menopause

Life is full of transitions, but few are as challenging to navigate as menopause. This process can cause uncomfortable physical and psychological symptoms such as hot flashes, painful intercourse, and severe vaginal dryness. Thankfully, there are ways to relieve menopausal symptoms. Menopausal hormone therapy (MHT), dietary supplements, and lifestyle changes can help reduce hot flashes, relieve vaginal dryness, and mitigate other menopausal symptoms, allowing you to comfortably transition into the next chapter of your life.

What Is Menopause?

Menopause is a natural process that marks the end of a person’s monthly menstrual periods. This is caused by the loss of ovarian follicular function and reduced production of the hormones estrogen, progesterone, FSH (follicle-stimulating hormone), and testosterone. Doctors typically diagnose menopause if menstruation hasn’t occurred for at least one year.

Hormonal birth control—including birth control pills and hormonal intrauterine devices—causes menstrual cycle changes and can mask symptoms of menopause, making it difficult to detect the start of perimenopause—the period before menopause during which the ovaries produce estrogen at a slower rate.

Who Experiences Menopause?

Menopause affects people with uteruses who are typically occurs between the ages of 45 and 55. Some people experience menopause before the age of 40, which is often referred to as early menopause. Research indicates smoking is one possible cause of premature menopause.

Anything that damages the ovaries or stops the body from producing estrogen (like hysterectomy, ovary removal, radiation therapy, or chemotherapy) will cause symptoms of menopause.

How Long Does Menopause Last?

The duration of perimenopause and menopause varies between individuals. Perimenopause can last between two and eight years.

While most people experience menopausal symptoms for less than 5 years, they can last between 7 and 11 years for some. Genetics and lifestyle factors can influence the length of menopause.

Menopause Symptoms

Menopause symptoms usually start during perimenopause and can impact day-to-day life. Here are some typical symptoms of menopause:

Menstrual Changes

During perimenopause, changes in the frequency and duration of menstrual periods are common. Additionally, some may experience spotting between periods.

Hot Flashes and Night Sweats

Vasomotor symptoms of menopause (VMS), such as hot flashes and night sweats, are also common. Hot flashes are a sudden feeling of heat in the upper body. Red blotches and profuse sweating can occur during hot flashes, and you may experience chills afterward. Low estrogen levels also cause nighttime hot flashes, known as night sweats, which often disrupt sleep.

You can relieve hot flashes by drinking ice-cold water, removing a layer of clothing, and using a fan when you feel a flash coming on.

You can also treat hot flashes by identifying and avoiding triggers such as stress and spicy foods. Medical treatment can help manage severe hot flashes.

Vaginal Dryness

Low estrogen levels during menopause can cause vaginal dryness, resulting in discomfort, itching, and burning. Vaginal dryness can also cause small tears in thinner vaginal tissues, causing pain during sex.

You can treat vaginal dryness with an over-the-counter vaginal moisturizer. Estrogen therapy in the form of low-dose vaginal preparations is also an effective treatment for many. Additionally, using a water-based lubricant can help prevent pain during intercourse.

If you prefer natural remedies over vaginal moisturizers, low-dose vaginal products, and other medicines, then herbal supplements—like sea buckthorn oil—and vitamins D and E may be helpful.

Mood Changes

Mood swings can make you feel irritable one minute and teary the next. Getting enough sleep, staying active, and reducing stress can help mitigate mood changes and enhance your overall well-being.

Depression and Anxiety

Menopausal symptoms and hormonal changes can cause depression and anxiety. Adequate sleep, a healthy diet, and regular physical activity can reduce the symptoms of depression and anxiety. Talk with your healthcare provider if you experience severe depression during menopause, as this may require therapy, medication, or both.

Urinary Incontinence

Decreased estrogen levels can weaken the pelvic floor muscles and urethra, making it hard to hold in urine long enough to get to a bathroom; this is known as urinary urge incontinence. Some individuals also experience urinary stress incontinence, whereby sneezing, laughing, or coughing can cause a leak of urine.

Physical therapy, maintaining a healthy weight, and doing Kegel exercises can help with these urinary symptoms. Products like incontinence pads, pessaries, and urethra caps can help contain urine leaks.

Brain Fog

Problems with focus and memory affect about two-thirds of menopausal individuals. Simple practices—like getting enough sleep, eating a balanced diet, staying socially active, and engaging in mentally challenging activities—can reduce brain fog.

How To Treat Menopause Symptoms

Menopause treatment options—such as menopausal hormone therapy and vaginal estrogen—can help relieve hot flashes, vaginal dryness, and other symptoms associated with menopause.

Hormone Replacement Therapy

Hormone replacement therapy (HRT), also known as menopausal hormone therapy (MHT) or estrogen therapy, can alleviate hot flashes, painful intercourse, and other menopause symptoms by using bioidentical hormones to replenish estrogen levels.

Progesterone hormone therapy may also be needed to protect the womb lining from the effects of estrogen hormone therapy. Taking progesterone and estrogen together is known as combined hormone therapy.

Different menopausal hormone therapy mediums include:

• Skin patches
• Tablets
• Implants
• Topical gels and sprays.

If you have a low sex drive that persists after systemic hormone therapy, your healthcare provider may recommend testosterone.

Benefits of Menopausal Hormone Therapy

While the effects of hormone therapy vary depending on individual factors, hormone replacement therapy is considered one of the most effective ways to treat menopausal symptoms and reduce the risk of conditions associated with menopause including osteoporosis, liver disease, uterine cancer, and heart disease.

Health Risks of Hormone Therapy

Menopausal hormone therapy is considered safe for most women, but that doesn't mean it’s without possible health risks—especially for those with pre-existing conditions or a family history of blood clots, cancer, and cardiovascular disease. Menopausal hormone therapy may not be safe for some and should be discussed with your healthcare provider if you have a family or personal medical history of any of the following:

• Blood clots
• Stroke
• Heart disease
• Heart disease risk factors (e.g., high cholesterol and high blood pressure)
• Breast cancer
• Gallbladder disease

Those undergoing menopausal hormone therapy may experience side effects including:

• Nausea
• Breast tenderness
• Headaches
• Hair loss
• Bone loss
• Diarrhea
• Leg cramps
• Depression
• Acne
• Vaginal bleeding or spotting
• Increased risk of blood clots and breast cancer

Non-Hormone Menopause Treatment

Alternative therapies like non-hormone treatments can help ease the symptoms of menopause if you decide against hormone therapy. Antidepressant medications, such as selective serotonin reuptake inhibitors (SSRIs), can help manage depression and anxiety resulting from menopause. Clonidine, a blood pressure medicine, and gabapentin, an epilepsy medication are known to help with the vasomotor symptoms of menopause. Cognitive behavioral therapy can help with anxiety and low mood resulting from menopause.

Lifestyle Changes

On their own or in combination with hormone therapy, these lifestyle changes can make a huge difference in managing symptoms of menopause.

• Stop smoking
• Reduce alcohol and caffeine consumption
• Eat a balanced diet
• Exercise regularly
• Engage in enjoyable activities to boost your mood
• Maintain a healthy weight
• Seek support from loved ones

Complications From Menopause

Decreased estrogen levels can result in long-term complications from menopause.

Osteoporosis

Osteoporosis is characterized by bone loss and decreased bone density, which is caused by a lack of estrogen.

Hormone therapy may help protect against menopausal bone loss. For those who can’t undergo hormone therapy, other approaches to decrease osteoporosis risk are encouraged (e.g., staying active, taking calcium supplements, and quitting smoking).

Antiresorptive medications—like bisphosphonates—reduce the breakdown and absorption of bone tissue and can be used to treat osteoporosis in postmenopausal individuals.

Cardiovascular Disease

The decline in estrogen during menopause increases the risk of developing cardiovascular disease. The rates of coronary heart disease are three times higher in menopausal women. To mitigate this risk, those experiencing menopause are advised to maintain a healthy and balanced diet and exercise regularly.

Conclusion

A decrease in estrogen levels during menopause can result in a wide range of physical, mental, and emotional changes in the body. Hot flashes, vaginal discomfort, mood swings, incontinence, and other symptoms can significantly impact daily life. However, there are ways to manage menopause symptoms. Hormone therapy has proved successful in treating symptoms by replenishing estrogen and progesterone levels. For those who are unable to receive hormone therapy for any reason, lifestyle changes, non-hormone treatments, dietary supplements, and other treatments can help alleviate symptoms. Discuss potential therapy and treatment plans with your healthcare provider so you can sail through menopause smoothly.