Menopause is a stage of life that every woman will eventually reach, but that doesn’t make the experience any less challenging. From hot flashes and mood swings to sleep disturbances and energy fluctuations, the effects can be overwhelming. The good news is that support and treatment options are available, and women don’t have to navigate this transition alone.
Perimenopause is the phase leading up to menopause. It typically begins in a woman’s late 30s or 40s and can last anywhere from two to 10 years, with average estimates falling between four to eight years. During this time, hormone levels fluctuate, resulting in symptoms like irregular periods, hot flashes, mood swings, sleep disturbances, and concentration difficulties. Perimenopause may also involve continued fertility, meaning pregnancy remains possible.
Menopause is defined as the point in time when a woman has gone 12 consecutive months without a menstrual period, marking the end of the reproductive phase. It most commonly occurs around age 51 in the U.S., though the range can vary depending on family history, health status, or medical factors.
One message I emphasize to my patients is this: menopause symptoms are not something you simply have to “tough out.”. When they begin to interfere with sleep, relationships, work, or daily activities, it is time to schedule an appointment with an experienced women’s health provider. These concerns can be addressed during an annual visit or at a separate appointment focused specifically on symptoms.
Having this conversation early makes a difference. It provides reassurance, opens the door to more treatment options, and helps prevent symptoms from becoming overwhelming as changes progress. My role and the role of my colleagues is to help women find treatments that make symptoms manageable and allow them to feel more in control.
There is no one-size-fits-all solution, but several effective treatment options exist to help women manage symptoms, improve quality of life, and feel more in control during this transition.
Hormone Replacement Therapy (HRT): HRT replaces the estrogen and progesterone that the body no longer produces. It can reduce hot flashes, mood swings, and vaginal dryness. Pills, patches, gels, and vaginal rings are among the available forms. Like any treatment, HRT carries risks. Some women may face a slightly increased risk of breast cancer, blood clots, or stroke, depending on age, dose, and medical history. It’s important to have a thorough conversation with your provider about possible side effects and weigh them against the potential benefits to determine whether HRT is the right choice.
Non-Hormonal Therapies: Certain antidepressants and seizure medications can ease hot flashes and mood swings. Vaginal moisturizers and lubricants can relieve dryness and discomfort during intimacy. There are new medications that have been approved, which work through thermoregulatory neurons, yielding very promising results.
Lifestyle Approaches: Exercise, healthy eating, and quitting smoking can all reduce symptoms. Practicing relaxation techniques such as yoga, meditation, and deep breathing can help alleviate stress and improve sleep.
Natural Remedies: Some women find relief with herbal supplements such as black cohosh, red clover, or primrose oil. Evidence is limited, so these should be discussed with a provider before starting.
Menopause can sometimes put stress on relationships, as changes in mood, energy, and intimacy may feel difficult for both partners. It’s easy to feel distant or misunderstood, but honest conversations and patience can make a big difference. I often encourage open communication between partners, since understanding what’s happening can help reduce frustration and create a sense of teamwork. Simple steps like focusing on self-care, making healthy choices, and seeking counseling if needed can help couples stay connected and even grow stronger together.
From my perspective as both a physician and someone who has guided women through this stage, here are a few key strategies:
Menopause and perimenopause are natural stages of life, but women don’t need to face them alone. With guidance, treatments, and support, it is possible to feel better and thrive.
The best step you can take is to start the conversation – both with your provider and with your loved ones. Together, we can create a plan that helps you live well and confidently through this transition.
To learn more about women’s healthcare at UNC Health Pardee, visit pardeehospital.org.
