Summary: 

This is a quick(ish) guide to everything you need to know about menopause. I’ll cover the definition of menopause, why I like to refer to a “menopause transition”, common symptoms, why women in the menopause transition need to eat differently and train differently, and health concerns that are more common for women in the menopause transition, hormone therapy, and the benefits of menopause. 

Menopause and the Menopause Transition  

The medical definition of menopause is “a point in time 12 months after a woman’s last period.” Menopause can also be caused by surgical removal of the ovaries. The average age of menopause in the United States is 51.

The menopause transition is a timeframe before and after that menopause date, consisting of perimenopause and early postmenopause. The full menopause transition (including the early postmenopause time) can span about 15 years.

Perimenopause is the time before menopause when estrogen levels fluctuate, resulting in an array of new symptoms and experiences. For most women, the perimenopause stage begins between 40-45 and can last 2-10 years. Every woman experiences perimenopause differently and has different symptoms and milestones. For a lot of women, this time can feel overwhelming and out of control. Understanding why this is happening and learning tools and strategies to manage symptoms can help immensely. 

There are no diagnostic tests that can confirm a woman is in perimenopause. Irregular periods and experiencing menopause-related symptoms, combined with age and menstrual history typically allow doctors to determine a woman is in the perimenopausal stage. 

Postmenopause is the time after menopause (the date 12 months after a woman’s last period). Postmenopause lasts the rest of a woman’s life, and the stage may account for more than 50% of a woman’s total life. Postmenopause can be an exciting time for women, filled with life milestones, newly found freedom, and more time to get to know themselves and chase new adventures. Postmenopause also brings a new set of challenges for women. Postmenopausal women are at a higher risk of cardiovascular disease and osteoporosis. These higher risk factors make it especially important to for a woman to eat differently and train differently to support this new stage of life. 

Common Symptoms 

• Hot Flushes (Hot Flashes) 

• Irregular periods

• Brain fog or trouble concentrating

• Headaches

• Night sweats

• Mood changes

• Anxiety

• Changes in sexual desire

• Vaginal dryness

• Insomnia or trouble sleeping/staying asleep 

• Joint and muscle pain

• Increased sweating

• Weight gain, especially around your stomache

• Needing to pee more often

The good news is that you likely won’t experience all of these symptoms. And you won’t experience symptoms all the time. In the coming weeks in the blog, we’ll focus on each of these symptoms more in depth, including why they happen, and what you can do about it.  It is important to note that these symptoms are real, you aren’t making them up, and there are things you can do to manage and eliminate them. You don’t need to accept this as your new normal. 

Exercise and Nutrition 

Your body is changing. Reduced estrogen impacts every major system in your body. Maintaining the same exercise and nutrition strategy you used pre-menopause will not have the same results. 

One common misconception is that menopause causes excess weight gain. There is no scientific evidence that this is true. Weight gain during the menopause transition can be tied to a few things. As women age, they become less active. As activity decreases, they lose muscle mass. As muscle mass decreases, metabolism decreases. These factors contribute to that dreaded weight gain during a woman’s 40’s and 50’s. The great news here is that this is controllable. Maintaining an active lifestyle and adding strength training can keep the creep of extra weight at bay. Weight gain during the menopause transition is not inevitable. 

Similarly, the way you ate prior to the menopause transition likely won’t work as well for you during and after the transition. To avoid excess weight gain and minimize menopausal symptoms, it is necessary to be more aware of what and when you are eating. Getting adequate protein each day is important, as this helps to maintain muscle mass. Calcium becomes an important mineral, as does vitamin D to help with calcium absorption. Caffeine and spicy foods may cause hot flashes, increased sweating, and more sleep disturbances. The first step in determining the best nutrition plan for you will be to evaluate what you are already eating, and how you can slowly add in foods that contain more protein, calcium, and vitamin D. Sugar and alcohol also tend to exacerbate many menopause symptoms (since when did one glass of wine keep you up until 3am, and cause a nasty hangover the next day?). Many women find that tracking their diets for a few days and tying certain foods to symptom occurrence can be a very helpful start in determining what to eat and what to avoid. 

Both exercise and nutrition auditing and planning are part of Strong In Menopause coaching. It has been awesome to see the impact minor tweaks to these two areas have had on the lives of our clients.   

Serious Health Concerns 

Two of the biggest chronic health concerns related to menopause are cardiovascular disease and osteoporosis. 

Cardiovascular disease: Heart Disease is the leading cause of death for women in the United States. Due to hormonal changes, peri- and postmenopausal women are at higher risk for high blood pressure, artery thickening, high blood sugar, high cholesterol, and metabolic syndrome. 

Osteoporosis: According to a study on osteoporosis in postmenopausal women, osteoporosis impacts ⅓ of women aged 50-60, and 50% of women 80 and older. Estrogen deficiencies that occur after menopauses increase the rate of bone reabsorption, while decreasing the rate of bone remodeling. Postmenopausal women see a 10% decrease in bone mineral density over the menopause transition years. Approximately 25% of women are classified as “fast bone losers,” and they may see a 20% decrease in bone mineral density over the menopause transition. Risks associated with osteoporosis are fractures, leading to decreased autonomy and quality of life. 

Both cardiovascular disease and osteoporosis can be mitigated by an active lifestyle and healthy eating habits. 

Hormone Replacement Therapy

Hormone Replacement Therapy (HRT), sometimes called Menopause Hormone Therapy (MHT) or Hormone Therapy (HT), is a medication used to treat common menopause symptoms. 

There are two types of HRT, Estrogen only therapy (ET) and estrogen progesterone therapy (EPT). ET Is typically prescribed to women who have had their uterus surgically removed, while EPT is prescribed to women who have a uterus, with the progesterone acting as a protectant against uterine cancer. 

HRT is delivered systemically or locally. Systemic products are available as an oral tablet, injection, gel, patch, spray, or emulsion. Systemic products circulate in the bloodstream and reach all areas of the body, making them effective at treating most menopause symptoms. Local products are available as a cream, tablet, or ring, and are typically used to treat vaginal symptoms as they affect only the localized area. 

The standard recommendation for HRT is to prescribe the smallest dose for the shortest amount of time. Women who are younger when they start HRT typically have more favorable outcomes. 

You may have heard HRT is risky or increases cancer risk. In the last two years, this has been disproven. We will cover this more in a future blog post. Research shows that HRT is effective in treating menopause symptoms and can improve overall quality of life. 

See this article for more information. 

Benefits of Menopause 

We talk a lot about the drawbacks of menopause, but there are some great benefits. Here are just a few.

• Postmenopausal women no longer need to worry about unexpected periods or uncomfortable PMS symptoms

• Postmenopausal women can have sex without the risk of an unplanned pregnancy 

• Postmenopausal women report increased confidence comes with the shift into a new stage of life

• Postmenopausal women often feel increased self love and gratitude

• Peri- and postmenopausal women experience a reprioritization in their life that leads to feelings of fulfillment and inner peace