What you can expect in menopause is very difficult to predict, since each woman experiences the “change” so uniquely. The “why” is that women’s ovaries are programmed to retire—a process that begins before we are born. We’re programmed to stop having children later in life. Many of the side effects of menopause are due to what is referred to as “estrogen withdrawal,” because, as our estrogen levels decrease as we approach menopause, the brain continues to crave more estrogen. While not all women experience hot flashes, about half do, and most women have at least one bothersome symptom that relates to a withdrawal syndrome (anxiety, palpitations, insomnia, mood swings, sweats, etc.) that may not be brief. There is essentially no test to determine how long such symptoms will last, but the range of duration for hot flashes—the most common problem—is 6 months to 3 years.

While men have a gradually decreasing but always regenerating supply of sperm, women have a finite number of eggs, which either implant for pregnancy, shed in menstrual periods, or die before those processes. When the last egg is “spent,” the reproductive function of the ovary is finished, but the ovary still provides a source of hormonal vitality beyond this time, prompting what some women may experience as “post-menopausal zest.” Menopause is not a disease, but it can put women out of sync with some of the estrogen-enhanced features, behaviors, and appearances on which they have come to rely. On the other hand, menopause offers a certain freedom as well, as if Mother Nature is saying, “Congratulations, you are off-duty. Now you may rely on your true, unadulterated personae to guide your passions—go forth and be free of hormones and periods.”