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Medical

Expert tips to navigate perimenopause and menopause like a pro

by Lyndsey Harper, MD

Menopause. We all go through it. And yet, until recently, the topic was quite hush hush in society and the media. Leaving women wondering what the heck is going on in their bodies when the symptoms start, and unable to find suitable solutions to improve their quality of life.

In this Rosy article, we’re giving you the 4-11 on all things perimenopause and menopause – because we believe it’s never too early (or too late!) to learn about this important life transition. So that when it starts, you know what to expect and where to turn for support. Let’s dive in!


What Is Perimenopause And How Long Does It Last?

Before menopause begins, your body goes through a transitional phase known as perimenopause. This typically starts in your early to mid-40s and lasts an average of 7.4 years. For women of color, it can last up to 10 years.

During perimenopause, your ovaries gradually produce fewer hormones – namely, estrogen and progesterone. Declining hormone levels can affect your menstrual cycle. Many women experience irregular periods or changes in cycle length.


Common Symptoms Of Perimenopause

Irregular periods are often the first symptom associated with perimenopause, but they’re just one part of the picture.

Other common symptoms include:

  • hot flashes

  • irritability

  • night sweats

  • trouble sleeping

  • difficulty concentrating, or “brain fog”

  • vaginal dryness

  • painful sex

  • weight gain around the abdomen

  • thinning hair

  • joint pain


These symptoms can vary from one woman to the next and may come and go throughout perimenopause.

Menopause Hormone Therapy (MHT) includes medicines that replace the declining hormone levels in the body. They can be delivered in the form of pills, patches, gels, sprays, and progesterone IUDs. MHT can help manage symptoms of perimenopause. Discuss your symptoms with your healthcare provider to find the solution that fits you best.


What Is Menopause?

When you haven’t had a period for 12 months in a row (and there’s no other medical cause for missing periods), you’re officially in menopause.

The average age of entering menopause is 51, but this can vary widely from woman to woman. During this time, the ovaries stop producing hormones altogether, and it’s no longer possible to get pregnant.

In some cases, menopause can occur earlier due to medical interventions. Treatments like chemotherapy, radiation, or surgical procedures such as the removal of the ovaries can trigger menopause by causing the ovaries to stop hormone production.

Approximately 1% of women will stop having periods before the age of 40 without a medical reason, this is called premature menopause.

Common Menopause Symptoms and How to Manage Them

Hot Flashes and Night Sweats

Hot flashes are one of the most common symptoms of menopause.

They feel like a sudden rush of warmth that spreads across the chest, face, and neck. Often leading to sweating, clamminess, or chills. When hot flashes happen at night, they’re known as night sweats – and can really get in the way of a solid night’s sleep.

Thankfully, there are several treatments to help with hot flashes:

  • Menopause Hormone Therapy (MHT), including combined hormonal contraception, progesterone-only birth control, or estrogen therapy can be very effective.

For those who prefer not to or cannot use hormones, non-hormonal options include:

  • cognitive behavioral therapy (CBT)

  • clinical hypnosis

  • medications such as SSRIs, gabapentin, fezolinetant, and oxybutynin


Mood Changes

Hormonal fluctuations during menopause can lead to mood swings, anxiety, and depression – but help is out there.

Cognitive behavioral therapy (CBT), journaling, mindfulness, and breathing exercises can help you work through mood changes.

If you’re feeling really low and natural remedies aren’t helping, don’t hesitate to reach out to a healthcare professional for support. They can start you on medication like antidepressants or hormone therapy to get you back on track.


Brain Fog

Another common symptom of menopause is brain fog, which can make you feel forgetful, sluggish, or unable to focus.

To manage brain fog, Menopause Hormone Therapy (MHT) and CBT are effective treatments. Additionally, lifestyle changes such as regular exercise, staying organized with a planner, and eating a diet rich in whole foods can help.


Sleep Disturbances

Lots of women experience changes to their sleep patterns during menopause due to fluctuations in hormone levels. Trouble falling asleep, waking up in the middle of the night, and racing thoughts can all happen.

Here are some tips to improve your sleep during menopause:

  • Maintain a consistent sleep schedule by going to bed and waking up at the same time every day

  • Create a calming bedtime routine

  • Minimize exposure to screens before bed

  • Try supplementing with magnesium glycinate, 5-HTP, or L-Theanine

If night sweats or racing thoughts are getting in the way of your Zzz’s despite these measures, consult with your healthcare provider for other options. High-quality sleep is vital to your mental and physical health.

Sexual Health and Vaginal Changes

Low estrogen levels in menopause can bring about changes in sexual health, like low sexual desire, vaginal dryness, itching, decreased lubrication, UTIs, vaginal infections, and painful sex. These can make sex less comfortable and have a serious effect on your personal and relationship health – but don’t fret. Help is out there.

Using lubricants during penetrative sex, applying moisturizer to your vulva, or using vaginal estrogen therapy can improve these symptoms.

If you’re still experiencing low sexual desire, you can try sex therapy, reading erotica, or consulting your doctor to discuss medications like flibanserin, bremelanotide, or testosterone can help.


Bone Health

Estrogen plays a vital role in maintaining the density of your bones. So when levels drop in menopause, bone loss can occur which increases the chance of fractures.

To protect your bone health, it’s recommended to do 20 minutes of weight-bearing exercises 3 times per week. This could include walking, dancing, or weight lifting. You can also speak to your doctor about supplementing calcium and vitamin D, starting Menopause Hormone Therapy, or trying other medications to reduce the risk of fracture.


Heart Palpitations

Finally, the feeling of a racing or irregular heartbeat, known as heart palpitations, can happen. This is due to the effects of declining estrogen on the autonomic nervous system.

If you experience this, it’s important to consult with a healthcare provider, as they may recommend seeing a cardiologist for further evaluation. Medications are available to help regulate your heart rate if necessary.


Getting Support During Menopause

Seeking support from healthcare providers, loved ones, or support groups can make a big difference when going through menopause.

Before a menopause health consultation, it’s helpful to keep track of your symptoms, jot down any questions you have, and list the medications or supplements you’re taking. That way, you can hit the ground running in your appointment and can have a productive discussion.

Here are our top picks to learn more about menopause and get support:

  • Podcast: Health by Heather Hirsch

  • Book: The Menopause Brain by Lisa Mosconi PhD

  • Book: Estrogen Matters by Avrum Bluming and Carol Tavris

  • Society: Menopause.org

  • Virtual care: Midi Health


Takeaway

Menopause is a natural stage of life that can bring about many changes to your mental and physical health. But remember that you don’t have to go through it alone and there are lots of treatments out there.

Listen to your body and what you need during this time of transition. Don’t hesitate to visit a healthcare provider to discuss your symptoms and create a plan to improve how you’re feeling.

For more expert tips and tricks on navigating menopause and all things women’s health, head to the Menopause Collection in the Rosy app. You’ll also find a library oflots of informative content made by women’s healthcare professionals in Quickies – short videos that are free for everyone. With a Silver subscription, you’ll also get a personalized plan to address all aspects of your health and help you feel better, inside and out.


Lyndsey Harper, MD is the Founder & CEO of Rosy, a Board Certified Ob/Gyn and sex medicine expert.