Every woman on the planet, who lives beyond 50 years of age, goes through the change of life known as the “Menopause.”
For a lot of women, it’s a period that they dread. We hear all kinds of stories about hot flashes, night sweats, irregular or heavy bleeding, insomnia, emotional imbalances, low sex drive, painful sex, weight gain, loss of bone density, aging and wrinkling. Is it any wonder we view this transition as if it were the plague rather than being something we look forward to?
So what’s the truth about menopause?
Menopause occurs when a woman ceases having her menstrual cycle and she is no longer fertile.
The average age of when women in the US go through natural menopause is 51 years old. Natural menopause is the spontaneous, permanent ending of menstruation that is not caused by any medical treatment. Menopause is a normal, natural event. It’s defined as the final menstrual period and is confirmed when a woman has not had her period for 12 consecutive months. The range when most women go through menopause is from 45 – 58 years old.1
However, some women go through this in their 30s, while others don’t reach this phase till their 60s. When I did my thesis on “Menopause In Women” I received a letter from one of the women participating in the study I was doing. Her mother went through very early menopause at age 28 and she went through menopause by the time she was 35.
Typically women go through the menopause at approximately the same age as their mothers and sisters.
Menopause can also occur due to medical reasons such as chemotherapy or surgery when both ovaries are removed.
1 Shifren, J.L., Gass, M.L.S., for the NAMS Recommendations for Clinical Care of Midlife Women Working Group. (2014). The North American Menopause Society Recommendations for Clinical Care of Midlife Women. Menopause; 21(10): 1038–1062.
The average life expectancy for US women today is 84 years old, which means that many women will spend approximately 40% -50% of their adult life in the post menopausal stage.2
An estimated 6,000 US women reach menopause every day. By the year 2020, the number of women who will be older than 55 is estimated to be 46 million.3
It’s estimated that in the year 1998, there were 477 million post-menopausal women in the world. That number is expected to more than double, to a projected 1.1 billion post-menopausal women in the world by the year 2025.4
The impact of menopause is different for each and every woman. For some, it causes very little disruption to their life with no symptoms, and for others there are severe disabling symptoms with significant disruption to the quality of their life. The majority of women experience symptoms of menopause, although some 20% of women have no symptoms and a further 60% experience only mild symptoms.5
Up to 10% of women simply stop menstruating without any prior menstrual irregularity or symptoms that are common during menopause.6
Studies have shown that only 57% of women suffer with more than one symptom of menopause and that the remaining 43% experience nothing more than irregular periods.7
The symptoms most commonly associated with menopause (in addition to menstrual changes) are hot flashes and vaginal dryness.
About 75% of women who go through natural menopause will have hot flashes (also called hot flushes) and night sweats.8
2 ACOG | American Congress of Obstetricians and Gynecologists. 2011 Women’s Health Stats & Facts: 33-34.
3 ACOG | American Congress of Obstetricians and Gynecologists. 2011 Women’s Health Stats & Facts: 33-34.
5 VMC | Virtual Medical Center: https://www.myvmc.com/diseases/menopause/
8 ACOG | American Congress of Obstetricians and Gynecologists. 2011 Women’s Health Stats & Facts: 33-34.
Almost 100% of women who go through surgically induced menopause will experience hot flashes.9
Other less consistently associated symptoms include sleep disturbances, insomnia, urinary complaints, sexual dysfunction, mood swings and quality of life disturbances.
For all symptoms including changes in menstrual cycle, women should always seek the advice of their doctor or health care practitioner.
During menopause hormone levels change and there is a natural decline in estrogen levels. Lower levels of estrogen decreases the amount of collagen causing wrinkling and aging of the skin and other conditions such as thinning of the lining of the vagina and bladder. There can be a significant decrease in bone density related to menopause as a result of reduced estrogen levels.
Hot flashes are the most common menopause symptom. Some women begin having hot flashes before menopause, while they are still menstruating each month. 10 Hot flashes are a sudden feeling of heat in the upper torso from the chest up to the head. Your face and neck may become red. Red blotches may appear on your chest, back, and arms. You may also get heavy sweating during hot flashes or cold chills after the hot flashes. Some women get more cold chills (also called cold flashes) than hot flashes.
Hot flashes are most common in women during the year prior to the cessation of their period and in the year after their period stops. However, recent studies show that hot flashes can continue for up to 14 years after menopause.12
Doctors and researchers do not know why hot flashes are so common during menopause. There are medicines that can prevent some hot flashes, and there are ways you can try to manage hot flashes when they do happen.
9 VMC | Virtual Medical Center: https://www.myvmc.com/diseases/menopause/
10 Shifren, J.L., Gass, M.L.S., for the NAMS Recommendations for Clinical Care of Midlife Women Working Group. (2014). The North American Menopause Society Recommendations for Clinical Care of Midlife Women. Menopause; 21(10): 1038–1062.
11 Tepper, P.G., Brooks, M.M., Randolph, J.F., Crawford, S.L., Khoudary, E., Gold, E.B., et al. (2016). Characterizing the trajectories of vasomotor symptoms across the menopausal transition. Menopause; 23(10): 1067–1074.
12 Avis, N.E., Crawford, S.L., Greendale, G., Bromberger, J.T., Everson-Rose, S.A., Gold, E.B., et al. (2015). Duration of Menopausal Vasomotor Symptoms Over the Menopause Transition. JAMA Internal Medicine; 175(4): 531–539.
How to deal with this:
Speak with your doctor or medical practitioner to discuss your options. You can also research complimentary and alternative medicine (CAM) and find a practitioner that specializes in dealing with this issue.
Here are some other recommendations from the Office on Women’s Health (OWH):13
- Track your hot flashes. Write down what triggers your hot flashes and try to avoid those things. Possible triggers might include spicy foods, alcohol, caffeine, stress, or being in a hot place.
- Drink cold water. Keep ice water close by to drink when you feel a hot flash coming on.
- Take off a layer of clothing. Dress in layers as much as possible.
- Use a fan. Turn on a fan at night by your bed and keep one at work if possible.
- Take deep breaths. Try taking slow, deep breaths when a hot flash starts. Slow, deep breaths tell your body it’s time to be calm and relax.
- Lose weight. Hot flashes may be worse in women who are overweight or obese. A 2010 study found that losing weight may help to improve the issue of hot flashes. 14
Vaginal problems, such as vaginal dryness, may start or get worse around menopause. Low levels of estrogen may cause the vaginal tissue to get drier and thinner. (This condition of the skin becoming thinner and drier is called vaginal atrophy.) This can cause itching, burning and pain or discomfort. It also can make sex painful (pain during sexual activity is called dyspareunia) and cause small cuts and tears in the vagina during sex. 15
13 Office On Women’s Health (OWH): https://www.womenshealth.gov/menopause/menopause-symptoms-and-relief#13
14 Huang, A.J., Subak, L.L., Wing, R., West, D.S., Hernandez, A.L., Macer, J., et al.; Program to Reduce Incontinence by Diet and Exercise Investigators. (2010). An intensive behavioral weight loss intervention and hot flushes in women. Archives of Internal Medicine; 170(13): 1161–1167.
15 Muhleisen, A. L., Herbst-Kralovetz, M. M. (2016). Menopause and the vaginal microbiome. Maturitas; 91:42-50.
How to deal with this:
Here are some recommendations from the Office on Women’s Health (OWH):16
- Vaginal Moisturizer. An over-the-counter vaginal moisturizer can help keep your vagina lubricated and can make sex more comfortable. You use this every few days.
- Vaginal lubricant. A water-based, over-the-counter vaginal lubricant can help make sex more comfortable. You use this before or during sex.
- Prescription medicine. You can also talk to your doctor about other ways to treat vaginal dryness, including hormonal birth control, menopausal hormone therapy, or a prescription estrogen cream, gel, or ring that is inserted into the vagina.
There is also a clinically proven vaginal moisture supplement that is 100% natural, contains no estrogen, is non-GMO and gluten-free called Membrasin®. It is sold in the US as well as dozens of countries worldwide: https://membrasinlife.com
Many women during menopause find it hard to sleep through the night. Low levels of progesterone can make it hard to fall and stay asleep. Low estrogen levels can also cause hot flashes that make you sweat while you’re sleeping (also known as night sweats.) 17 Menopausal women can be prone to having urinary symptoms that make them get up several times during the night to urinate.
How to deal with this:
Speak with your doctor or medical practitioner to discuss your options and to rule out any other serious health issues. You can also research complimentary and alternative medicine (CAM) and find a practitioner that specializes in dealing with sleep problems.
Here are some other recommendations including ones from the Office on Women’s Health (OWH): 18
- One of the best ways to get a good night’s sleep is to do regular physical activity. However, you may need to schedule a work out earlier in the day. Too much activity close to bedtime can make you more awake. Even if you haven’t exercised regularly in the past, starting to exercise during menopause may help you feel better. Studies show that certain exercises, such as yoga and stretching, may help improve hot flashes. 19
- Do not eat, drink alcohol or smoke before bed. Avoid large meals, smoking, and drinking alcohol right before bedtime. Avoid caffeine after noon.
- Drink warm drinks. Try drinking something warm before bedtime, such as caffeine-free tea or warm milk.
- Limit screen-time near bedtime. Limit TV, phone, or computer use near bedtime, especially in your bedroom. The bright screen light tells your brain to wake up instead of sleep. 20
- Practice good sleep habits. Keep your bedroom dark, quiet, and cool. Use your bedroom only for sleep and sex, if you can.
- Don’t nap during the day. Try to go to bed and get up at the same times every day.
- Train your brain. If you wake during the night and can’t get back to sleep, get up and do something relaxing until you’re sleepy again.
- Have a warm bath before bed. Having a warm bath or shower prior to sleeping or even doing a warm foot soak can help you to feel relaxed and fall asleep.
16 Office On Women’s Health (OWH): https://www.womenshealth.gov/menopause/menopause-symptoms-and-relief#13
17 Kravitz, H. M., Ganz, P. A., Bromberger, J., Powell, L. H., Sutton-Tyrrell, K., Meyer, P. M. (2003). Sleep difficulty in women at midlife: a community survey of sleep and the menopausal transition. Menopause; 10, 19–28.
18 Office On Women’s Health (OWH): https://www.womenshealth.gov/menopause/menopause-symptoms-and-relief#13
19 Innes, K.E., Selfe, T.K., Vishnu, A. (2010). Mind-body Therapies for Menopausal Symptoms: A Systematic Review. Maturitas; 66(2): 135-149.
20 National Sleep Foundation: https://www.sleepfoundation.org/sleep-news/lights-out-good-nights-sleep
Changes In Sex Drive:
Changes in sex drive can occur during and after menopause. Studies show that as much as 75% of menopausal and post-menopausal women don’t feel less attractive due to menopause. On the contrary, many women feel sexually liberated, as they no longer have to consider the possibility of falling pregnant due to their sexual activity. Others may feel less aroused and less interested in sex especially if it is uncomfortable or painful due to drier or thinner vaginal tissue. Additionally, lower hormones may lower your sex drive and it may take you longer to get aroused.21
21 Office On Women’s Health (OWH): https://www.womenshealth.gov/menopause/menopause-and-sexuality#7
How to deal with this:
If you are experiencing vaginal dryness then there are safe over-the-counter and prescription treatments to improve vaginal lubrication. (See above under Vaginal Problems.)
Some women are less interested in sex during menopause due to other menopausal issues such as stress, anxiety, depression or lack of sleep and associated fatigue. For these issues, discuss your options regarding treatment with your doctor or health practitioner.