What Is Menopause?
My grandmother called menopause “The Change" on the rare occasion menopause was spoken of out loud in her house. Usually, she would lower her voice too as if the very mention of it was not the done thing in polite society.
This, together with mysterious hospital stays and the fact that the women of my family only talked about menopause in negative terms, meant it was best for me to push the whole thing to the back of my mind.
No woman can avoid menopause, so rather than dread the unknown, it’s worthwhile educating yourself what menopause is. After all, knowledge is power and knowing what to expect and all about the options open to might make your menopause experience easier. You’ve made the first step by clicking on this resource!
Let’s start with unpacking exactly what menopause is, the symptoms of menopause, and how to cope during menopause.
What Is Menopause? The Definition of Menopause
According to Dictionary.com, the word originates from 1852 (from 1845 as a French word in English), from French ménopause, from medical Latin menopauis, from Greek men (genitive menos) "month," and pausis "a cessation, a pause," from pauein "to cause to cease." Also, menopause was earlier known as “the change of life" – so my grandmother was using a very old term!
The definition does at least clear up any confusion amongst those who think the word menopause sounds like menstruation pauses and then starts up again, which might be the case if you were using our understanding of the modern word "pause" as a temporary cessation.
Dictionary.com (rather unkindly I feel) uses “midlife crisis" as an alternative term to menopause, but millions of women will attest that not everyone going through menopause will have a midlife crisis.
The other potential confusion we should clear up here and now is that the start of what most people understand to be menopause symptoms are not officially menopause but peri-menopause. Hot flashes, mood swings, spotty skin and heavier, lighter or irregular periods are all signs of perimenopause.
You are only officially in menopause when you have not had any bleeding for a full 12 months.
What Are The First Signs of Menopause?
The first signs of menopause vary as each woman experiences menopause in their own unique way. For many, a change in their pattern or flow of menstruation can be the first sign that things are changing.
Nowadays with many women able and wanting to give birth later in life, some women might miss these first variations, attributing them to post birth anomalies.
Keeping a menstruation diary can be useful, and those who have kept one throughout their fertile life may spot changes faster than those who haven’t. You can download apps to help track menstruation and other signs and symptoms or make a note on your usual calendar or diary. It might also be useful to start noting any symptoms including headaches, mood swings or skin changes.
If menstruation has always been irregular, the first signs of menopause might be those more familiar ones like hot flashes or a change in mood, trouble sleeping or changes to skin and hair.
What Are the Symptoms of Menopause?
The symptoms of menopause can be many and varied, and you might even be one of those lucky women who breeze through perimenopause and menopause with a slow tailing off of menstruation and no other noticeable symptoms.
Or you could be one of the unfortunate ones whose face breaks out like a teenager, can’t sleep at night, feels inexplicably anxious or depressed or switches between cold and hot minute by minute.
Other women experience a loss in libido, vaginal dryness, and loss of elasticity, pain during intercourse, or urinary incontinence.
However, some women are freed from the need to practice safe sex and the roller coaster of the monthly hormone cycle and menstruation itself, to enjoy the best sex of their lives.
Hot Flashes
As mentioned earlier, probably the most famous symptom of menopause is the hot flashes. It sounds like nothing doesn’t it? After all, how bad can a temporary change in temperature be?
If you are one of the unfortunate women whose hot flashes leave them red-faced, sweaty, bedraggled, embarrassed, uncomfortable and looking like they have spent 20 minutes in a steam room fully clothed, you will know this symptom can be inconvenient and distressing.
Stress can often exacerbate hot flashes so your feeling that they strike at the most inconvenient times might not be all in your imagination. If you are planning to ask for a pay-rise, meet with the Principal to fight your child’s corner or confront someone, make sure you are dressed in natural fabrics in layers you can remove if the heat hits you.
Mood Swings
Menopausal mood swings may be almost indistinguishable from pre-menstrual mood changes which are unsurprising as they are both caused by hormonal activity.
However, during menopause, their frequency and severity may increase which can be upsetting and unsettling.
There are ways to decrease the frequency and severity of mood swings ranging from tweaking your diet to include more fruit, vegetables and soy products to taking hormone replacement therapy (HRT).
The first thing to do if you realize your mood is low, you feel anxious, aren’t enjoying life as much as you did previously or have any concerns about your mood, confidence or state of mind is to talk about it.
Confide in a friend or family member if it helps, but your best point of call is your physician who may be able to help you sort out some counseling or, if necessary, medication.
Counseling takes many forms nowadays, and you don’t necessarily have to lie on the shrink’s sofa. There are even very useful online counseling services you can self-refer to and counselors who work entirely over the phone.
Headaches
Headaches are another side effect which, like mood swings, are caused by hormonal changes. Your first line of defense would be over the counter headache pain remedies, but if headaches become frequent or severe, mention them to your doctor as they can be a sign of other conditions.
Physical Intimacy
Symptoms which affect your sex life can be the most distressing as they tend to be the sort of side effect people don’t talk about leaving many people feeling they are suffering alone.
Physical symptoms like vaginal dryness and loss of elasticity which can cause pain during intercourse can be solved with the use of over-the-counter lubricants.
A loss of libido might be down to fear of pain from these physical symptoms, could be hormone related or could be an expression of fear or sadness over the loss of fertility or the physical changes to an aging body.
Oddly regular sex is the best way to keep libido perky and to keep genitals stretchy and lubricated for longer. HRT and counseling can also help.
Skin and Hair
Like the vaginal area, skin on the rest of your body may change, along with your hair.
Some women suffer for the first time with dry skin while others develop greasy skin. Hair may also become dry or greasy, and women may notice it thinning and losing luster and bounce too.
It may be time to review which hair and skin products you use. Many brands make products specifically designed for the over 40s, 50s, and beyond, which you can buy off the shelf, or you could ask advice in your local beauty store, spa or hair salon.
They may advise changing the style or color of your makeup and hair too. Shades which looked great when you were younger may be too strong now. A good cut could bring life back to your limp locks also.
Some stores offer free samples of skin care and make-up products and free or subsidized makeover sessions so you can try before you buy.
Sleep Issues
Disturbed sleep and insomnia can be a stand-alone symptom during perimenopause and menopause or can be tied in with one or more of the symptoms listed above.
Not getting enough sleep can, of course, have a significant impact on how you cope with the daytime hours with lack of sleep causing anxiety, irritation, fatigue, and concentration problems.
Hot flashes, anxiety, sex-life problems, and headaches can all play havoc with sleep. Other issues which can cause your sleep to be disturbed or make it difficult to drop off include bladder problems and incontinence.
Here are a variety of ways to improve your chances of falling asleep quickly and staying asleep:
- Use natural fabrics for your bedclothes and sleepwear.
- Stick to a regular schedule, so your body knows it is time for bed.
- Get some fresh air and if possible at least 30 minutes of sunlight a day (using sun protection).
- Try meditation, yoga, deep breathing or other relaxation methods to de-stress before bed. Try playing soothing sounds or reading for a set time each night.
- Avoid screens too close to bedtime. Read or listen to calm music or nature sounds instead.
- Take a warm bath, avoid alcohol or caffeine (found in tea, coffee, cold drinks, and chocolate) before bed.
If despite all these measures you still can’t sleep, don’t lie in bed worrying about not getting sleep. Get up and find something relaxing to do until you start to feel sleepy again.
What Are the Stages of Menopause?
Did you know there are effectively three stages of menopause? The stages cover before, during and after menopause.
Perimenopause (Before)
I mentioned perimenopause earlier. This is the time before menopause and when estrogen levels begin to fall. Perimenopause typically lasts around three to five years although some women might have a shorter or longer perimenopause period.
Although menstruation may become irregular and bleeding lighter, it is still possible to get pregnant during this time so birth control should be used until at least 12 months have passed since your last menstrual period and you are officially in menopause.
Menopause (During)
Technically you are in menopause after you’ve gone 12 full months without any menstrual periods and the lack of menstruation is not down to pregnancy, medication, illness or breastfeeding.
The transition from perimenopause to menopause proper usually takes between one to three years, and most women enter the menopause in their early 50s.
Some women experience all of the symptoms mentioned above and more while others experience few if any signs.
Postmenopause (After)
You are described as post-menopausal a year after your last menstrual period. Symptoms which started during perimenopause may continue through menopause and postmenopause.
Additionally, some women fall into a higher risk category for heart disease and low bone density (osteopenia and osteoporosis) due to the lower levels of estrogen in their body.
How To Cope With Menopause
I wish I could give you a magic formula for coping with menopause, but the simple truth is each woman experiences and copes with the stages of menopause in their own unique way.
Symptoms which are mildly irritating to some women can be devastating to others depending on life circumstances and health conditions.
If you feel you would benefit from help, you could make an appointment with your usual health care provider or find a doctor who is a specialist in menopause. Other women prefer to try homeopathic remedies, make lifestyle changes or plow through menopausal stages without any support, medical or otherwise.
The thing to remember is there are no prizes for suffering when you don’t need to. Accepting help, whether that is a talking therapy or hormone replacement therapy, does not make you a failure.
Hormone Replacement Therapy
Most people have heard of hormone replacement therapy (HRT), but any lingering doubts about safety should be relieved by a visit to your doctor who should reassure you about modern versions of the medication.
HRT is available in tablet, patches, gels, and topical form. Put simply HRT replaces the hormones that are at lower levels as you approach the menopause.
As well as relieving symptoms like hot flashes, night sweats, mood swings, vaginal dryness, and reduced sex drive it can help prevent the conditions which cause your bones from weakening which are more common during and after menopause.
HRT is available in a number of variations with or without progesterone. It is suitable for most women, but make sure your physician knows about any history of breast, ovarian or uterine cancer, blood clots, high blood pressure or liver disease. These conditions don’t necessarily rule out HRT, but it’s important they are taken into consideration while choosing what type and combination you might try.
Be aware that it is still possible to get pregnant while on HRT so you should use contraception until two years have passed since your last period if you are under 50, or one year if you are over 50.
Most women take HRT for a couple of years until their menopausal symptoms have ceased. You can just stop it, but most medical professionals advise you gradually decrease your HRT dose to prevent symptoms from returning.
There are some risk factors to taking HRT including a slightly higher risk of blood clots and breast cancer, but the benefits are generally considered to outweigh the risks.
Bioidentical Hormones
If HRT isn't an option for you, you may ask your doctor about bioidentical hormones made from plant sources. They are available in tablet, patch and gel forms.
The U.S. Food and Drug Administration (FDA) has approved some forms of manufactured bioidentical hormones, including bioidentical estriol (a weak form of estrogen) and progesterone. However, the FDA hasn’t approved any custom-compounded bioidentical hormones. Most bioidentical hormones are manufactured and sold without controls for safety, quality, or purity.
Many medical organizations have taken a stand against the marketing and use of unapproved bioidentical hormones.
Alternatives to Hormone Replacement Therapy
If you aren’t able to take HRT, or you’d prefer not to, there are alternatives ways of managing menopausal symptoms:
- Make lifestyle changes. Ensure you eat a healthy diet and exercise regularly, get plenty of rest to improve mood and sleep. Activities like yoga or Tai Chi may help you relax. Cut down on caffeinated foods, alcohol, and spicy foods. They have all been known to trigger hot flashes.
- Stop smoking. Ask your health care provider or even check the aisles of your local pharmacy for help. You can join a support group, try hypnotherapy or use patches, e-cigarettes or gum to help you. Giving up smoking could reduce hot flashes as well as lower your risk for serious health conditions.
- Use lubricants and add romance. If your sex life is struggling due to dryness, pain or a loss of libido explore the lubricants on offer in stores. You can also buy estrogen-free creams and lotions which can moisturize the genital area and relieve any soreness or itching caused by dryness. Take a little longer to get in the mood. Maybe just a small glass of wine, some candles or utilize whatever turns you on to make sex more relaxed and enjoyable.
- Try counseling and/or antidepressants. If your mood is consistently low or you are feeling very anxious talk to your healthcare provider, especially if mood swings are affecting your work or personal life.
- Experiment with complementary therapies. Health shops sell a wide range of combination menopause remedies along with herbal remedies like evening primrose oil, black cohosh, angelica, ginseng, and St John’s Wort. It’s a good idea to ask your doctor or pharmacist for advice about complementary therapies, especially if you take conventional medication for any other health conditions. Buy complementary therapies from reputable sources such as licensed homeopathic practitioners or your local drugstore rather than from the internet.
The Bottom Line...
The main thing to take from this is taking control of your own menopausal period is the best way to avoid “suffering" from the menopause.
Don’t be afraid to talk about your experiences with friends and family so they can be understanding if you are not feeling yourself. Always remember it’s okay to ask for help.