• What is menopause?
• Is menopause the same as perimenopause?
• What are the symptoms of perimenopause and menopause?
• Should I see my doctor if I think I’m menopausal?

As a woman, you may find it hard to imagine a time when your monthly menstrual cycle ends. Yet that is exactly what happens to approximately 1.3 million American women each year who enter a phase of their life called menopause. For many people, the shift takes place around age 50 and marks the end of their reproductive years.

Menopause isn’t something to be feared. Instead, it is a time in a woman’s life that can be productive, full, and happy. 

But what is menopause? Is menopause different from perimenopause? Perhaps an even better question is—will I have hot flashes?

Menopause is the phase of life after your reproductive (child bearing) years. This happens when your ovaries shut down and stop releasing eggs and subsequently menstruation stops. As estrogen production declines or fluctuates, many classic menopause hormonal symptoms start. So, how does this all happen?

To understand menopause, you should first understand the female body from the reproductive perspective. A woman’s eggs are in her ovaries  which also make the female hormones estrogen and progesterone. Every month or so, an egg is released from the ovaries (ovulation). When a released egg is not fertilized by sperm, the built up lining of the uterus is not needed to support a pregnancy, the menstrual flow (blood)   is the blood-rich uterine lining and that sheds. This is your period.  

We are born with all of the eggs we are ever going to have. No new eggs are made during a lifetime. The number of eggs declines over time. We have 1-2 million eggs at birth and only about 400,000 at puberty. Even though you usually only ovulate 1 egg per cycle,you lose about 1000 eggs a month. The eggs that you lose don’t go anywhere, they just really never develop and resorb. When the body reaches the end of fertility—when there are no more eggs—there are also no longer periods. The end of menstruation and the reproductive health cycle is a new phase known as menopause. We define menopause as one year without a menstrual cycle due to ovaries shutting down.

Perimenopause is the transition phase from your reproductive years into the menopause years. Some call it puberty #2. Hormone levels start fluctuating; they are up one day and bottom out the next. It is the hormone swings in perimenopause that make us feel so out of sorts. Hormone levels decline as we are getting closer to menopause, therefore, many of the symptoms of perimenopause are very similar to menopause. 

The big difference is that we are still having menstrual cycles in perimenopause, even though they may be very irregular. During perimenopause, your body is like a clock that is slowly winding down.

It’s hard to distinguish between the symptoms of perimenopause and menopause. Most of the hormonal symptoms are due to estrogen levels dropping. Every woman’s reproductive health journey is also different, so they can manifest differently for different people. 

For example, while the “average” age of menopause is 51, you can become menopausal at any age. Abnormally early menopause is before 40 years old. You can be menopausal at any age if your ovaries are surgically removed. The point is that the road toward menopause is rarely a straight line—but we all get there eventually. 

In many cases, perimenopause and menopause share the same symptoms. This is because of estrogen levels. 

As hormone levels fluctuate, you may have typical perimenopause symptoms such as 

• Anxiety and mood swings
• Breast tenderness
• Erratic periods
• Fertility issues
• Hair changes and hair loss as well as new hair growth on the face or other parts of the body
• Headaches
• Heart palpitations
• Heavier or lighter than normal periods
• Muscle aches
• Problems concentrating and forgetfulness
• Reduced sex drive
• Strong cramping and severe premenstrual syndrome (PMS)
• Urinary tract infections
• Weight gain

As your estrogen levels continue to drop you may also experience:

• Depression and anxiety
• Dry skin
• Fatigue
• Frequent urination
• Hot flashes
• Insomnia
• Irritability
• Night sweats
• Vaginal dryness

Keep in mind that not all of these symptoms will occur in everyone. Some women make it through perimenopause and into menopause with few or no symptoms. Other women suffer from hot flashes for years. The truth is that we don’t know exactly why it’s so different for each woman. 

Thankfully, if you’re someone who is struggling with uncomfortable symptoms, there are treatments that can help.

Yes, you should see your doctor at least annually, even if you never get sick. Proactive, routine checkups can help keep you healthy and will allow doctors to identify illnesses early on before they develop into serious problems. Anytime your periods become erratic, it can be a cause for concern. Fortunately, there are both over-the-counter and prescription treatments that you can take to alleviate symptoms you may be struggling with. These include:

• Antidepressants can ease mood swings
• Estrogen hormone therapy treatments can level out uncomfortable symptoms
• Insomnia medications can help with sleeplessness
• Gabapentin is a seizure medication that can help with severe hot flashes
• Prescription vaginal creams alleviate dryness

You can also make some lifestyle changes or take home remedies to help with perimenopausal and menopausal symptoms. For example:

• Cut back on sugar and processed foods
• Drink alcohol in moderation
• Drink more water
• Eat foods high in calcium and vitamin D to build bone strength
• Eat foods called phytoestrogens that mimic the effects of estrogen in the body (beans, flaxseeds, tofu, and soy)
• Limit caffeine intake
• Pay attention to your diet, focusing on fresh, healthy foods and smaller portion sizes
• Regular exercise can help with weight gain and improve your mood
• Stop smoking

Far from being something to dread, menopause is a time to celebrate the body’s natural cycles of life. If you’re experiencing menopausal symptoms, speak with your doctor to access the many effective treatments that will allow you to enjoy this time in your life. 

If you have any questions about your health, please reach out to the caring and experienced team at Women First Obstetrics & Gynecology. We’re here to help.

Contact us today to speak with one of our team members.