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Menopause 101: Signs, symptoms, and treatment

Menopause. The word can conjure up tears just thinking about it! But menopause is a very real thing that all women deal with once they reach a certain age. It manifests itself in different ways for each woman, and it can take a major toll on the body, mind, and emotions in one way or another.

Let’s explore the nitty gritty of menopause, and help you gain a better understanding of this womanly right of passage, so that you can face it with, grace, dignity, and some healing tools in your arsenal.

What is menopause?

Menopause is a natural part of female aging — when the final menses of one’s life has taken place, and hormones change in the process. That’s menopause — once menstruation no longer occurs. But there are actually three stages of menopause for a healthy woman. They are:

  • Perimenopause (the years leading up to menopause)
  • Menopause (this phase begins the year after your very last period)
  • Post menopause (the years that follow menopause)

This may come as a surprise, but the symptoms of menopause can start as early as age 35. This phase would be called the beginning of perimenopause. Slowly but surely, the ovaries start getting smaller. Estrogen and progesterone production decreases, and your entire reproductive system begins to change. In other words, for most women, by age 35, fertility is on the decline.

Hormonal changes

Estrogen and progesterone are key hormonal players for women. But there’s actually a handful of hormones that change during the menopausal process. They are:

  • Estrogen
  • Progesterone
  • Testosterone
  • Gonadotropin-releasing hormone
  • Follicle-stimulating hormone
  • Luteinizing hormone

As you can probably imagine, menopause is quite a complex process that lasts for years. The most significant hormonal change, however, is estrogen loss, due in large part to the loss of ovarian follicles.

Perimenopausal symptoms

For the average woman, perimenopause begins around age 45. But it can start earlier and last anywhere from a few months to a decade! The average length of perimenopause is four years, and a variety of factors determine when you’ll actually begin perimenopause. Your genes figure into the equation, but more importantly, lifestyle factors play an essential role.

For example, if you smoke, you’re expected to begin perimenopause two years earlier than your non-smoking peers. If you don’t eat right and skip regular exercise, you might also begin earlier because these factors contribute to hormonal imbalances. Other factors that upset hormones — such as sleep deprivation, stress, too much sugar, and even chlorine — can also play a role.

During perimenopause, your hormones are constantly in flux; therefore, it’s tough to pinpoint precisely what’s going on with your hormones at any given time. That said, here’s what you can expect from the years leading up menopause:

  • Mood swings and changes in behavior
  • Decreased energy
  • Unpredictable and erratic menstrual cycle
  • Hot flashes
  • Night sweats
  • Weight gain (particularly around the tummy) and a decrease in metabolism
  • Sleep issues, up to and including insomnia
  • Vaginal atrophy (vaginal dryness is a common result)
  • Decrease in sex drive
  • Headaches and even migraines
  • Poor concentration and focus
  • Depression and anxiety

Menopausal symptoms

You are officially in the menopausal phase of your life if you haven’t had a period for 12 months. At this time, it’s no longer possible for you to birth a child. Common symptoms of menopause include:

  • Hot flashes
  • Night sweats
  • Vaginal atrophy and vaginal dryness
  • Mood swings
  • Sleep issues
  • Difficulty losing weight
  • Thinning of hair
  • Breast tissue changes
  • Urinary changes


Nowadays, the average American woman spends one-third of her life post-menopause. This means taking care of yourself during the menopausal years is more important than ever. And many women report the post-menopausal stage as being the best period of their lives. There’s a reason they call it the golden years! You have more wisdom, empathy, and compassion than ever. You’ve been through so many life experiences that you know exactly who you are. Welcoming your menopausal years with grace will contribute to a happier, healthier post-menopause.

Menopause treatment

Clean diet

When you’re in the throes of menopause, it’s more important than ever that you eat a whole-foods diet that supports hormonal health. Think organic vegetables and fruits. Sprouted whole grains, beans, nuts, seeds, clean proteins, and foods with omega-3 fatty acids are also beneficial. Spring water is the best liquid to feed your body, and nut milks in smoothies are good, too.


Meditation is such an ideal practice for the menopausal years as you truly come into your own as a wise woman. The practice of meditation not only soothes emotional and mental stress that exacerbates menopause, it also helps you see reality as it is, giving you distance from irrational thoughts, and the emotions and behaviors that often follow.

Yoga, weight training, and cardio

It’s always good to exercise regularly, and a mind-body discipline like yoga is ideal for menopause as it integrates healing on all levels — mind, body, and spirit. It’s also so versatile — you can practice yin or restorative yoga on days when you need extra TLC, and more vigorous practices like vinyasa yoga when you need to sweat. Weight training a few days a week mixed with cardio exercise can also help alleviate certain menopausal symptoms.

Hot flashes, night sweats, and insomnia

To alleviate the discomfort of hot flashes and night sweats, consider keeping a cold pack beneath your pillow at night. Try to go to bed and wake up at the same time each day, and expose yourself to sunlight in the morning. Take your last sip of coffee by noon, and limit alcohol intake to one drink in the evening with dinner. Herbs to help you sleep include passionflower, chamomile, valerian, and lavender. Make sure your bedroom is always quiet, dark, and cool.

Welcome the change

Menopause can be a beautiful time in a woman’s life — one of self-discovery, self-compassion, and the opportunity to connect with other women experiencing the same thing. Asking for help from your trusted doctor, friend, or therapist — as strong and self-reliant as you may be — always helps ease the journey. At OB/GYN Associates of Alabama, we can help you understand menopause and the range of treatment options available. Contact us to request an appointment.

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