Menopause is a health event all people with ovaries experience in their lifetime. Yet even though half of the population will experience it at some point, there are still a lot of questions as to what is going on in the body during this time. Maiah Hall, ARNP, CNM, DNP, and Darcy King, ARNP, CNM, both with Valley Women’s Healthcare, discuss many hot topics – including, of course, hot flashes! – surrounding menopause in this DocTalk video.
A summary of the conversation can be found below the video.
What are the differences between perimenopause and menopause, and what are the typical ages people start experiencing these phases
Perimenopause is the transition phase leading up to menopause, often lasting about four to seven years (and sometimes up to a decade). During this time, menstrual cycles can become irregular as hormone levels change. Menopause officially occurs when someone has gone 12 months without a menstrual period, and on average, this happens between ages 51 and 52. Some people may begin noticing changes in their 40s, and if periods stop before age 45, especially before 40, this could be premature menopause and should be checked by a healthcare provider.
What are the typical and less typical symptoms of perimenopause?
Common symptoms that often bring people to the clinic include hot flashes, night sweats, and irregular periods. People may notice their periods becoming heavier and longer, or alternatively shorter, before they stop. Other symptoms can include brain fog, joint pain, muscle aches, sleep disturbances, fatigue, and heart palpitations. It’s important to note that symptoms can vary significantly–some people experience frequent hot flashes while others have none.
Are there any differences in how some racial and ethnic groups experience menopause?
Women of color tend to experience more frequent vasomotor symptoms (hot flashes and night sweats) that can last longer, up to a decade or more. Cultural view on menopause and aging also vary significantly among different racial and ethnic groups, which can affect how people experience and manage this transition.
How does menopause affect anxiety and depression?
There is an increased likelihood of mood changes, including anxiety and depression, during the menopausal transition. Cultural factors, personal history, and the stories shared by mothers, sisters, and friends can influence a person’s understanding and acceptance of these changes. While not everyone will face mood changes, it’s important to recognize the connection and seek help if needed.
How can you tell the difference between perimenopause symptoms and other medical conditions?
Age is often a key clue; symptoms typically start around age 45 or later. If they begin much earlier, it’s worth checking for other conditions. Certain routine screenings can help rule out issues like thyroid dysfunction, anemia, sleep apnea, diabetes, or depression. Since symptoms like fatigue, mood shifts, or irregular cycles can overlap with other health issues, it’s essential to get a comprehensive evaluation if something doesn’t feel right.
What are some lifestyle options and medical treatments for managing menopause symptoms?
Lifestyle adjustments, such as improving nutrition, regular exercise (including strength training), and avoiding personal triggers (like alcohol) can help. Hormone therapy is an option if symptoms significantly affect quality of life, and starting it before age 60 and within 10 years of the final menstrual period is generally considered safe. Non-hormonal treatments are available including selective serotonin reuptake inhibitors (SSRIs), gabapentin, or a newer medication targeting hot flashes, fezolinetant. Cognitive behavioral therapy can also help with mood, sleep, and even low libido.
Are there treatments for the decrease in libido or other sex life changes?
Many people can still have fulfilling sex lives after menopause, even if the initial spontaneous drive is lower. Non-hormonal medications and, in some cases, carefully monitored testosterone therapy can help. Vaginal estrogen therapy is safe for local symptoms like dryness, pain, or irritation during intercourse. The goal is to address what’s causing distress–whether it’s physical discomfort or changes in desire.
Are there long-term health effects associated with menopause?
Over time, decreased estrogen levels can lead to changes like reduced vaginal and vulvar change, increased risk of urinary tract infections, and bone density loss (raising the risk of osteoporosis). Changes in body composition and skin texture are also common. Because the risk of cardiovascular disease rises as we age, maintaining a healthy lifestyle, monitoring blood pressure and cholesterol, and getting regular screenings are important.
When should you seek care from a healthcare professional?
Seek care when you don’t feel like yourself anymore or when changes affect your quality of life. You don’t need to wait until symptoms are severe–many people benefit from simply learning more about the changes their body is experiencing. Care providers can include OB/GYNs, gynecologists, nurse practitioners, or nurse midwives. If you don’t have an established relationship with these specialists, start with your primary care provider.
For more information, visit the Menopause Society website at menopause.org, which offers friendly, evidence-based information about menopause and its management.
Understanding Our DocTalk Videos
The information shared in the video above represents the opinions of the individual healthcare provider(s) featured. Our DocTalk presenters will sometimes give a general overview including risks, symptoms, and treatments for the medical conditions they are addressing. Therefore, they may not cover specific details that would be available in other resources or in an appointment with a provider about your own healthcare conditions. Please also note that the written summary may not capture every detail contained in the video, and additional information might only be in the video format. Our goal is to inform, educate, and inspire healthier living. If you have any questions about the video content, please contact us HERE.
