The Modern Menopause Blueprint: From Hormone Decline to Hormone Harmony
We’ve all seen how menopause is portrayed on television and in media: jokes about hot flashes and irritability, and maybe a throwaway line about somebody going through “the change of life.”
All told, it’s not a very thorough or accurate picture. And if that weren’t enough, characteristics and treatments of menopause are chronically under-researched. (Speaking to the journal Nature, endocrinologist Susan Davis said, “We’re not good at treating perimenopause because we don’t completely understand it.”)
There’s also a persistent communication gap between the research and the doctors treating patients. Treating insomnia, for example, might not spur a doctor to think of menopause as an underlying cause.
It’s no wonder many women reach middle age with only a passing knowledge of what menopause really brings. Did you know that perimenopause can last as long as 10 years? Before we became experts, we sure didn’t!
Luckily, we’re here to share with you all the knowledge we’ve gained over the years of helping women balance their hormones and manage their symptoms. When treatment is effective, many women feel refreshed and glowing—and feel just as good as or better than their pre-menopausal selves. Let’s dig into the details.
What Happens During Menopause?
Menopause is a natural process for women, typically occurring in your 40s or 50s (though it can start earlier or later, depending on other hormonal or biological processes).
It begins with perimenopause. During this time, your hormones begin to fluctuate, and your period starts to become irregular. The longer you’re in perimenopause, the more irregular it will become. Eventually, you may start to go two or more months between them. This can last between two years and 10 years, but the average is around four years.
When your period fully stops, and you’ve gone 12 consecutive months without one, that’s menopause. The average age for this milestone in the United States is 51, but it can happen earlier or later.
Do you see the issue? Menopause is a moment in time. And you only know it was menopause when you look back at it, not while you’re going through it.
After this, you begin your post-menopausal era, which will last the rest of your life. For many women, the symptoms of perimenopause continue into post-menopause for a while.
Since it can be hard to pinpoint exactly when you’re leaving one stage and starting the next, the full transition, starting from perimenopause and into post-menopause, is typically referred to as just, well, “menopause.” In every stage, your hormones are adjusting and fluctuating, creating symptoms that you may or may not realize are due to menopause.
How Your Hormones Change During Menopause
In perimenopause, progesterone tends to decline, while estrogen production will vary, meaning it can spike and plummet. Day-to-day hormone levels can also change quite dramatically, making it difficult to pinpoint longer-term changes.
As you get closer to menopause and post-menopause, estrogen decreases to a level low enough to prevent ovulation (meaning your ovaries don’t release eggs). Once you reach full menopause, you won’t have your period anymore, and you won’t be able to become pregnant.
In the post-menopausal phase, the lower level of estrogen puts you at increased risk of heart disease, osteoporosis, urinary incontinence and weight gain. Plus, your libido may be lower, which could be a result of your hormone levels or of your other symptoms affecting your drive.
What Are Common Signs of Menopause?
So how do you know if you’re in any stage of menopause? Well, as you may have guessed, one symptom is irregular periods. However, those can also be caused by any number of other factors: high stress, uterine fibroids, endometriosis, medication (including birth control) or other hormonal imbalances.
The other symptoms of menopause can be caused by other factors as well. This can make it extremely difficult to determine if you’re in perimenopause.
If you have any of these symptoms, it’s important to get your hormones tested so you can see whether there are any imbalances. (Just remember, though, that during perimenopause, your hormone levels are fluctuating every day, so hormone tests may not show the full picture.)
- Hot flashes (technically called vasomotor symptoms) and heart palpitations
- Night sweats, migraines and headaches
- Insomnia and/or poor-quality sleep
- Weight gain due to having a slower metabolism
- Vaginal dryness and pain during intercourse
- Lowered interest in sex
- “Mental fog,” difficulty concentrating and a lack of motivation
- Sadness, depression or anxiety
- Thinning hair or hair loss
- Dry skin
Menopause can also affect your cardiovascular and bone health.
Some lucky women don’t experience any major physical or emotional changes, and they may not have any idea they’re in perimenopause until they stop getting their period for good. Others, unfortunately, suffer from extreme symptoms that affect every part of their day.
So what’s a woman to do? Luckily, with the right management and treatment, most women continue to live vibrant, happy lives from peri- to post-menopause.
How To Manage or Treat Menopause Symptoms
Whatever your symptoms, you’ll want relief. The thing to remember is that symptoms are not one-size-fits-all, so treatment won’t be either. Some women have great success managing their worst symptoms with non-hormone treatments, while others have only found relief after stabilizing hormone levels through menopausal hormone therapy.
Let’s look at each method.
Managing Your Menopause Symptoms
The first step, particularly if you’re in the early stages of perimenopause, is just to manage symptoms as best you can. There are a variety of non-permanent and non-hormonal options to try:
- Non-hormone medical treatments: The FDA has approved several medications that target specific symptoms, including ones for hot flashes, osteoporosis or pain during intercourse. The Mayo Clinic suggests treating vaginal dryness or itchiness with lubricant or a vaginal moisturizer.
- Therapy, hypnosis or acupuncture: Many women have tried these non-medicinal options to find relief from hot flashes, with varying results.
- Herbal treatments: Herbs have been associated with alleviating symptoms of menopause. Common ones include sage (hot flashes and memory issues), lemon balm (insomnia), fennel (hot flashes and vaginal atrophy) and primrose (hot flashes).
- Birth control: If you still need to take birth control, but have symptoms of menopause that are starting to affect your day-to-day, hormonal birth control can be a great option.
- Daily healthy habits: Lowered stress, weight loss, exercise and nutrient-dense foods can all help keep your body in a more steady state. Exercise also helps with bone strength, which is ideal for preventing osteoporosis.
If you’d like to manage your symptoms but don’t know where to start, try The Endocrine Society’s Menopause page. There, you’ll find resources like a symptom tracker and a list of questions to ask your doctor.
Treat Symptoms Long-Term With Menopause Hormone Treatment
Each woman’s health history, hormone levels and treatment responses will differ from one another. For women who struggle daily with strong symptoms, menopause hormone therapy can often provide longer-term relief and help you feel more like yourself.
While the early 2000s brought indications (based on a flawed study) that hormone therapy could increase your risk of breast cancer and stroke, that has been debunked. While there are always risk factors with medications, recent studies show that menopause hormone therapy is safe and effective for the majority of women.
Hormone therapy works by replacing the levels of estrogen and/or progestogen in your body. You can start hormone therapy in the perimenopause phase or later. It can be administered in a number of ways:
- Pills
- Pellets
- Patches
- Gels
- Creams
- Sprays
- Vaginal rings
Each of these methods delivers supplemental hormones that get absorbed into your bloodstream and then distributed throughout your body.
And method isn’t the only factor. Each method can support a variety of dosages and types of hormones (estrogen-only, progestogen-only or estrogen-progestogen combination).
Benefits of BHRT vs. Traditional Therapy
One newer method of hormone therapy is BHRT. BHRT stands for “bioidentical hormone replacement therapy.”
The word “bioidentical” means that the hormone, which comes from plants, is actually chemically identical to estrogen produced in our bodies—unlike the synthetic version of estrogen used in traditional hormone therapy. This makes it a safe and natural way to get hormones.
BHRT has been shown to alleviate symptoms of menopause for many women. It’s available in multiple forms, including hormone pellets that supply your body with a constant dose of hormones. They work by slowly releasing hormones into your bloodstream over a course of several months.
Here at Balance Hormone Center, we focus on BHRT due to the natural hormones it provides. We’ve seen many women be successfully treated and have reduced menopause symptoms so they can live a happier, hot-flash-free life.
Find Out if BHRT is Right for Your Stage of Life
At Balance Hormone Center, we specialize in helping men and women treat the root causes of their frustrations, rather than just the symptoms. Our personalized treatments focus on your individual hormonal makeup, and our doctors work closely with you to help find the right treatment for you based on your circumstances and health history.
Our specialty training helps us quickly identify hormonal problems, design targeted treatment plans and help you start feeling better. Reach out to our expert team in Arizona and Iowa today to start your journey to wellness!
FAQs
What is the difference between perimenopause and menopause?
Perimenopause is the transitional phase before menopause when hormone levels begin to fluctuate and periods become irregular. Menopause is officially reached when a woman has gone 12 consecutive months without a menstrual period. After this point, a woman enters post-menopause.
How long does perimenopause last?
Perimenopause can last anywhere from two to ten years. For most women, the transition lasts about four years before menopause is reached.
What are the most common symptoms of menopause?
Common symptoms include hot flashes, night sweats, sleep disturbances, mood changes, weight gain, vaginal dryness, reduced libido, headaches, and difficulty concentrating. Symptoms vary widely from person to person.
At what age does menopause usually start?
The average age for menopause in the United States is 51. However, the transition can begin earlier during perimenopause, typically in a woman’s 40s, though some women may experience it earlier or later.
Can menopause symptoms be treated?
Yes. Many women manage symptoms with lifestyle changes, non-hormonal treatments, or medications. Others find relief through hormone therapy, which helps stabilize hormone levels and reduce common symptoms like hot flashes, sleep disruption, and mood changes.
What is bioidentical hormone replacement therapy (BHRT)?
BHRT is a form of hormone therapy that uses hormones chemically identical to those naturally produced by the body. These hormones help restore balance and may reduce menopause symptoms such as hot flashes, fatigue, and low libido.
When should you consider hormone therapy for menopause?
Women who experience persistent or severe symptoms that interfere with daily life may benefit from hormone therapy. A healthcare provider can evaluate hormone levels, symptoms, and medical history to determine whether treatment is appropriate.
