Menopause is not always well understood by the women going through it or approaching it. Like a lot of women’s health issues, there are myths, old wives’ tales, and half-truths. Here are some facts you need to know about this part of your natural life cycle.
1. Menopause is a process, not a single event.
You probably began menstruating in your teens, when production of a number of hormones began to ramp up. For all of your fertile years, these hormones regulate a monthly cycle in which your body prepares for the possibility of pregnancy, releases an egg cell to be fertilized, and then if conception does not occur, clears out the uterine lining and prepares again. The shedding of the lining is menstruation, or your monthly period.
As you approach the end of your reproductive years, the production of hormones gradually slows, and this cycle becomes less regular. Menopause is said to have occurred once you have gone 12 months without a period.
It’s important to recognize that menopause is not a single momentary event or a crossing of a finish line. It’s a gradual process, and you may only recognize that menopause has taken place when you look back and realize how long it’s been since you have had a period.
2. Perimenopause is when you have most of the typical symptoms associated with menopause, and it begins years before you reach menopause.
As you reach your mid-40s, or earlier if you are showing symptoms, you begin hearing doctors use the word “perimenopause.” In many ways perimenopause is more significant than menopause, as it is the time when you most notice the effects of the changes your body is undergoing.
“Peri-” means “around” or “near.” Perimenopause is therefore the time when you are approaching menopause. The most significant sign of this is your periods often become less regular, and the typical length and heaviness of monthly menstruation can change. This is the outward sign of the decrease of hormone production.
While you often ovulate less frequently during perimenopause, you can still ovulate and thus still become pregnant. If this is something you do not want to happen, you need to continue using birth control until your periods have completely ceased.
Perimenopause can be a matter of months in some women, and over a decade in others. Typically perimenopause lasts around five years, with frequency of symptoms ebbing and flowing through this time.
3. You can estimate when you will probably reach menopause, but there’s no way to know for sure.
This question has been studied extensively, but there is still no clear-cut answer. The studies can tell us of averages and what is typical for different groups of women, but that doesn’t tell you when you will experience menopause yourself.
Menopause can begin as early as a woman’s early 40s and as late as her early 60s. The average age is around 51, with women who smoke tending to reach menopause somewhat earlier than women who don’t smoke.
Your personal experience is determined by a number of factors. There is some hereditary aspect, as many women seem to reach menopause around the same age as their mothers did. But environment, medication, and other health conditions and factors can influence the timing for you.
4. Perimenopause and menopause effect your entire body, not just your reproductive system.
The most obvious sign that you are progressing toward menopause is the changes in your menstrual cycle. However, there are other symptoms experienced by most women during perimenopause.
One of the most common is having hot flashes and night sweats. These are fluctuations in your body’s temperature control that make you suddenly feel too hot. Your face, neck, and chest will feel uncomfortably warm and may temporarily redden. When hot flashes happen while you are in bed asleep, they lead to night sweats, where you sweat to rid your body of the excess warmth. This in turn can cause chills as your body cools and the damp sheets make you feel colder.
Fatigue and insomnia, frequently experienced by women in midlife, can be related to the hot flashes and night sweats. The periods of uncomfortable warmth and chilliness may not be extreme enough to wake you all the way, but they can disturb your sleep enough that you don’t get the full amount of rest that you should. If hot flashes and night sweats are occurring strong enough and often enough to affect your sleeping, you should talk to your doctor about it.
Some other symptoms may include an increase in facial hair growth, change in voice, and a lower sex drive. These are all caused by the hormonal changes and are an annoying but natural part of the process.
5. Side effects of menopause can take a toll on your sex life, but there are steps you can take.
This varies from woman to woman and also changes over time during perimenopause. Some women have an increased libido, while many others experience less interest in sex.
Sometimes women lost interest in sex because it becomes painful. The declining hormone levels in your body also means that your vagina produces less moisture, even when you are sexually aroused. This can be helped by using KY Jelly or other water-based lubricants that are specifically designed for this purpose.
This is another common issue that can be easily remedied. During menopause, due to a declining estrogen level, many women experience vaginal dryness. You can either ask your doctor to prescribe you estrogen tablets or you could go with the safer option and just use a lubricant.
6. Hormone therapy isn’t necessary for all women, but for those who need it, it is not as risky as its reputation suggests.
Most doctors will recommend that you first try to treat perimenopausal changes using natural methods like herbal supplements. Many of the emotional symptoms of stress, depression and mood swings can be relieved simply by increasing the amount of exercise you get, or combining exercise with calming movement in yoga or tai chi. Practicing mindfulness and meditation can also help you cope with the emotional symptoms.
If symptoms become truly disruptive to your life, hormone therapy may be needed. There are potential side effects and some risks associated with it, depending on the hormone combination used. Your doctor can provide specific information about the type they prescribe for you.
However, it is important to recognize that the scary headlines that had people panicking a few years ago came from studies focused on older, long-term postmenopausal women who had been using hormone therapy for many years. Because hormone replacement was thought to have only good effects and even reduce risks of heart attack, doctors routinely prescribed hormone therapy for just about every woman as they approached menopause, and many of the women studied simply never stopped taking it.
Hormone replacement is used mainly to get through the worst symptoms of perimenopause, and women are encouraged to stop using it once they are fully into menopause and their symptoms ease up.
Every woman’s experience of perimenopause and menopause is individual to them. The best approach is to be attentive to what your own body is telling you, and bring all your questions and concerns to your doctors.
