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  • Writer's pictureMonica Bell

What is Menopause?

Updated: Dec 15, 2021

When you hear the word menopause you likely have some strong thoughts, feelings and ideas about this biological process. If you are already in menopause, there might be some expletives as well! There is not only the physiological impact of menopause but the psychological transition away from childbearing years and other changes associated with growing older.

Attitudes about women, their roles as they age, and the process of menopause is changing the way we view and approach this inevitable time of life. Women aren’t finished living and demand qualify of life past their child-rearing years. And those that haven’t had children are also creating new pathways of exploration as they age. Menopause is not the end. It is just another beginning.


Natural Menopause

The transition phase before menopause is called perimenopause, and it has its own symptoms and challenges. As most women approach their late 30’s, the ovaries make less and less estrogen and progesterone. These two hormones regulate menstruation, and as a result, fertility declines.

Your menstrual cycle will fluctuate in your 40’s with some women experiencing heavier and shorter periods and others lighter, less frequent periods. On average, by early ’50s, periods stop. Generally speaking, menopause is when you have had no period for 12 months consecutively. Some women experience menopause earlier or later than their 50’s.


Surgical Menopause

Surgical removal of the uterus is called a hysterectomy. If the ovaries are left intact, then this doesn’t usually cause premature menopause. However, removal of the ovaries causes immediate menopause. The challenge with surgical removal of the ovaries is the drastic and sudden change in hormone levels rather than the gradual transition during natural menopause.


Physiological Symptoms of Menopause

Now to the nitty-gritty. Not all women have the adverse effects we associate with menopause, but most do. There is a great deal of variability among women as to the length and severity of symptoms.

Hot Flashes

Hot flashes are by far the most common symptom of menopause. Most women have hot flashes on average for about two years, but some hot flashes persist for years. Hot flashes are brief, intense increases in body temperature. A hot flash may be accompanied by an increase in heart rate as the body tries to regulate the temperature. This can result in heart palpitations and dizziness.

Vaginal Atrophy

The lining of the vagina dries and thins, leading to painful penetration, vaginitis, urinary tract infections, and cystitis.


Trouble getting to sleep and staying asleep resulting in less than 6 hours a night have profound implications for health and well-being. Lack of sleep leaves you feeling tired, stressed, anxious and depressed, along with poor concentration and headaches. Hot flashes contribute to insomnia.

Bone Loss

As the hormones estrogen and progesterone start to decline, your bones begin to weaken, leading to osteoporosis. Osteoporosis is the leading cause of fractures as women age.

Weight Gain

You might be thinking, “what’s the big deal with weight gain?” Weight gain is typical during menopause due to decreased energy and hormonal changes. Weight gain contributes to breast cancer, depression, heart disease, and type 2 diabetes.

Dry Skin

Estrogen is related to the production of collagen and the making of natural oils that keep your skin moisturized. Your skin may become thin, dry, and itchy, along with acne, rashes, and wrinkling.

Breast Changes

During menopause, you might think, “what happened to my breasts?!” They seem to have put on a disappearing act. Estrogen is responsible for hydration and connective tissue that keeps breasts full and firm. When estrogen declines… yep, so do the breasts.


Psychological Symptoms of Menopause

When you feel physically terrible, it is difficult to feel good about yourself. Then, in addition, hormonal changes contribute to mood swings and other mental health symptoms.

Reduced Libido

With declining estrogen and testosterone, it can be hard, if not impossible, to become aroused. Vaginal lubrication, weight gain, depression, and fatigue all affect your sex drive.


The causes of depression are often not easy to pinpoint. But, we know that menopause can cause feelings of isolation, fears about aging, the loss of children leaving home, relationship changes, and frustration with symptoms. Estrogen helps to regulate mood-enhancing hormones such as serotonin, dopamine, and norepinephrine. When estrogen levels drop, mood swings result.

Brain Fog

Brain fog is characterized by difficulty concentrating, impairment of verbal learning, and memory problems. The hormonal changes of perimenopause and menopause, along with secondary symptoms, are thought to be responsible for these changes in cognition.

Sadness and Irritability

Honestly, who wouldn’t be irritable dealing with these symptoms? Lack of sleep, feeling unattractive, no libido, difficulty concentrating on work and family can leave you feeling overwhelmed and sad.


What To Do About Menopause

Menopause is inevitable but living with the symptoms is not. The hormonal changes of menopause are complex and individual. Your approach will need to be tailored, determined, and patient. There is no “cure” for menopause, but taking charge of your physical and mental health will give you the confidence to move through this phase of life with renewed vitality and well-being. Here is your improvement checklist.

  • Consider bio-identical hormone replacement therapy. Hormone replacement is the logical first step to feeling better. By replacing and replenishing your depleted hormones, you can start to reduce and treat symptoms.

  • Take a good hard look at what you eat. Your brain and your body need a healthy and balanced diet to function well. What does this mean? Focus on fresh plants, seeds and nuts, organic soy, cold-water fish, and fresh fruits. Avoid meat, processed foods and limit dairy products.

  • Move more often. Whatever you are doing now, take it up a notch. If physical movement hasn’t been a part of your life, it is never too late to start. Walk, swim, bike, weight lift, do yoga- anything that challenges your body to do more.

  • Work on your relationships by staying connected to people. It is very tempting to hide away when you aren’t feeling like yourself but nurture yourself by reaching out to others.


Menopause and Feeling Better

Much of coping with menopause involves a mind shift away from cultural and societal messages that devalue women’s experiences during this time of life. Bio-identical hormone replacement will get you started on the right path, followed by a renewed focus on all areas of well-being. Take charge and take control of your body, mind, and spirit.

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