Menopause is a natural phase in a woman's life, typically starting between 45–55 years. But it can bring disruptive symptoms that last for years and affect quality of life. The ClinicsJo Editorial Team reviews symptoms and modern treatments.
What Is Menopause?
Menopause is the absence of menstruation for 12 consecutive months without another cause. It occurs when the ovaries stop producing eggs and estrogen/progesterone levels drop.
Menopause Stages
1. Perimenopause
Begins 4–10 years before menopause (average 40–44 years). Hormones fluctuate, causing:
- Irregular cycles.
- Hot flashes.
- Mood swings.
2. Menopause
Average age 51. Diagnosed retroactively after 12 months without a period.
3. Postmenopause
The years afterward. Some symptoms continue, and risks of osteoporosis and cardiovascular disease rise.
Symptoms
Vasomotor
- Hot flashes: the most common, affecting 75% of women. Sudden intense warmth in the face and chest lasting 1–5 minutes.
- Night sweats: wake from sleep.
Psychological
- Mood swings.
- Anxiety and depression.
- Concentration difficulty ("brain fog").
- Sleep disturbances.
Genitourinary
- Vaginal dryness.
- Pain during intercourse.
- Decreased libido.
- Recurrent UTIs.
- Urinary incontinence.
Other Physical
- Weight gain (especially abdominal).
- Dry, thinning skin.
- Hair loss.
- Brittle nails.
- Joint pain.
- Headaches.
- Facial hair growth.
Long-Term Risks
- Osteoporosis: a woman loses 20% of bone density in the 5–7 years after menopause.
- Cardiovascular disease: risk rises because estrogen had protected the heart.
- Type 2 diabetes.
- Central obesity.
- Memory disturbances.
Diagnosis
Clinical in most cases. Tests when needed:
- FSH (elevated >30 mIU/mL).
- Estradiol (low).
- AMH (very low).
- TSH (to exclude thyroid disorders).
Hormone Replacement Therapy (HRT)
The most effective treatment for symptoms. Contains estrogen (with/without progesterone):
- Forms: pills, patches, gels, vaginal suppositories.
- For women with a uterus: estrogen + progesterone.
- For women without a uterus: estrogen alone.
Benefits
- Reduces hot flashes by 75–90%.
- Improves sleep.
- Prevents vaginal dryness.
- Protects against osteoporosis.
- Improves mood and memory.
Risks
- Slight increase in breast cancer risk (after 5 years of use).
- Blood clot risk.
- Stroke (rare).
When HRT Is Not Suitable
- History of breast or endometrial cancer.
- History of blood clots.
- Active liver disease.
- Unexplained vaginal bleeding.
- Stroke history.
Non-Hormonal Treatment
For women unsuitable for HRT:
- SSRI/SNRI antidepressants: paroxetine, venlafaxine — reduce hot flashes.
- Gabapentin: effective for flashes and sleep.
- Clonidine: a blood pressure drug that eases flashes.
- Fezolinetant (Veozah): a new drug specifically for hot flashes.
For Vaginal Symptoms
- Daily vaginal moisturizers (Replens, Vagisil).
- Lubricants for intercourse.
- Topical vaginal estrogen (very safe, local effect only).
- Vaginal DHEA (prasterone).
- Vaginal laser (MonaLisa Touch).
Natural Treatments and Supplements
- Soy isoflavones: moderate effect.
- Black cohosh: evidence is mixed.
- Flaxseed: phytoestrogens.
- Vitamin E: for reducing hot flashes.
- Calcium and vitamin D: essential for bones.
- Melatonin: for sleep.
Lifestyle
- Exercise: 150 minutes weekly + strength training 2–3 times.
- Diet: rich in calcium, vitamin D, vegetables, protein, low in sugar.
- Avoid hot-flash triggers: coffee, spicy food, alcohol, stress.
- Wear clothing in layers you can remove during a flash.
- Stay hydrated.
- Meditation and yoga reduce flashes and stress.
- Quit smoking.
- Regular sleep in a cool room.
Medical tip: Don't suffer in silence. Modern menopause treatment is safe and effective — there's no reason to spend years in distress. Discuss your options with your gynecologist.
Preventing Complications
Osteoporosis
- Bone density (DEXA scan) at menopause and every 2 years.
- 1,200 mg calcium daily.
- 800–2,000 IU vitamin D.
- Weight-bearing exercise.
- Medications like bisphosphonates when osteoporosis is confirmed.
Heart Disease
- Annual blood pressure, cholesterol, glucose checks.
- Mediterranean diet.
- Regular exercise.
- Healthy weight.
For a personalized menopause treatment plan, book an appointment with a specialist gynecologist on ClinicsJo.
