By Kiara Zamorano, MSN, FNP-C
When it comes to reproductive health, there’s often an abundance of information available for women in their teens, 20s, and 30s, especially around menstruation, fertility, and pregnancy. But as women get older, the conversation tends to quiet down. Why is that?
One of the most important stages in a woman’s health journey, menopause, is still surrounded by stigma, silence, and misunderstanding. As a primary care nurse practitioner, I’ve seen firsthand how many women feel unprepared for the changes that come with this phase of life. So let’s break that silence and talk openly about what menopause is, what to expect, and how to manage it with confidence.
What Is Menopause?
Menopause isn’t something that happens overnight. It’s a gradual process, and it often comes with a lot of questions. In the simplest terms, menopause is officially diagnosed when a woman over the age of 45 has gone 12 consecutive months without a menstrual period. And yes, we really mean 12 full months. If you’ve gone 10 months without a period, you’re almost there, but not quite. We stick to that 12-month marker because it helps us clearly distinguish menopause from the transitional phase before it.
Once you’ve reached menopause, your body stops ovulating, and your estrogen levels naturally decline. From that point on, you should no longer experience periods. If you do notice any bleeding after menopause, known as postmenopausal bleeding, it’s important to talk to your healthcare providers at CVMG. While most causes are benign, such as uterine fibroids (non-cancerous growths in the uterus), it’s essential to rule out other potential issues with your uterine lining.
What about labs?
When it comes to diagnosing menopause, hormone tests aren’t always super helpful. Hormone levels like estrogen and FSH can fluctuate a lot during this time, so one lab test might not give a clear answer. Instead, we usually look at your symptoms, your age, and your menstrual history to make the diagnosis. It’s really more about how you’re feeling than what the numbers show.
What About the Time Before Menopause?
That in-between phase you may be experiencing, where your periods are irregular, heavier or lighter than usual, or spaced out unpredictably, is called perimenopause. This phase can begin several years before actual menopause, often starting in a woman’s mid-to-late 40s.
Perimenopause is driven by shifting hormone levels, especially estrogen, which can cause a wide range of symptoms. These may include hot flashes, night sweats, mood changes, sleep disturbances, vaginal dryness, and decreased libido.
Sound familiar? If you’ve seen dramatic portrayals of menopause in movies or on TV, your experience might feel less intense, or sometimes even more confusing. Every woman’s experience is different.
Mental Health and Menopause
One aspect of menopause that’s often overlooked is its impact on mental health. As estrogen levels decline, some women experience increased anxiety, mood swings, or even symptoms of depression. This is a normal biological response to changing hormone levels, but that doesn’t mean you have to suffer in silence.
Opening up about your emotional well-being during perimenopause and menopause is just as important as discussing physical symptoms. You’re not alone, and you deserve support.
Treatment Options and Moving Forward
The good news is there are effective ways to manage symptoms. Here’s a quick overview of some of the most common treatment options.
· Vaginal Estrogen: For women dealing with vaginal dryness or discomfort during sex, vaginal estrogen creams, tablets, or rings can provide relief directly to the area without affecting the whole body. This form of treatment requires consistency and patience for you to see the effectiveness.
· Non-Hormonal Medications: Options like antidepressants (SSRIs), gabapentin, Veozah or clonidine can help reduce hot flashes and improve mood. These might be a good choice for women who can’t or choose not to take hormones.
· Hormone Replacement Therapy (HRT): This treatment involves taking estrogen (and sometimes progesterone) to replace hormones your body isn’t producing anymore. It can be very effective for managing hot flashes, night sweats, and vaginal dryness but isn’t right for everyone. This form of treatment requires close monitoring and is usually considered when other forms of treatment are not effective.
· Lifestyle Changes: Regular exercise, a healthy diet, and good sleep hygiene can help manage many symptoms, including mood swings, weight gain, and sleep disturbances. Reducing stress through mindfulness or yoga can also make a big difference.
· Herbal Supplements: Some women find relief from symptoms with supplements like black cohosh, evening primrose oil, or soy isoflavones, though it’s important to talk to your provider before trying these to ensure they’re safe for you.
· Acupuncture: This traditional treatment may help reduce hot flashes and improve mood by balancing the body’s energy and improving blood flow. It can be a good option for women looking for a natural approach.
· Cognitive Behavioral Therapy (CBT): If mood swings or anxiety are a concern, CBT can be helpful. It focuses on changing negative thought patterns and can improve coping strategies for emotional symptoms related to menopause.
Each treatment option comes with its own set of benefits and possible side effects, so it’s important to have a detailed conversation with your provider at CVMG. What works well for one person might not be the best fit for another, and your provider can help you weigh the options based on your symptoms, health history, and lifestyle. Together, you can choose a plan that helps you feel your best while keeping any side effects in check. By normalizing discussions around menopause, we can empower more women to take charge of their health and feel prepared for the changes that lie ahead.
Final Thoughts
Menopause is not an ending. It’s a transition. A natural, beautiful, sometimes frustrating part of the aging process that every woman deserves to navigate with knowledge, support, and compassion.
Every woman’s journey is unique. You may breeze through menopause with few symptoms, or you may need a little extra support, and that’s completely normal. Either way, you don’t have to go through it alone. Start the conversation, ask questions, and advocate for your health. Our staff at CVMG values these challenging topics surrounding women’s health. We know you deserve nothing less.
