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Answers to help you prepare for menopause

Last Modified: November 21, 2022

Women & Children, Family Medicine


An estimated 1.3 million women in the United States will start menopause this year. While that’s a huge number, the experience can feel isolating, particularly when you don’t know what to expect. We asked Abby Mitchell, NP, PPG – OB/GYN, Huntington, to take some of the uncertainty away by answering a handful of basic questions for those approaching this milestone.  

What is menopause?

Menopause is the end of menstruation and fertility for a woman. It is when a woman stops having periods.

When does menopause occur?

Menopause starts when a woman has her last period. Once she has gone 12 consecutive months without a period, she is considered postmenopausal. It is somewhat retroactive, because she will not know for sure that she is in menopause until she has not had a period for those 12 months. Most women go through menopause between the ages of 45-55. The average age for menopause is 51.

How long does menopause last?

Once menopause occurs, a woman is then considered postmenopausal for the rest of her life.

What are the symptoms of menopause?

Many women will start experiencing symptoms during perimenopause. Perimenopause usually starts anywhere from 2-10 years before menopause. A perimenopausal woman will experience fluctuations of the hormones estrogen and progesterone. These fluctuations can cause irregular bleeding, shorter or longer periods, and heavier or lighter periods. During menopause and postmenopause, only a small amount of estrogen and progesterone are produced by the body. This lack of hormone production, especially estrogen, leads to the symptoms of menopause:

  • Hot flashes
  • Night sweats
  • Vaginal dryness
  • Weight gain

Also, sleep disturbances caused by hot flashes can lead to increased irritability.

How can women manage menopause symptoms?

The severity of menopausal symptoms is different for every woman. Some have mild symptoms and do not need any medications. Some women, however, have symptoms that interfere with their daily life; this is when medications may be helpful. The lack of estrogen can lead to thinning bones and osteoporosis. Calcium and vitamin D supplements are important to help with bone loss, but there are prescription medications to treat osteoporosis if needed.  

Hot flashes are typically the most common symptom of menopause. There are certain supplements that help with hot flashes, including black cohosh or increasing soy in the diet. Certain essential oils like peppermint and clary sage have shown benefit in helping reduce the severity of hot flashes.

Hormone replacement therapy (prescription estrogen and progesterone medications) is an option for some women who are not helped by these natural remedies. There are even hormone-free prescriptions that can help with hot flashes for those women who cannot take hormones.

Vaginal dryness can be helped with vaginal moisturizers which can be bought over the counter. There are prescription medications available to help with vaginal dryness if over-the-counter options are not enough.

What are some tips for managing symptoms of menopause aside from medication?

Drinking alcohol and smoking can make hot flashes worse, so avoiding these is usually beneficial. Regular exercise can help decrease hot flashes, and strength training can help maintain bone strength, so staying active is important. Many women going through menopause have increased stress due to growing children and their own aging parents. Finding outlets to manage stress through hobbies, relaxation, or even cognitive behavioral therapy can be very beneficial for overall well-being as a woman transitions through menopause.

Anything additional you think would be beneficial for women to know?

Some supplements marketed to help with menopausal symptoms interact with certain prescription medications, so check with your medical provider if you plan to start a new supplement.?

Any woman who stops having periods prior to the typical age of menopause (in her 30s or early 40s) should consult a medical care provider to ensure there are no other medical reasons she has stopped having periods.

Postmenopausal bleeding (vaginal bleeding after a woman has gone 12 months without a period), even if it is only spotting, is considered a red flag and should be evaluated by a medical care provider.



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