grouped together.
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Perimenopause: Symptoms like hot flashes and mood swings start as you gradually move toward menopause. Periods often become irregular.
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Menopause: You’ve officially reached menopause once you’ve gone a full year without having a period.
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Postmenopause: You’ll stay in postmenopause for the rest of your life, and it’s frequently accompanied by additional symptoms.
When does menopause start and how long does it last?
You can start transitioning into menopause several years before you actually reach it, a stage known as perimenopause. This transition is different for everyone: For instance, you may start experiencing perimenopausal symptoms at age 42, while your best friend doesn’t have any symptoms until 47.
On average, women reach perimenopause in their mid-to-late 40s, according to the Office on Women’s Health, part of the U.S. Department of Health & Human Services. Perimenopause might last anywhere from two to eight years, but on average, it lasts about four years. Menopause itself is not a stage you remain in for a defined time frame, according to the Cleveland Clinic — it’s simply the point at which you’ve gone a year without your period.
How can you tell the difference between menopause and perimenopause?
People often confuse menopause with perimenopause because the latter is talked about less often. Perimenopause is the time frame that leads up to menopause and is when you experience the most symptoms, such as hot flashes, mood swings and irregular periods.
“People actually feel more symptoms during perimenopause than they do when they’re in full menopause,” Tang says. “It can last a decade before your periods fully stop, which can be a confusing time when you’re missing periods and having hot flashes.”
Tang says your symptoms should dissipate once you’ve officially reached menopause.
6 surprising things doctors don’t always tell you about menopause
While you might expect hot flashes and mood swings, these are perimenopause symptoms — though Tang notes that they can stick around for a short time after you’ve reached menopause. Here are some other surprisingly common symptoms that you may not associate with perimenopause and menopause.
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Bladder changes: You may feel the urge to urinate more frequently, including in the middle of the night. The culprit: a “drastic reduction in endogenous estrogens” that spurs bladder changes, according to the Journal of Women’s Health. “People can start to develop UTIs often because the tissue gets dry and delicate, making it easier for bacteria to enter,” Tang adds, referring to urinary tract infections.
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Body aches: Muscle and joint pain, especially in the feet and knees, is a common symptom you might not expect, Tang says. Low estrogen levels are to blame because the hormone “helps to protect joints and reduce inflammation,” according to Healthline.
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Brain fog: You could experience memory issues and have trouble concentrating. Tang notes that during this time, some women leave their jobs because they can’t focus on their workload. It’s unclear why women are getting brain fog in perimenopause, but research suggests it could be linked to a drop in estrogen.
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Changes in sexual health: Lower estrogen levels can lead to low libido, more trouble achieving orgasm and vaginal dryness, which can cause burning and pain during sex, Tang says. Many women find that this change can also affect their relationships.
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Hair loss: Since menopause causes your estrogen levels to decrease, you might notice your hair is thinner than it used to be. Your hair follicles can become thinner over time because estrogen plays an important role in promoting hair growth and thickness. (Read more about menopause and hair loss in women.)
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Poor sleep: Some women wake up a lot at night, Tang says. The aforementioned bathroom trips are one reason, but night sweats and hot flashes due to hormone fluctuations can also interrupt a good night’s rest. (A set of cooling sheets can help you feel more comfortable.)
“These symptoms can really be disturbing to some people and affect their quality of life,” Tang says. The good news? There’s one burden you can bid farewell to: painful periods.
How to treat perimenopause and menopause symptoms
There are several ways to treat common menopause symptoms, but your doctor may make different recommendations based on your specific symptoms.
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Exercise: As estrogen levels drop, your metabolism often slows. This might contribute to weight gain and more belly fat, Tang says. She recommends changing your exercise program to include more strength training because women transitioning into menopause tend to lose more muscle mass.
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Hair growth products: There are tons of hair growth products designed for women that can help with hair thinning and shedding.
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Hormone replacement therapy: You can receive a combination of estrogen and progesterone via a skin patch or pill, Tang says. There are also creams and gels that can be applied directly to the vagina, and a vaginal ring that can be inserted. These help symptoms by replacing the hormones your body isn’t making enough of — for instance, estrogen, according to the Cleveland Clinic. When your hormone levels stabilize, your symptoms should ease.
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Lubrication: Tang says using lubrication during sex can help with the vaginal dryness associated with lower estrogen levels.
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Nonhormonal treatments: For people who aren’t interested in taking hormones or who can’t — for instance, breast cancer patients whose treatments and risk factors preclude hormone therapy — there are nonhormone treatments for hot flashes, Tang says. “There’s a new medication called Veozah, which works on the receptors in the brain to help with hot flashes, and antidepressants can help with mood swings,” she says.
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Supplements: “Centrum has a line of menopausal support supplements that help in a nonhormonal way with things like hot flashes,” Tang says. There’s a multivitamin option with non-soy phytoestrogens — Tang notes that these act like estrogen but they contain no hormones — that can help with hot flashes. Other multivitamins can help you sleep and bolster focus and clarity lost to brain fog.
Do you need a diagnosis for menopause?
“In terms of hormone testing, you don’t actually need a blood test to tell you that you’re in menopause,” Tang says. If someone’s in the typical age range, their periods are irregular and they’re having menopausal symptoms, doctors will generally diagnose the patient with perimenopause, she says — they don’t need a blood test for confirmation.
Testing could be necessary if someone is not in a typical age range for menopause — for instance, they’re in their mid-30s. If their periods are stopping or they’re getting hot flashes, doctors may run tests to rule out thyroid problems or a condition such as polycystic ovary syndrome, which can present with similar symptoms, Tang says.
If you believe you might be in perimenopause and you’re curious about your hormone levels (and you’re not quite due for your annual trip to the gynecologist), check out the at-home menopause test kits that we’ve tested and reviewed. These shouldn’t be used in lieu of a doctor’s appointment, as a professional can give you a more thorough diagnosis, but they may be able to give you more insight into what’s going on with your body.
Menopause FAQs
What does bleeding after menopause mean?
Several things can cause postmenopausal bleeding, and a common one is vaginal dryness. Tang says the vagina can get easily irritated, which can lead to spotting. Polyps can also cause bleeding, she says.
“Doctors like to rule out things like uterine cancer, which is the most concerning thing it could be,” she adds. “The majority of postmenopausal bleeding is noncancerous, but we still have to test for the really concerning stuff with ultrasounds to see if there’s anything unusual looking in the uterus, and perform biopsies of the tissue.”
What signals the end of menopause?
You’ll know you’ve officially reached menopause when you haven’t had a period for 12 consecutive months.
How can I lose weight during menopause?
Tang says to be more mindful about what you eat and to exercise. You can try adding more strength training to gain more muscle mass. You also need to make sure you’re getting enough protein, fiber, calcium and vitamin D to protect your bones, because bone thinning can occur, Tang adds.
What does menopause feel like?
If you get hot flashes, you might experience what feels like heat waves coursing through your body at random times. Mentally, you may lack focus or experience brain fog. You might also notice that your moods are constantly changing because your hormones are out of balance.
If you have any questions about menopause or are confused about what’s going on, Tang recommends making an appointment with your gynecologist or primary care physician to talk about your symptoms and potential treatment options.
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