Menopause 101: A primer for the perimenopausal
The information available on menopause could fill several books, but we understand you’re a busy woman—so here’s a bite-sized introduction to the subject.
Menopause is defined as the final menstrual period and is usually confirmed when a woman has missed her period for 12 consecutive months (with no other obvious causes). Menopause results in lower levels of estrogen and other hormones. It is a normal, natural life event that all women experience if they live long enough.
- Most women experience menopause between ages 40 and 58. The average age is 51.
- Physical changes begin years before the final menstrual period. This transition phase is called perimenopause and may last for 4 to 8 years. It begins with changes in the length of time between periods and ends 1 year after the final menstrual period.
- Induced menopause is when a woman’s menstrual periods end due to a medical intervention, particularly surgical removal of both ovaries or cancer treatments such as chemotherapy or pelvic radiation.
- Smoking and genetics are two factors that can influence the timing of natural menopause. Smokers reach menopause about 2 years earlier.
Common Body Changes at Menopause
Each woman’s experience of menopause is different. Many women report no physical changes during perimenopause except irregular menstrual periods that stop when menopause is reached. Other women experience symptoms of hot flashes, night sweats (heavy sweating from hot flashes at night, often disturbing sleep), and thinning and drying of vaginal tissue that can make sex painful. How severe these body changes are varies from woman to woman, but for the most part these changes are perfectly natural and normal.
- Hot flashes are the most common menopause-related discomfort. They involve a sudden wave of heat or warmth often accompanied by sweating, reddening of the skin, and rapid heart beat. They usually last 1 to 5 minutes. Hot flashes frequently are followed by a cold chill.
- Night sweats are hot flashes at night that interfere with sleep. While it’s a myth that menopause itself makes women irritable, the sleep disturbances that stem from hot flashes and night sweats can certainly make a woman irritable. Treatments for night sweats and hot flashes include lifestyle changes, nonprescription remedies, hormone therapy (with estrogen plus progestogen, or estrogen alone for women without a uterus), and nonhormonal prescription drugs.
- The drop in estrogen around menopause leads to vaginal atrophy (the drying and thinning of vaginal tissues) in many women. It can cause a feeling of vaginal tightness during sex along with pain, burning, or soreness. Over-the-counter vaginal lubricants and moisturizers are effective in relieving pain during intercourse. For women with more severe vaginal atrophy and related pain, low-dose vaginal estrogen products may be needed.