Generally speaking, menopause, which is defined as going a full 12 months without a period, can happen anytime ranging between the late 30s to late 50s, with the average age being 52. In the time period leading up to menopause, which is known as perimenopause, the body can go through a number of changes, with this transitory period lasting an average of four years. Even after menopause ends, you’re still not done, as symptoms can persist for years after.
During this whole process of menopause, one of the major changes is a decrease in estrogen levels — it will fluctuate in the earlier stages, and then gradually decline. “Menopause is the backside of puberty,” said Erin Manning, a gynecologist at Houston Methodist Hospital.
These declining hormone levels cause a number of symptoms, ranging from hot flashes and night sweats to mood changes and an increased risk of osteoporosis. “If you think about some of the mood symptoms that go along with puberty, some of the same things come along with the perimenopausal transition,” Manning said.
Menopause symptoms that are rarely discussed
In addition to the discomfort of hot flashes and night sweats, menopause also brings with it a host of other annoying symptoms, including vaginal dryness or itching, pain during intercourse, hair loss, dry mouth, insomnia, and cognitive changes, such as brain fog, or an inability to concentrate. In the years leading up to menopause, periods can either become very irregular or they can be unusually heavy.
Many women also struggle with weight gain, which is usually due to a loss in lean mass, which is known to decrease your metabolism. Menopause can also come with a number of mood changes and an increased risk for developing anxiety and depression. “The weight gain and mood changes are usually what is least talked about and can be the most problematic,” Manning said.
Serious menopause symptoms that are often overlooked
Hot flashes and night sweats, while annoying, aren’t having a serious effect on your health. However, the declining levels of estrogen can also make you more vulnerable to some serious conditions, including increasing your risk for osteoporosis, or your risk of developing heart disease.
With both osteoporosis and heart disease, estrogen seems to play a protective role. “When estrogen levels decrease, the risk for heart attack goes up,” said Michael Adler, an ob/gyn at UTHealth Houston and Memorial Hermann Hospital.
Menopause is also when bone loss starts accelerating, which can lead to osteoporosis. “You don’t see too many premenopausal women with osteoporosis,” Adler said. To offset this bone loss, it’s really important to engage in regular weight-bearing exercise, such as strength-training, to help strengthen the bones.
Don’t skip out on your annual wellness exams
Once menopause has ended, it can be tempting to skip out on your annual well visit with your ob/gyn. “Sometimes my patients neglect themselves,” Adler said. However, skipping an annual well exam means “there might be some dangerous things we may miss,” Adler said. Those dangerous things may include cervical cancer, breast cancer, colon cancer, or the early stages of bone loss. “We want people living long, healthy lives,” Adler said.
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