An Overview of Menopause

Menopause is the term used to describe your final menstrual period, which occurs when your ovaries have stopped producing the hormones that drive your menstrual cycle. Menopause is most accurately diagnosed after you have missed your period for 12 consecutive months. Because of the way your hormone levels change around menopause, there is no accurate and reliable blood test to diagnose it.

Menopause is not reversible.

Once your ovaries have stopped producing hormones, you will no longer get your period. The signs and symptoms of menopause are caused by the changes in the function of your ovaries.

There are three different ways your body can enter menopause.

  • Naturally Occurring Menopause: This is the most common progression to menopause. Every woman will eventually stop getting her period. This usually occurs around age 52. However, it is completely normal for menopause to occur between age 40 and 58. 
  • Premature Menopause: This is menopause that happens before age 40. Unlike naturally occurring menopause, premature menopause is considered abnormal. It is often associated with other autoimmune disorders and puts you at increased risk of osteoporosis. If you are less than 40 years old and you think you are in menopause, it is very important that you discuss this with your doctor.
  • Induced Menopause: This type of menopause occurs when there is some injury to the ovaries, which is typically related to medical treatments like surgery, chemotherapy, or radiation. Unlike naturally occurring menopause, which happens gradually, induced menopause is usually abrupt, and menopausal symptoms are often sudden and intense. 

    Is Perimenopause the Same as Menopause?

    Unless your ovaries have been removed surgically, menopause doesn't happen overnight. Instead, your ovaries gradually decrease the amount of hormones they produce. This winding down of your ovarian function typically takes several years and is called perimenopause or the menopausal transition.

    Your ovaries don't slow their function in a predictable way. Some months your ovarian hormone production could be close to normal, while other months your hormone production could be way off from normal.

    During your menopausal transition, you might start to notice some changes in your period. Lighter and/or less frequent periods are a normal change and an expected response to your decreasing hormone levels. Heavier and/or more frequent periods need to be evaluated by your doctor. Although this can be a normal way your body responds to your hormonal changes, it can also be a sign of an underlying condition that is causing abnormal uterine bleeding.

    You may also start to experience some typical menopausal symptoms as a result of your changing hormone levels. For some women, the symptoms of menopause are more intense during perimenopause than they are in the early postmenopausal years.

    Top 3 Symptoms of Menopause

    Some women may have very severe menopausal symptoms, while other women will barely have any complaints.

    Every woman experiences menopause differently. However, there are some predictable menopausal symptoms that are commonly noticed by most women.

    Hot Flashes/Flushes

    Hot flashes or flushes are a very common—and very unpleasant—symptom of menopause. The clinical term for a hot flash is a vasomotor symptom. Although we don't know exactly what causes the vasomotor symptoms of menopause, we do know that changing hormone levels are likely a trigger that disrupts your body's temperature control system.

    If you have experienced a sudden feeling that your face, neck, or chest is burning up, you likely have had a vasomotor symptom of menopause. Typically after you feel the intense heat you may turn red, begin to sweat, and get the chills. Sometimes this may also be associated with anxiety or heart palpitations. A typical vasomotor symptom lasts anywhere from one to five minutes. Most women who experience vasomotor symptoms will have a least one a day. It is common to have mild vasomotor symptoms, especially at night in the late luteal phase of your cycle just before your period. This can signal the beginning of your menopausal transition. 

    Vaginal Dryness

    With menopause, your estrogen levels drop because your ovaries have stopped producing this hormone. Estrogen is important for your vagina, and vaginal dryness is a direct result of a lack of estrogen. Without adequate amounts of it, the walls of your vagina lose volume and moisture and become thin, dry, and easily irritated. This can lead to painful sex, an increase in vaginal infections, and chronic vaginal discomfort.

    Sleep Disturbances

    Night time vasomotor symptoms are a big cause of interrupted sleep. Many women will report waking up because they are cold, drenched in sweat, and/or lying in a wet bed. For some, this awakening will ruin an entire night's rest because of difficulty falling back to sleep.

    The age of menopause is also the age when underlying medical conditions such as sleep apnea and overactive bladder can cause frequent awakenings. Some women will also have trouble falling asleep at night. This can be a symptom of stress or depression. Chronic sleep deprivation is not good for your health. If you are experiencing disturbed sleep it is important to discuss this with your doctor.

    5 Unpleasant Changes That Could Signal the Approach of Menopause

    The hormonal changes during the menopausal transition and menopause often bring along some unpleasant and sometimes unexpected changes in your body.


    Having flashbacks to the trauma of teenage breakouts? Chances are if you had acne when you were a teen, you will have acne around menopause. With your ovaries decreasing the production of estrogen, there is a relative increase in acne-causing hormones.

    Hair Loss

    Thinning hair. More visible scalp at your part line. Female pattern hair loss can sometimes be associated with menopause. Decreasing estrogen levels are thought to play a part. Stress is thought to contribute to hair loss as well. However, there appears to be a relatively significant genetic predisposition to menopausal hair loss. So, if your mother lost her hair in menopause, there is a good chance you will too. 

    Increasing Waist Line

    Are your pants suddenly too tight in the waist? The loss of estrogen is thought to be associated with a shift in fat distribution in women from the typical upper thighs and buttocks to around the waistline. This type of weight gain is particularly unhealthy and is associated with an increase in cardiovascular disease.

    Facial Hair

    Facial hair growth occurs as a result of the same hormonal imbalance as acne and hair loss. The relative increase in androgens stimulates male pattern facial hair growth. Sometimes this may be just a single stray chin hair that you can easily pluck yourself. However, if your facial hair growth is more significant, you may want to consider laser hair removal.

    Sagging Skin

    The lack of estrogen in menopause results in a loss of collagen. Collagen is responsible for giving your skin its thickness. In the first few years after menopause, your body loses about 30 percent of its collagen. This leads to thinner and stretchier skin. Menopause also brings a loss of muscle and a redistribution of the fat under your skin, worsening the sagginess. 

    What to Do if You Are in Menopause

    Despite all of the symptoms and changes in your body, menopause is not a disease that needs to be treated. It is a normal part of getting older. That being said, you may decide to seek treatment to help with the unpleasant symptoms of menopause (or you may simply decide to just wait them out). Either way, menopause is a good time for you to take care of yourself. 

    Check Your Lifestyle

    Menopause is the perfect time to take a look at your lifestyle. Are there changes you can make to improve your overall health and wellness?

    We all know that a healthy, well-balanced diet and adequate physical activity are very important. If you are not already eating well, you may consider talking to your doctor or seeing a nutritionist to better understand what a healthy diet is for you. The same goes for exercise. If you are not already in a good groove with your physical activity, you may consider seeing a personal trainer who can help you kick-start a workout routine. 

    In addition to following the general principles of a healthy, well-balanced diet and regular physical activity, there are a few specific diet and exercise tips to help you achieve your best physical health in the years during and after menopause.

    • Build Muscle: Strength training is crucial to your overall physical health. You start to lose lean body mass (a.k.a. muscle) at the age of 40.
    • Eat More Protein: You need protein to build muscle.
    • Drink More Water: Most women don't drink anywhere near the required amount of water a day (as a general rule, that's two liters daily). Among the other important reasons to drink enough water, it will help improve the appearance your aging skin and help you control your weight.

    See Your Doctor For a Physical Exam

    Your busy life may have distracted you from checking in on your own health. Maybe you have kept up with your pap smears and your mammograms, but have you had your routine screening for thyroid disease, diabetes, or heart disease lately?

    Get to your primary care doctor for a physical exam. The age of menopause and the hormone changes related to it put you at risk for many chronic medical conditions. Get screened. Prevention and early detection are the ultimate goals.

    Take Care of Your Mental Health

    The age at which you approach menopause often coincides with many social stressors. You may be seeing your kids off to college, dealing with the death of a parent, struggling with marital problems, or worrying about your finances. The added symptoms of menopause, including sleep deprivation and possible anxiety or depression, can certainly make things worse.

    It is very important to take care of your mental health during menopause. Sometimes that can be accomplished by long walks, meditation, or yoga. But sometimes it takes more than that. Don't be afraid to talk to your doctor if you are having trouble coping with the demands of your daily life. Your mental health should be your number one priority.

    Learn About Treatment Options

    There are many options to help ease the menopausal transition and improve the symptoms of menopause. Treatment options range from acupuncture to herbal remedies to hormone replacement. You should discuss treatment options with your doctor. You might even decide to see a gynecologist or a menopause specialist.

    A Word From Verywell

    Yes, menopause can be difficult to manage. It is not a disease, but it still affects your body physically and mentally. Understanding the changes in your body and learning about coping strategies and treatment options can help you to live very well during and after menopause.


    American College of Obstetricians and Gynecologists (2014). ACOG practice bulletin no.141: Management of Menopausal Symptoms. Obstet Gynecol 2014;123:202-16.

    North American Menopause Society. (2014). Menopause Practice A Clinician's Guide. Mayfield, Ohio.

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