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Menopause Is a Journey


Submitted by Advanced Women’s Healthcare

Going through menopause is a little like driving on an unfamiliar, twisting road with an unclear destination. You may not be sure of all that is happening, where you are going, or what’s coming next. In fact, you won’t realize you have reached your destination (menopause) until you are past it and see it in your rearview mirror.

The average age of menopause is 51. That means that almost half of all women have their last period and reach menopause before that age, and some women may not have even started perimenopause yet.

It’s not easy to know when you are in the menopausal transition. Menopausal symptoms, along with a physical examination, medical history, and maybe some blood tests, may provide useful clues, but it is not possible to correctly predict when a woman’s final period will be. Your doctor could test the amount of estrogen in your blood or the level of FSH (follicle-stimulating hormone), another hormone that changes at this time. Levels of both estrogen and FSH normally go up and down during your menstrual cycle, so these test results alone cannot be used to predict or confirm menopause.

Signs of the menopausal transition
Menopause affects every woman differently. Some women have no symptoms, but some women have changes in several areas of their lives. It’s not always possible to tell if these changes are related to aging, menopause, or both. Some changes that might start in the years around menopause include the following:

Menstrual cycle changes. The first thing many women notice is a change in their periods. They might start coming farther apart or closer together. They might last longer or end sooner. The flow could be heavier or lighter. Even though your monthly periods are not regular anymore, you can get pregnant! In fact, the irregular periods common in menopause make it harder to predict when an ovary is releasing an egg. Do not assume that a couple of missed periods mean you are beginning the menopausal transition. Check with your doctor to see if you are pregnant or if there is another medical cause for your missed periods.

Hot flashes and night sweats. Many women also start to be bothered by hot flashes or night sweats. During a hot flash, your face and upper body begin to feel hot. Your skin gets flushed or red because blood vessels close to the surface are expanding. You might start sweating a lot, sometimes followed by cold shivering. Some hot flashes leave you with only a slight feeling of warmth or a light blush. Others may drench your clothes. Hot flashes can happen several times an hour, a few times a day, or just once or twice a week. They usually occur for just a few years and then stop.

Your skin and other tissues. As you age, your skin becomes drier. You might also start to lose fatty tissue and collagen under your skin and also in the areas near your vagina and urinary tract. These losses can make your skin thinner and less elastic. If your vaginal tissues are affected, these changes can make them drier and more likely to tear and become infected. Sexual intercourse may become painful.

Sleep and fatigue. Many women report having problems sleeping and feeling tired. It is difficult to know if sleep changes are a part of growing older, the result of hormone changes, or both. Sometimes, it is night sweats that wake you in the middle of the night, or it might be that you have to go to the bathroom. Either way, once awake, you can then have trouble getting back to sleep. Perhaps you can’t fall asleep in the first place, or you find yourself waking too early in the morning. When this happens over and over, you will become very tired, and feeling tired can affect everything you do during the day.

Sexuality. You might notice changes in your interest in having sex or in your ability to become sexually aroused. After menopause, some women say that freedom from concerns about pregnancy lets them feel more open to sex and more relaxed in general. Other women report losing interest in sex. If such changes bother you, talk to a doctor to make sure there is no other cause. For example, medicines, such as those prescribed to treat high blood pressure, depression, and cholesterol problems, might play a role.

Mood. There is some evidence that stress, a history of depression, and poor general health are more likely to contribute to mood changes, anxiety, and irritability during mid-life than do hormonal fluctuations. So, while women at mid-life are sometimes portrayed as having extreme mood swings, this may not be a true picture. The specific connection of mood to the hormone changes of menopause is not clear.

Physical changes. Mid-life is a time when you may see changes in your body. Your joints or muscles might ache or feel stiff. Your waist might be getting thicker, and you could be gaining weight. Shifts in your body makeup such as the loss of muscle and increases in fatty tissue also take place. Muscle helps us burn a lot of calories, so losing muscle mass over time can make it harder to burn off calories and easier to gain weight.

The symptoms that come with menopause can seem challenging, but there are many ways to deal with them.

Next month: What you can do for hot flashes and other menopausal symptoms.

Dele Ogunleye, M.D., and Lisa Emm, M.D., provide a full range of obstetric and gynecologic services. Brittany King is an advanced-practice nurse specializing in women’s health. She works alongside Dr. Ogunleye and Dr. Emm to provide a full range of obstetric and gynecologic services. You may contact them at Advanced Women’s Healthcare, 309-808-3068 or The office is located at 2111 East Oakland Avenue (Next to the Jewel-Osco Plaza).