Menopause is a time of great change in the life of a woman. After a lifetime of dealing with periods, it is the time when your body is getting ready to take charge and shape the next chapters of your life. As your body transitions into menopause over several years, it is not unusual to start noticing a change within you. These changes are perfectly normal as your body is entering to a new phase.

For many women, the menopause journey can be a confusing time as it does not have a clear starting or ending point. The hormonal levels in the body undergo progressive changes during this phase, you may experience a wide range of symptoms, all of which have physical, emotional, and psychological aspects. However, these symptoms vary from person to person.

Before discussing about the early signs and symptoms of menopause, let us have a quick overview about menopause.

About menopause

Menopause is a natural biological process. It is a normal part of aging and marks the end of reproductive years of a woman. Menopause typically occurs in late 40s to early 50s. Some women experience menopause early as a result of a surgical intervention (such as removal of the ovaries) or due to any damage to the ovaries. Menopause that occurs at 40 or younger is considered premature menopause. Clinically, menopause is defined as a complete year without menstruation, in the absence of any surgery or any medical condition.

As you age, the reproductive cycle which has been continuously functioning since puberty begins to slow down and prepares to stop. During this time, the quality of eggs in a woman’s ovaries diminishes and ovulation will become irregular. Eventually, the production of estrogen and progesterone by ovaries also decreases. This leads to irregular or missed periods and then absence of the periods.

Stages of menopause

Menopause doesn’t happen overnight. According to the National Institute on Aging, the full menopausal transition lasts for an average of seven years. The whole process has mainly three stages:

  • Perimenopause: This is the transitional period that starts before menopause. During this time, woman’s fertility typically starts to decline.
  • Menopause: This stage officially begins either 12 months after the last period or when menstruation has stopped for a clinical reason, such as the removal of the ovaries.
  • Post-menopause: This refers to the period after menopause. Due to low estrogen levels after menopause, most women are at increased risk of health issues such as heart disease and osteoporosis.

How will you know that you are transitioning into menopause?

In the months or years leading to menopause (perimenopause), the natural decline of estrogen levels is responsible for most of the symptoms you experience during menopause. Some of these symptoms may begin suddenly and are very noticeable while others may be very mild at first.

Here are the most common changes you might experience while transitioning into menopause:

  1. Irregular periods

    The first sign that menopause is approaching is usually irregularity in your periods. The fluctuating hormones are often associated with these changes in the menstrual cycle. Initially, periods could become heavier and tend to happen in shorter cycles. Later on, the periods will settle down and become lighter and less frequent and eventually stop.

    If the heavy bleeding continues for too long or is too severe, then you should seek a medical attention.

  2. Breast tenderness

    As you enter perimenopause, it is common to experience pain or tenderness in breasts. When the estrogen and progesterone levels in the body fluctuate unpredictably, it can cause fluid to build up in the breasts, making them feel swollen and tender.

  3. Worsening of premenstrual syndrome (PMS)

    Worsened PMS symptoms before each cycle are also common for women who enter the perimenopause stage. As you experience shorter cycles during this stage, periods might occur more frequently with aggravated menstruation-related symptoms. Fortunately, PMS generally resolves in menopause stage, when hormones finally level out and the body adjusts to its new normal.

  4. Hot flashes

    One of the major symptoms of menopause is a sudden sensation of heat in the upper body; this is known as hot flashes. It can make your whole body uncomfortably warm for a minute or more. The sensation usually starts in the face, neck, or chest and progresses upwards or downwards. A hot flash can last anywhere between 30 seconds and 10 minutes. Some hot flashes are strong enough to wake a person in the night, these are called night sweats.

  5. Sleep disturbances

    Hormonal and mood changes during perimenopause stage can contribute to sleep disturbances. Changing and decreasing levels of estrogen will result in insomnia (disorder that prevents you from getting adequate sleep). Additionally, night sweats and urinary urgency also affects your sleep duration.

  6. Urinary incontinence

    Reduced levels of estrogen starting around menopause can cause thinning of the lining of the urethra (tube that passes urine from the bladder out of the body). Additionally, aging will cause relaxation of the pelvic muscles. As a result, women at early menopause are at increased risk for urinary incontinence, or the involuntary leakage of urine.

  7. Mood swings

    Hormonal changes around menopause can intensify your moods. Researchers showed that estrogen plays a role in serotonin (neurotransmitter in brain responsible for emotional balance). Decrease in the estrogen level during perimenopause will drop the serotonin levels, which in turn could impact mood.

  8. Loss of libido and sexual discomfort

    Hormonal changes can negatively affect your sex drive. Additionally, vaginal pain and urinary tract infections can also make sex uncomfortable.

  9. Vaginal itching

    During the menopause transition, fluctuating levels of hormones especially estrogen can cause inflammation of the vagina that can result in discharge, itching and pain. This is known as vaginitis or vaginal itching. This can lead to pain during sex and urinary tract infections

  10. Physical changes

    Around the time of menopause, most women may experience physical changes as a result of decreased production of estrogen and progesterone in ovaries. These changes include buildup of fat around the abdomen, weight gain and changes in hair color, texture, and volume.

The onset of menopause can be emotionally challenging for some women. The key to manage the symptoms naturally is to understand menopause and get ready for it both mentally and physically.

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