Menopause is something every woman will go through at some point in her life. Yet, it still remains misunderstood and somewhat of a mystery. To navigate this rite of passage with confidence and grace I believe women need to understand what to expect during each phase. In this blog, I’ll discuss each stage of menopause, provide some insight with scientific research, and do my best to provide a clear picture of what to expect and more importantly, how to thrive amidst the changes that come with this transition.
Stage 1: Perimenopause—The Prelude to Menopause
What is Perimenopause?
Perimenopause typically starts in a woman’s 40’s but can start as early as mid 30’s. The average time this stage lasts is around 4-8 years though it can differ significantly. Regardless of when perimenopause begins or ends for you, it is the transitional period leading up to menopause. During this timeframe, less estrogen is produced by your ovaries. Therefore, leading to a wide range of symptoms that we will discuss below.
Symptoms of Perimenopause:
- Irregular periods: Changes to your menstrual cycle is one of the earliest and easily detectable signs of perimenopause. You may experience shorter, longer, heavier, or lighter periods during the beginning stages. Also, the duration between periods may increase or decrease. In other words, your experience will be as unique as you are.
- Hot flashes and night sweats: Many women experience hot flashes and/or night sweats (hot flashes during sleep) due to fluctuations in estrogen levels during this phase. These can range from mild and infrequent to intense and often depending on your hormone levels.
- Mood changes: Think 2nd puberty, only this time instead of starting your period, you are gearing up to complete the cycle. As estrogen gradually declines at this stage it may lead to what seems like constant irritability, rapid mood changes, and sometimes even depression.
- Sleep disturbances: Sleep can be a significant issue during perimenopause. Some may exhibit difficulty falling asleep and others staying asleep. Either catches up with you quickly.
- Vaginal dryness: Decreased estrogen is also the culprit that leads to vaginal dryness. This can lead to painful intercourse.
Scientific Insights:
Menopause: The Journal of The North American Menopause Society published a study that stated up to 75% of women experience hot flashes at some point during perimenopause, so remember that you are not alone! Speak to friends about what you are experiencing. I bet they have been through some of the same things and talking about it can help. Team up and decide to take action together!
Set up an appointment with your doctor and get some labs done. Then you have a jumping off point and can begin to figure out the best course of action. In the meantime, be gentle with yourself, and focus on one lifestyle change at a time. A good place to start is your sleep routine!
Stage 2: Menopause—The Official Transition
What is Menopause?
Menopause is officially marked 12 months after your last period. For example, if your last period was on September 4th, 2024, then you will not be considered to be in menopause until you have gone without a period for 12 consecutive months or in this case Sept 4th, 2025.
In the US, the average age this occurs is 51. However, it may occur sooner or later. At this point, the ovaries are no longer releasing eggs, and the production of estrogen has undergone a significant decrease which can cause continued symptoms as well as increased health risks.
Symptoms of Menopause:
- Cessation of periods: Menopause is marked by no longer menstruating. This is determined at the point you have not had a period for 12 consecutive months.
- Continued hot flashes and night sweats: I wish I could say once you hit menopause these stop but many women continue to experience hot flashes after menopause. The good news is they eventually decrease in intensity and become less frequent as your body adjusts to making less estrogen.
- Bone density loss: The rate at which women loss bone density increases as estrogen levels decrease. This is known to increase the risk of osteoporosis. Be mindful of creating habits to combat bone density loss like weight training.
- Cardiovascular changes: Menopause triggers changes in cholesterol levels. Higher bad cholesterol can lead to a higher risk of heart disease. Be aware of your numbers and take necessary precautions.
- Urogenital symptoms: Symptoms like vaginal dryness, a frequent and urgent need to urinate, and discomfort during intercourse may continue or even worsen during menopause. Use lubricants and talk to your doctor to make sure other things aren’t going on. Prolapses are common at this stage as pelvic muscles become weaker with less estrogen production and may be the underlying reason for some of these issues.
Scientific Insights:
The Women’s Health Initiative (WHI) did a study about the long-term health risks correlated to menopause, specifically in regard to bone health and cardiovascular disease. The study concluded that it was extremely important to monitor both cholesterol and bone density both leading up to as well as after menopause. It never hurts to be proactive and begin things like balance training, weight training, and eating to support both bone and cardiovascular health.
Stage 3: Post-Menopause—Life After Menopause
What is Post-Menopause?
Post-menopause refers to any time after you have reached menopause. During this stage, menopausal symptoms may begin to diminish. However, you aren’t in the clear yet. As stated above, due to sustained low estrogen levels you are at higher risk for osteoporosis and cardiovascular disease.
Symptoms and Health Considerations:
- Decreased frequency of hot flashes: Many women experience less frequent and more mild hot flashes once they are in the post menopause stage. Some women even say they cease to exist.
- Increased risk of osteoporosis: Without the protection of estrogen, the loss of bone density accelerates, making this a crucial time to focus on bone health with strength training and good nutrition.
- Higher cardiovascular risk: Maintaining a heart healthy lifestyle is essential for post-menopausal women due to being at a higher risk for heart disease. Go for a brisk walk, eat a heart healthy nutrition plan, and get regular check ups to stay on top of this risk.
- Continued vaginal dryness: Estrogen plays an important role in vaginal health so as it decreases vaginal dryness and urogenital atrophy can persist, affecting sexual health and comfort levels. Pay attention to this and use lubricants to help with discomfort. Speak to your doctor if pain persists or you suspect there is something more going on. You know your body best. Listen to it and act accordingly!
Scientific Insights:
The Journal of Clinical Endocrinology & Metabolism published research highlighting the importance of calcium and Vitamin D, along with strength training to increase bone health and decrease the risk of fractures in post-menopausal women. Furthermore, the American Heart Association reports that making lifestyle modifications is of utmost importance to combat the increased risk of heart disease after menopause.
Make a list of foods high in calcium and Vitamin D that you are willing to eat and that agree with your digestive system. Once you have the list, keep these in mind as you do your weekly groceries. Post it on the refrigerator as a reminder until it becomes habit.
Navigating Menopause with Confidence
My hope is that now that you have a better understanding of the stages of menopause that you can use what you learned here to better anticipate and manage the changes your body will undergo during this transition. While menopause can be challenging, it’s also a golden opportunity to focus or re-focus on your health and well-being. Being well informed and proactive will help you navigate and thrive during your menopause journey.
If you suspect that the symptoms you are experiencing are menopausal, it’s important to talk to a healthcare provider who specializes in women’s health. They can guide you with your best options to manage your symptoms and protect your long-term health. Each woman’s journey through menopause will be as unique as she is. However, armed with the right knowledge and support, I’m confident that you can turn this transition into a positive chapter in your life.
Are you ready for support and guidance in navigating your menopause journey but don’t quite know where to start? Have no fear, Christine with a solution! Join me in my 6-week Menopause Mastery Challenge. Each week we focus on a different aspect of wellness including mindset, creating your menopause mission statement, movement, nutrition, self-care, and reflection regarding the strides you have made. Got questions? Reach out at [email protected] and I will answer them so we can get you started. Ready to get started? Join here!
Not looking for menopause help but need to make some changes to your health routine? Check out my Healthy Makeover Challenge. This one is self-paced so you can go through is at your own speed and I am always a text or email away if you need support. You can sign up here.
Wishing you much love, health, and happiness,
Christine
References:
1. Menopause: The Journal of The North American Menopause Society, study on the prevalence of hot flashes.
2. Women’s Health Initiative (WHI), cardiovascular health and bone density research in menopausal women.
3. The Journal of Clinical Endocrinology & Metabolism, research on osteoporosis risk in post-menopausal women.
4. American Heart Association, guidelines on heart health after menopause.
