There is more to menopause than the end of a woman's menstrual cycle. However, it isn’t talked about openly, so the experience can feel overwhelming and isolating.
We spoke with Carilion Clinic's Yasmeen Adams, NP, who specializes in Obstetrics and Gynecology, to learn more about menopause symptoms and treatments.
She recommended that women start with reliable sources of information, such as:
- American College of OB/GYN
- The Menopause Society (formerly known as NAMS)
Yasmeen, who is certified by the Menopause Society as a menopause practitioner, says that online resources are only a start, and that women should consult their physician with concerns.
"Some women breeze through the menopause transition, but other women have significant problems with the symptoms," she said. "I encourage women to talk to their healthcare provider about their concerns and possible therapeutic options if needed."
Menopause
Menopause is defined as the final menstrual period a woman experiences. It is usually confirmed when a woman has missed her periods for 12 consecutive months in the absence of other obvious causes.
Menopause is a normal, natural event that occurs most often between ages 45 and 55 and marks the permanent end of fertility.
The Menopause Society describes perimenopause as the “gradual transition” from a woman's child-bearing years to menopause, when you may begin to see signs and symptoms of the end of your cycle.
Perimenopause can last for many years.
Signs and Symptoms
As a woman approaches menopause, she may start to notice her periods spacing out, or skipping months. Some women have hot flashes and night sweats even before their period stops.
Each woman’s experience is different, with some having no difficulties and others with symptoms that include:
- Hot flashes/flushes
- Vaginal dryness
- Depression
- Mood swings
- Difficulty sleeping
Although their exact cause still isn’t fully understood, hot flashes are thought to be the result of changes in the hypothalamus, the part of the brain that regulates the body’s temperature.
Not every woman experiences hot flashes, but those who do can experience:
- Perspiration
- Increased heart rate
- Red, flushed face and neck
- Cold chill following each flash
Help for Hot Flashes
Most women experience hot flashes for six months to two years, but they can last as long as 10 years. Hot flashes can reoccur more than 10 years after menopause, even into a woman’s 70s or beyond.
Until recently, there was no reliable non-hormonal treatment for hot flashes. In May 2023, however, the U.S. Food and Drug Administration approved Veozah, a non-hormonal medication, to treat moderate to severe hot flashes.
While relief from hot flashes can indirectly help to improve sleep and mood, Veozah does not address other menopause symptoms.
Help for Other Menopause Symptoms
Hormone replacement therapy (HRT) is often prescribed to smooth the transition into menopause or to address symptoms after menopause.
HRT is associated with some potential risks, however. There is a small risk of developing a blood clot or having a stroke. There is also a small increase in the risk of breast cancer (about 1 more case in 1,000 women per year).
It's important to review your medical history with your physician or practitioner when considering HRT.
Yasmeen recommends topical vaginal estrogen, or local therapy, to address vaginal dryness and help to minimize discomfort. “Estrogen cream can help strengthen thinning vaginal tissues, improve elasticity and increase lubrication,” said Yasmeen.
"Local therapy can often be used in women to treat genitourinary syndrome of menopause who should not or choose not to use HRT,” she said. “But vaginal estrogen will not help with hot flashes."
Women who experience mood changes should talk with their primary care physician or OB/GYN, whether their symptoms are related to menopause or not.
If you have questions or concerns about these or other menopause symptoms, make an appointment to discuss them with your OB/GYN or your primary care physician.
