Menopause: Symptoms, Stages & What to Expect   

Menopause: Symptoms, Stages & What to Expect

Clinical Contributors to this story:
Meghan Rattigan, D.O.

Women usually experience perimenopause and menopause during their 40s and 50s. The occurring hormone shifts may cause erratic menstrual cycles, insomnia and mood changes.

During perimenopause, a woman’s hormone levels decrease as her body transitions toward menopause. She reaches menopause when she hasn’t had a menstrual period for 12 months.

The average woman is 51 when she reaches menopause after experiencing several perimenopausal years. Some women notice new symptoms during this time, while others simply have no periods.

“There’s a certain relief for a lot of women because they don’t have to worry about an unplanned pregnancy,” says Meghan I. Rattigan, D.O., an OBGYN in Freehold, New Jersey. “It’s another chapter of your life.”

Symptoms of Perimenopause and Menopause

During perimenopause and menopause, women experience menstrual changes. Other possible symptoms include:

  • Hot flashes
  • Night sweats
  • Mood changes
  • Depression
  • Anxiety
  • Insomnia
  • Urinary urgency or incontinence
  • Difficulty losing or maintaining weight
  • Weight gain

During menopause, women may also experience:

  • Vaginal dryness
  • Painful sex
  • Decreased libido

Signs That You’re Entering Perimenopause

Often, women first realize that they’re perimenopausal because their menstrual periods become irregular. 

“Your periods may become longer, shorter or spaced out,” Dr. Rattigan says. “There’s a wide variety; it’s just a change from what you’ve had before.”

During perimenopause, you may feel hot, tired or oversensitive. These normal symptoms are caused by hormone changes.

“You may experience vasomotor symptoms – hot flashes, night sweats or a combination of both,” Dr. Rattigan says. “You may feel moodier, like you have PMS for the first time.”

Difficulty with weight management is a common complaint during perimenopause. Hormone changes cause the metabolism to slow down, leading to weight-related concerns.

“Patients stick with the same diet and exercise routine and they’re not losing weight, or even gaining,” Dr. Rattigan says. “It’s something that tends to level out once you’re in menopause.”

Healthy lifestyle habits can help you manage perimenopausal symptoms. 

“Maintain a well-rounded diet, keep your body moving, practice good sleep hygiene, limit alcohol,” Dr. Rattigan says. 

Hormone-containing forms of birth control may provide relief. Some OBGYNs keep patients on hormonal birth control throughout perimenopause, to minimize symptoms.

“If they’re doing well, I prescribe it until the average age of menopause, 51,” Dr. Rattigan says. “Then we do a trial, coming off of it to assess symptoms and their period.”

Signs That You’ve Reached Menopause

Once you go 12 months without a menstrual period, you have reached menopause. Blood tests may verify it happened, but the absence of periods confirms the milestone.

In menopause, women produce less estrogen and testosterone than during their reproductive years. The drop in hormones may cause sexual symptoms.

“A very common complaint is vaginal dryness, from lack of estrogen,” Dr. Rattigan says. “And too little testosterone can contribute to vasomotor symptoms (like hot flashes or night sweats) and decreased sex drive.”

Over time, hot flashes, weight gain or other symptoms may fade.

“A lot of people feel that once they’re in menopause, the symptoms get better,” Dr. Rattigan says. “They could linger for five to seven years, on average, after your period stops.”

Treatments for Menopause Symptoms

If you’re uncomfortable during perimenopause or menopause, seek help. You don’t have to cope with unwanted symptoms.

“Talk to your doctor about the symptoms that interfere with your quality of life,” Dr. Rattigan says. “There are treatments available.”

Doctors may prescribe hormonal or non-hormonal medications to alleviate symptoms. 

Hormones may be prescribed as pills, transdermal patches, topical gels or vaginal rings. Non-hormonal options include antidepressants, anti-anxiety drugs and medication for overactive bladder.

An SSRI antidepressant could help with hot flashes and mood swings,” Dr. Rattigan says. “And overactive bladder medications can help with hot flashes, which many people don’t know.”

Be vocal about your symptoms so your doctor guide you through this experience and improve your quality of life.

“Don’t have the mentality that ‘This is something I’m just going to have to live with,’” Dr. Rattigan says. “Any symptom causing a disturbance to your life should be mentioned.”

Next Steps & Resources:

The material provided through HealthU is intended to be used as general information only and should not replace the advice of your physician. Always consult your physician for individual care.


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