What Is Menopause? A Top OB/GYN’s Guide

Menopause marks a major change in a woman’s life, yet it’s often misunderstood. In this post, Shamsah Amersi, MD, offers a quick guide to help women navigate menopause and embrace the future. 

Perimenopause and menopause

Many women consider menopause to begin at the moment they begin to experience symptoms, but that’s rarely the case. Menopause begins when you’ve had 12 consecutive months without a period. The months and years leading up to menopause are referred to as perimenopause — literally, “around menopause.” 

Punctuated by fluctuations in estrogen and progesterone, perimenopause is when many women begin to notice symptoms like hot flashes, night sweats, and changes in their menstrual cycle.

Why menopause happens

Menopause is a natural part of aging caused by the decline in the hormones estrogen and progesterone. Your ovaries primarily produce these hormones. During perimenopause, ovary activity slows down, causing the hormonal fluctuations responsible for perimenopausal symptoms. Perimenopause generally lasts from 2 to 8 years, but timing can vary significantly from one woman to another.

Menopause can also be triggered “artificially” by surgeries, like hysterectomy or oophorectomy (removal of the ovaries), or as a result of certain medical treatments, like chemotherapy. This type of menopause is sometimes referred to as “induced” menopause. In these instances, symptoms can be more intense and occur far more rapidly compared to menopause, which occurs with aging.

When menopause happens

As noted, menopause officially arrives when you haven’t had a period for 12 consecutive months, and other potential causes of period changes have been ruled out. 

For most women, perimenopause begins when a woman is in her mid-40s, with menopause occurring at an average age of 52 (although the timing can vary from one woman to another). Menopause that happens at ages 40-45 years is considered early menopause; before age 40, it’s considered premature menopause.

Diagnosing menopause

Menopause is often diagnosed based on symptoms (including changes in your menstrual cycle) and age, but depending on your health history and risk factors, Dr. Amersi may recommend lab tests to measure your hormones and confirm that menopause has begun. Lab tests are also recommended for women under age 45 who are experiencing menopause symptoms. 

Menopause symptoms

Menopause symptoms can vary in type and severity, and each woman’s experience will be unique. Listed here are the symptoms most commonly associated with menopause:

• Irregular periods
• Hot flashes and night sweats
• Sleep disturbances
• Moodiness, irritability, nervousness, or depression
• Vaginal dryness (with possible discomfort during sex)
• Weight gain
• Thinning hair
• Dry or itchy skin
• Reduced sex drive
• Fatigue
• Changes in breast tenderness or shape
• Problems with concentration or memory (sometimes called “brain fog”)

Many of these symptoms are also associated with other health issues, so if you’re experiencing them, it’s important to schedule an evaluation with Dr. Amersi.

Menopause health risks

Once you’re in menopause, your periods end, and you can no longer become pregnant, changes that many women embrace. However, menopause also comes with health risks that can benefit from regular monitoring.

Specifically, women in menopause have increased risks of:

• Cardiovascular disease
• Stroke
• Urinary incontinence
• Osteoporosis and stress fractures
• Oral health issues, like dry mouth and cavities

All these changes are associated with the hormone decline that occurs once menopause begins.

Managing menopause: How we can help

Menopause may be a natural part of aging, but that doesn’t mean it has to be unpleasant. Many treatments can help today, and Dr. Amersi tailors every treatment plan for optimal relief.

Many women benefit from hormone replacement therapy (HRT) using bioidentical hormones to supplement and replace naturally-produced estrogen and progesterone. HRT can be administered systemically via pills, patches, or implants or directly through creams and gels to treat localized symptoms like vaginal dryness. 

Regular monitoring ensures your HRT plan stays optimized for your evolving needs, so you always enjoy maximum benefits with minimal side effects. HRT can also help reduce health risks, such as low bone density, “brain fog,” and cardiovascular disease.

In addition to HRT, many women benefit from lifestyle changes, like a balanced diet, regular exercise, stress management, and improved sleep hygiene. Dr. Amersi also offers MonaLisa laser therapy and vaginal dilators, lubricants, and moisturizers to address symptoms of vaginal dryness and painful sex.

Embrace your journey

Menopause marks the start of a new chapter in your life, and with the right treatment plan and a deeper understanding of your own body, it can also be a time of personal empowerment. To learn more about menopause and the therapies that can help you navigate its changes easily, request an appointment online or over the phone with Dr. Amersi at her Santa Monica, California, office today.