Published On By Dimitar Marinov [MD, PhD]

All about Menopause

Menopause usually starts when a woman is between 45 and 55 years old. This transition lasts around seven years, but for some, it can go on for up to 14 years.

The duration of the menopausal transition may be different for each one, depending on factors like their smoking habit, their age when it starts, and their ethnicity.

Menopause occurs because the ovaries produce less estrogen and progesterone, which regulates your menstrual cycle.

Even though menopause is natural, it could bring some bothersome symptoms like mood swings, chills, and vaginal dryness.

Thus, understanding menopause may help you manage these changes better and find effective ways to relieve symptoms.

Read along to learn about the stages of menopause and what available treatment options are there to guide you through this phase.

What Is Menopause?

Menopause is a biological process that indicates the ending of menstrual cycles for women who have not experienced a period for 12 consecutive months. It usually occurs around the age of 50, although the average age of menopause in the U.S. is 51.

The stages leading up to menopause, known as perimenopause, may bring various symptoms as the body adjusts to declining estrogen levels. Menopausal symptoms may include irregular periods, hot flashes, night sweats, vaginal dryness, mood changes, and changes in libido.

Stages Of Menopause

  1. Perimenopause

    During perimenopause, which can last 4 to 10 years before menopause, the ovaries gradually start producing less estrogen. Perimenopause usually begins in a woman’s 40s.

    Perimenopause is the period where hormonal shifts begin, leading to various symptoms. This phase signifies your body’s natural progression towards menopause, characterized by irregular menstrual cycles and fluctuations in hormone levels.

    As perimenopause progresses, typically in the last one to two years, the decrease in estrogen intensifies, causing more pronounced menopausal symptoms. However, you can still menstruate and remain fertile while experiencing perimenopause symptoms.

    Common symptoms during perimenopause include hot flashes, night sweats, vaginal dryness, and sleep disturbances.

  2. Menopause

    The menopause phase naturally occurs around age 50, which signifies the end of the menstrual period. During menopause, estrogen levels decline, which might cause night sweats and emotional fluctuations. Some of you may also experience changes in metabolism, which may contribute to weight gain during menopause.

  3. Post menopause

    Postmenopause is a significant phase where the hormonal fluctuations of your menopause stabilize, but the impact of decreased estrogen levels on bone health and cardiovascular function persists.

    During postmenopause, you may notice improvements in symptoms like hot flashes, chills, and mood changes. However, the long-term effects of estrogen decline might become more prominent. Hormonal changes in postmenopause may increase the vulnerability to osteoporosis, a condition of weakened bones, and increased heart health risk, a leading cause of mortality.

Symptoms Of Menopause

  1. Hot flashes

    Hot flashes are short episodes of heat, leading to perspiration and a reddened complexion, generally affecting the face, neck, and chest. These episodes may occur unpredictably throughout the day or night, which can disrupt your sleep and cause discomfort.

    Changes in estrogen levels are believed to cause hot flashes during menopause. While these episodes are a natural part of this life stage, their impact on your daily life can be profound.

  2. Chills

    Chills during menopause could be sudden sensations of coldness and shivering, often accompanying other symptoms like hot flashes, night sweats, and mood changes. These chills can be intense and unpredictable, causing you discomfort even in warm environments. Hormonal fluctuations, especially the drop in estrogen levels, are the primary cause of chills during menopause, affecting the body’s temperature regulation. The beginning of chills may disrupt your daily activities and contribute to frustration and discomfort during the menopausal phase.

  3. Irregular periods

    As menopause gets closer, the ovaries make less estrogen and progesterone, which may affect the menstrual cycle. Periods could become irregular, meaning they might be shorter, longer, or happen at unexpected times before menopause.

    Irregular periods happen because the hormonal changes mess with how the ovaries release eggs. As estrogen levels drop, ovulation isn’t as regular, so the lining of the uterus isn’t shed predictably. It may lead to changes in how often and how long your bleeding happens during periods.

  4. Weight gain

    You may also experience weight gain during menopause due to hormonal fluctuations and lifestyle changes impacting metabolism and fat distribution.

    Lower estrogen levels during menopause might contribute to weight gain, particularly around the abdomen. Factors like hot flashes, mood swings, and sleep disturbances associated with menopause can disrupt your normal sleep patterns and increase stress levels, which could further worsen the weight gain.

  5. Sleep problems

    Hormonal changes during menopause may affect your sleep-wake cycle, leading to difficulties falling asleep, staying asleep, or experiencing restorative sleep. These disruptions might result in fatigue, irritability, and difficulty concentrating during the day.

    Common Sleep Problems During Menopause Description
    Insomnia Difficulty falling or staying asleep.
    Sleep apnea Pauses in breathing during sleep.
    Restless leg syndrome Uncomfortable sensations in the legs cause an urge to move them.
    Night sweats Episodes of sweating during sleep, lead to disrupted rest.
  6. Mood changes

    You may find yourself experiencing sudden and intense shifts in emotions, from deep sadness to elevated irritability, sometimes without a clear trigger during menopause. The increased sensitivity during menopause may impact your everyday stressors and challenges.

    Feelings of anxiety and tension can become more prevalent during menopause, impacting daily interactions and activities.

  7. Vaginal dryness

    During menopause, the issue of vaginal dryness occurs due to the decline in estrogen levels, leading to vaginal tissues becoming thinner, drier, and less elastic. Vaginal dryness may manifest in the form of itching, burning sensations, and pain during intercourse.

    Urinary problems such as frequent urination or increased susceptibility to urinary tract infections may occur during menopause due to changes in the vagina’s pH balance caused by reduced estrogen levels.

  8. Night sweats

    Dealing with night sweats can be frustrating and uncomfortable, impacting your overall quality of life. Night sweats could often disrupt your sleep with sudden and intense episodes of sweating during the night. While the exact cause isn’t fully clear, they’re believed to occur because of hormonal changes during menopause.

  9. Thinning hair

    Menopausal hormonal changes may lead to a gradual thinning of your hair all over the scalp, resulting in a less voluminous appearance. You might notice an increase in hair shedding, with more hair being lost in the shower, on pillows, or during brushing, leading to concerns about bald spots. The quality of your hair could change during menopause, becoming finer, weaker, and more prone to breakage, further worsening the appearance of hair thinning.

  10. Loss of breast fullness

    During menopause, you might notice that your breasts become less fuller. It happens because of a decline in estrogen levels, as estrogen may help keep your breast tissue full and firm. As estrogen decreases during menopause, the tissues in the breasts can lose some of their elasticity and volume, making the breasts seem less full. Thus, losing breast fullness may affect how you feel about your body and your confidence. It’s important to know that this change is normal during menopause.

Menopause Causes

The end of monthly egg release and the stoppage of periods signals the start of menopause. Menopause occurs when a woman’s ovaries no longer release an egg each month, leading to a decline in estrogen and progesterone production.

Menopause is a natural process that typically happens around the age of 51. However, premature menopause, occurring before the age of 40, could result from genetic factors, medical procedures like oophorectomy, or conditions such as premature ovarian failure.


Diagnosis Of Menopause

  1. Thyroid Function Test

    Thyroid hormones, including thyroxine and triiodothyronine, may influence various bodily functions, such as heart rate, energy levels, and weight management. During menopause, hormonal fluctuations can sometimes affect thyroid function, leading to fatigue, weight changes, and mood disturbances. Therefore, assessing thyroid function becomes essential to differentiate between menopausal symptoms and potential thyroid disorders.

    The Thyroid Function Test includes measuring levels of thyroid-stimulating hormone (TSH), T4, and T3 in your blood. Elevated TSH levels may suggest an underactive thyroid (hypothyroidism), while decreased levels could suggest an overactive thyroid (hyperthyroidism). Thus, proper diagnosis and management of thyroid conditions are crucial in menopausal women to relieve menopause symptoms and prevent long-term health complications.

  2. Follicle Stimulating Hormone Test

    A follicle-stimulating hormone (FSH) test may help evaluate the levels of follicle hormone in the blood, which may provide insights into a woman’s hormonal status and reproductive health. The FSH test measures the amount of FSH, a hormone crucial for egg production, present in the blood.

    FSH levels tend to rise as women approach menopause due to the ovaries producing less estrogen, prompting the pituitary gland to release more FSH to stimulate the ovaries.

    Thus, high levels of FSH may indicate that a woman is in menopause or approaching it. However, it is essential to analyze FSH levels alongside other hormonal tests and clinical symptoms to confirm a menopausal status accurately.

  3. Estradiol Test

    The Estradiol Test is a diagnostic tool used to measure estradiol levels in the bloodstream, a crucial form of estrogen often affected during menopause. It helps healthcare experts to understand the hormonal changes that occur during the menopausal stage of life.

    Estradiol supports bodily functions, including bone health, heart health, and maintaining reproductive tissues. Its levels fluctuate throughout a woman’s menstrual cycle, but during menopause, these levels tend to decrease significantly. Low estradiol levels could contribute to menopausal symptoms, such as night sweats, mood swings, and vaginal dryness.

Menopause Treatment

  1. Topical hormone therapy

    Topical hormone therapy, typically in the form of estrogen cream, inserts, or gel, may help address vaginal dryness experienced during menopause. These topical treatments have easy application directly to the vaginal area, providing targeted relief where it is needed most. Topical hormone therapy includes estrogen-containing creams, which might help restore vaginal moisture, elasticity, and thickness. However, consult a healthcare expert to understand if the topical hormone therapy is suitable for your needs to ensure optimal effectiveness.

  2. Hormone replacement therapy (HRT)

    Hormone replacement therapy, commonly known as HRT, includes medications to supplement the hormones that the body no longer produces naturally during menopause.

    It might help reduce menopausal symptoms such as loss of bone density, hot flashes, and vaginal dryness.

    Some studies suggest that prolonged use of hormone replacement therapy can increase the chances of heart disease and breast cancer. Therefore, it is crucial to utilize the lowest effective dose of HRT for the shortest time possible.

  3. Nonhormone medications

    If you are seeking alternatives to hormone therapy in managing menopausal symptoms, nonhormone medications could be viable options for addressing issues like hot flashes and vaginal dryness.

    The FDA-approved depression drug paroxetine a low dose of 7.5mg (Brisdelle, Paxil) in treating hot flashes.

    Nerve medications like gabapentin (Gralise, Neuraptine, Neurontin) and the blood pressure medication clonidine (Catapres, Kapvay) could also help relieve menopause symptoms.

    Selective estrogen receptor modulators could help relieve symptoms of bone loss during menopausal women. Raloxifene, a SERM, could help prevent osteoporosis and vertebral fractures caused by menopause.

Frequently Asked Questions

  • Can Menopause Affect Dental Health?
    Menopause can affect dental health by causing dry mouth, gum disease, and bone loss due to hormonal imbalance. Regular dental check-ups, proper oral hygiene, and discussing menopause-related concerns with your dentist can help maintain good dental health during this stage.
  • How Does Menopause Impact Skin Changes?
    Menopause may impact skin changes due to hormonal shifts. Decreased estrogen levels could lead to reduced collagen production, causing skin to become thinner, drier, and more prone to wrinkles. Proper skincare, hydration, and sun protection are essential to prevent these adverse skin effects.
  • Are There Natural Remedies for Menopausal Symptoms?
    Natural remedies for menopausal symptoms include lifestyle changes like physical exercise, a balanced diet rich in fruits and vegetables, stress management methods such as yoga or meditation, herbal supplements like black cohosh, and staying hydrated to relieve these symptoms.
  • Can Menopause Cause Changes in Body Odor?
    Menopause may indeed cause changes in body odor due to hormonal fluctuations impacting sweat production and bacterial growth. Understanding these shifts can help you manage any odor changes through proper hygiene practices and potentially seeking medical advice.
  • How Does Menopause Affect Vision Changes?
    Menopause could affect vision changes due to hormonal fluctuations impacting tear production and eye health. Dry eyes, irritation, and blurred vision may occur. Regular eye exams, artificial tears, and proper hydration may help you manage these symptoms for improved visual health.


As menopause signifies the end of your reproductive years, it could come with emotional and physical distress.

While some women pass menopause even without noticing any significant changes, others might experience unexplained irritation and thinning of hair because of the physical effects of menopause.

Thus, adopting a healthy approach and seeking professional support might assist you in tackling menopause discomforts.

Focus on creating a healthy lifestyle that combines physical movement, a balanced diet, and self-care methods.

Try to manage your stress and avoid potential triggers to maintain a healthy and calm state of mind during menopause mood fluctuations.

  • The details in this article are for informational purposes only and should not be considered medical advice.
  • It is not recommended to disregard/delay seeking professional medical advice or treatment because of what you read or accessed through this article.
  • The results may vary from individual to individual.
  • It is recommended to consult your doctor for any underlying medical conditions or if you are on any prescribed medicines before trying any tips.

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