Menopause: What to Expect When You’re No Longer Expecting

When you’re a woman nearing or at mid-life, you might begin to learn more about an impending transition about to happen with your body. That’s me. And I’ve been uncovering as much as I can about it because it’s going to happen to me sooner or later.

Menopause.

Was I looking forward to it? Most certainly not. Declining estrogen levels, hot flashes, and potential cognitive impairment wasn’t something I felt I should be all that excited about, unlike other important womanly phases that get all the hype (puberty/motherhood).

I’d heard a wide range of stories from other women (even some men) about their experience with menopause. I found the stories helpful, some of them worrisome, some of them really funny, but with something so individual, I needed to do more than gather anecdotal perspectives. I wanted to find out if there was anything I could do to prepare for the worst while staying optimistic enough to hope for the best, so I made lists. Here’s what I’ve learned:

First, the Bad News:

The decrease in estrogen from perimenopause and menopause has been tied to a number of health conditions or concerns that become more common as women age.

Things like…

Moodiness and depression
Osteoporosis
Heart disease
Urinary incontinence
Vaginal dryness
Greater risk of dementia
Poor muscle power and tone
Decreased sexual function/libido
Poor skin elasticity (aka, more wrinkles)
Sleep disturbances
Headaches
Poor memory or concentration
Vision changes

(For a complete list of conditions and information, see “Menopause A-Z” from Red Hot Mamas.org.)

Now, for the Good News:

Although women are at higher risk of these conditions during menopause, they are treatable, and most are even preventable. But what about the symptoms? This next list shows exactly what I can expect and what possible lifestyle choices or strategies I can try to help ease or prevent symptoms of menopause. It’s helped me feel more like welcoming menopause as a natural “finish line” rather than seeing it as “the end of the line.”

Symptom	Description	Lifestyle Recommendation, if applicable
Irregular periods	Changes in menstrual flow with unusually heavy or light bleeding; the time between periods may become longer.	Don’t panic! This is normal.
Hot Flashes	Affects 75% to 85% of women. Feels like sudden intense warmth that creates flushing or redness in the face and chest.	Eat healthily, limit alcohol, caffeine, and spicy foods. Stop smoking (nicotine increases hot flashes); wear layered clothing or natural breathable fibers; use a fan; exercise regularly to improve circulation, raise endorphin levels and help promote better sleep and reduce stress levels.
Night Sweats	Simply a hot flash that occurs in your sleep.	See “Hot Flashes”
Loss of Libido	Decreased sex drive.	Kegel exercises help tighten floor muscles and regular intercourse helps improve vaginal condition. Avoid alcohol, caffeine, diuretics, and antihistamines as they can be dehydrating.
Vaginal Dryness	Usually experienced by those who have undergone surgery, chemotherapy, or drug therapy that causes a sudden drop in estrogen.	Treatable. There are over-the-counter vaginal lubricants that may be helpful. Some clinicians may recommend medication.
Mood Swings, Anxiety	Low levels of estrogen are associated with low levels of serotonin, which can lead to mood swings, irritability, frequent crying, anxiety, and even insomnia.	Increase exposure to sunlight, get a massage, exercise, eat healthily, meditate, and focus on the positives.
Fatigue	Extreme lack of energy.	Talk to your clinician about your fatigue levels, hydrate, exercise, eat well, and get enough sleep.
Sleep Disturbances	Can be due to hot flashes/night sweats, anxiety, urinary frequency, or anything that keeps you from getting restful sleep such as obstructive sleep apnea (OSA) or insomnia.	Make a bedtime routine, have a comfy sleep environment, get 7-9 hrs of sleep, and wind down before bed. Rule out potential health conditions that prevent sleep with your clinician.
Memory Lapses or Trouble Concentrating	Forgetfulness and trouble concentration.	Talk to your clinician about ways to resolve your memory problems. Sometimes, hormone therapy may be of some help. You can also keep your memory sharp by engaging in activities that challenge you mentally. Exercising regularly will increase blood flow to the brain. Keep lists and calendars.
Headaches	Can increase in frequency and intensity especially with hormone fluctuations.	Track them and identify any triggers. Talk to your clinician about treatment options.
Weight Gain	Lower estrogen levels mean a slower metabolic rate, making it easier to store fat and more difficult to lose weight.	Get enough exercise and eat healthy to avoid gaining weight.
Joint Pain/Aching Body	Stiffness, pain	Talk to your clinician about using glucosamine and about treatment with hormone therapy.

For more information, community and support, PLEASE VISIT Red Hot Mamas Community: A menopause support community. Share experiences with hot flashes, sleep, estrogen, progesterone, HRT, and more in the discussion group.