The ovaries contain all of the eggs at birth they will ever contain. The menstrual cycle controls the monthly release of eggs until menopause. The menopausal transition starts when this process changes and production of hormones like estrogen begins to decline. Most women start this transition (also called perimenopause) in their late 40s. But it can happen earlier or later. During this time, women may experience certain symptoms, such as changes in their periods and hot flashes. If a woman hasn’t had a period in 12 months, she can say she’s entered menopause. But for many women this transition is less clear.

“Around one in eight women enter menopause because of a medical intervention, like having their ovaries removed surgically,” says Dr. Sarah Temkin, a women’s health expert at NIH. If this happens, they enter menopause suddenly, with no transition. The bothersome symptoms that they experience are often more significant than if they had entered menopause naturally.

If you haven’t had a period in a year, blood tests can verify that you’ve reached menopause. But no test can confirm when you’ve begun the transition into menopause. If you have symptoms, your doctor may order tests to rule out health conditions.

The menopausal transition (perimenopause) usually lasts around seven years. But it can be shorter or longer.

Cooling Hot Flashes Down

Many women experience only mild symptoms during perimenopause. For others, symptoms are severe and can interfere with work and life. The most common are called vasomotor symptoms. These include hot flashes and night sweats

“A lot of symptoms can be interrelated,” says Dr. Andrea LaCroix, a menopause researcher at the University of California, San Diego. “If you have hot flashes, they might interfere with your sleep. Then once you get sleep deprived, you don’t feel so good overall.”

If you have mild hot flashes, you may be able to manage them with lifestyle changes. These include dressing in layers that can be removed, carrying a portable fan, and avoiding alcohol and caffeine.

Women with severe symptoms now have several drug options to consider. Some women can safely use menopausal hormone therapy, or MHT. Two decades ago, hormone therapy for women in the menopausal transition fell out of favor. Doctors had concerns about the risk of breast cancer, heart disease, stroke, and blood clots from hormone therapy. These concerns were based on a large study that tested hormone therapy to prevent chronic disease in older women. The study showed higher chronic disease risk for some women taking MHT. More recent studies have confirmed these findings but also found that healthy, younger women who use MHT don’t have the same increased risk as older women. Talk with your health care provider about the potential risks and benefits if you’re considering MHT. Some women can’t use hormone therapy because of certain personal risk factors. Others may not want to use it. “But there are other treatment choices,” says LaCroix.

“All of these treatments have been found to be helpful, so women have choices.” LaCroix says. “There’s a huge amount of stigma about women talking about their reproductive health,” Temkin says. “Women sometimes feel, going through the menopausal transition, that they’re in it alone,” agrees Dr. Chhanda Dutta, an aging expert at NIH. “And while women experience this transition in very different ways, they need to be aware that they’re not alone.”

Transitioning 

Into Menopause?

Perimenopause symptoms can be different for everyone and include:

• Changes in your period. Periods happening very close together or farther apart than usual; heavy bleeding or spotting; periods that last for more than a week.

• Hot flashes. A sudden feeling of heat in the upper part or all of your body.

• Night sweats. Hot flashes that happen during sleep.

• Sleep problems. Trouble falling asleep or staying asleep.

• Bladder issues. Sudden urges to urinate, or urine leaking during exercise, sneezing, or laughing.

• Changes in vaginal health and sexuality. Vaginal dryness; discomfort or pain during sex; changes in sexual desire.

• Mood changes. Feeling moody or more irritable; feelings of anxiety or depression.

• Changes in body composition. Muscle loss or fat gain; skin can become thinner; joints and muscles may feel stiff or achy.

Monique Koerner is the Family and Community Wellness Agent with K-State Research and Extension – Cottonwood District. You may reach her at: 785-628-9430 or moniquek@ksu.edu.