Menopause is the 12-month time frame after a woman’s last menstrual period. The menopausal transition affects each woman uniquely and in various ways. Before starting menopause, in perimenopause women can have changes in the timing, and volume of bleeding of their periods, get night sweats, have hot flashes, mood swings and have other symptoms. This is known as menopausal transition or perimenopause. Medication or healthy lifestyle changes may reduce the risk of these symptoms or conditions.

Menopause starts between ages 45 and 55. Menopause lasts between seven and 14 years. After menopause, due to the decrease in protection from the hormone estrogen, women are more vulnerable to heart disease and osteoporosis. Eating a balanced diet and being active is important before, during, and after the menopausal transition.

Stages of Menopause

Perimenopause

Perimenopause is the time leading up to your last period. Perimenopause happens when your hormone levels change, and your ovaries make different amounts of estrogen and progesterone. This leads to different menopause symptoms. Perimenopause lasts between two and eight years.

Menopause

Menopause is diagnosed when a woman has gone 12 months in a row without a period. Factors that affect the start of menopause include:

• Never giving birth.
• Smoking.
• Chemotherapy
• Surgery to remove ovaries or uterus.

Post-menopause

Once menopause is over, you can’t get pregnant, and you won’t have a period. If you’re still bleeding after menopause, you should call your doctor as soon as possible. This may indicate a serious problem. Post-menopausal women can have:

• Hot flashes and night sweats.
• Vaginal dryness and sexual discomfort.
• Depression.
• Changes in sex drive.
• Insomnia.
• Dry skin.
• Weight changes.
• Hair loss.
• Urinary incontinence.

Signs and Symptoms

During perimenopause, you might have irregular periods. Your periods can:

• Be shorter or longer.
• Have heavier bleeding.
• Have spotting.

During menopause, you can have:

• Hot Flashes. Your hot flashes may be a result of changes in estrogen levels. Your hot flashes can last between 30 seconds and 10 minutes.
• Bladder Control. You might have a sudden urge to urinate, or you might have bladder leakage during simple activities like sneezing or bending over.
• Sleep. You might struggle with:
  • Falling asleep.
  • Staying asleep.
  • Waking up too early.
• Vaginal Health and Sexuality. Less estrogen during perimenopause and menopause may make the vagina drier. You might find sexual intercourse uncomfortable. You might also be less interested in sexual activities.
• Mood Changes. You may more mood swings than usual. This is normal during menopause. These mood changes can come from factors such as stress or family changes.

Treatment

There are options that may help relieve menopausal symptoms. These include:

Hormone Therapy

• Low-dose hormonal therapy.
• Menopausal hormone therapy.

Non-hormonal

• Mood stabilizers.
• Vaginal creams or lubricant.
• Eating a diet rich in plan-based sources of estrogen. This includes:
  • Whole-grain cereals.
  • Flaxseed.
  • Chickpeas.
  • Legumes.