Answers to common questions about menopause

Menopause is a normal phase of life, but many still share unanswered questions or common misconceptions about the process. In recognition of World Menopause Month, we're explaining the differences between perimenopause, menopause, and post-menopause, plus what happens at each of these stages. Continue reading to learn more about the menopausal transition.  

At what age should women start thinking about menopause?

Many women assume that menopause is something they will think about by around age 50. While it is true that for most women, the last menstrual period typically occurs around age 51-52, perimenopause symptoms can start in your 30s and 40s according to The American College of Obstetricians and Gynecologists. Elektra Health recommends women start learning more about perimenopause and menopause around 40, so they can proactively take control of their menopause experience.

What happens during the menopausal transition?

Officially, menopause is defined as the single point in time at which a woman’s monthly menstrual cycle ends. Being “in menopause” or “postmenopausal” means that menstruation has not returned for 12 consecutive months. Biologically, this happens because the ovaries have stopped producing most of their estrogen and progesterone, and the body has stopped releasing eggs or ovulating. Menopause is comprised of three distinct phases:

1. Perimenopause: This translates to “around menopause,” this is the time when hormones start shifting and changing, periods become erratic, and symptoms first begin. Perimenopause is the phase that tends to be most bothersome and is often characterized first by mood and sleep difficulties, worsening PMS and breast discomfort, and weight gain; and eventually, hot flashes, night sweats, and vaginal dryness. However, it is not all bad! Some women do not experience these at all and many have minimal symptoms.

2. Menopause: A point in time when menstruation ends. Typically, menopause is “diagnosed” for sure 12 months after that last period, i.e. retrospectively, since at the time we are not sure if it is truly the last time someone will menstruate. Menopause can also result from a medical condition or surgery.

3. Post-menopause: Life after menopause. Women spend up to half of their lives in the post-menopause phase.

As with all health definitions, the “average age” of menopause onset varies widely across demographics, ethnicity, and geography.

What are some of the challenges women face during menopause?

As estrogen, progesterone, and testosterone levels shift during the menopause transition, our entire person is affected. Estrogen alone affects 100+ parts of our body, so it makes sense that we feel these shifts everywhere. Levels continue to change, so symptoms evolve over time.

How long does menopause last?

From start to finish, the menopausal transition takes an average of 10 years, with symptoms lasting anywhere from 4 to 5 years on average, though some women will experience them for shorter or longer time periods.

How does a woman know that menopause has started?

Often, one of the first things that women notice as they enter the menopause transition is changes in their period and worsening PMS, often combined with breast tenderness and mood changes. For most women, periods become more frequent, and for some, heavier. This symptom pattern then gives way to the “later” phase of perimenopause, when periods happen more sporadically and are lighter. The more classic symptoms of menopause, such as hot flashes, night sweats, and vaginal dryness, also start to show up more in this phase.

While you can test your hormone levels during perimenopause, given your body's unpredictable fluctuations over the course of several years, this is not very useful. Hormone levels in perimenopause can change daily, so typically they are not used just to identify that you are going through the transition. Sometimes, however, it is important to check hormone levels to make sure that your symptoms are not due, for example, to a thyroid condition.

How many women are impacted by menopause and what kind of disruption does it have on a woman's everyday life?

75% of women experience hallmark symptoms of menopause, including hot flashes and night sweats. Roughly 60% experience symptoms related to the vagina, vulva, and bladder, such as decreased libido, stress incontinence, and vaginal dryness. This is likely for you if you’re experiencing itching, painful sex, or increased UTIs. And roughly 45% experience emotional and mental health impacts, including irritability, anxiety, depression, and feelings of distraction.

These changes can have a meaningful impact on women’s lives, both personal and professional. For example, an estimated one-third of women experiencing menopause consider leaving the workplace. But before this information starts affecting your mental health, know that many of these changes, like hot flashes, are temporary, and/or have solutions.

To learn how your hormones could be affecting your health, register for our webinar on October 26th at 11 am EST featuring board-certified family nurse practitioner Jacqueline Giannelli RN, MSN, FNP-BC, NCMP: