The million-dollar question about menopause is also the No. 1 complaint — what you can do about it

Don’t sweat it!

Menopause is a natural process that affects all women — it occurs when ovaries produce less of the hormones estrogen and progesterone and stop releasing eggs altogether.

It’s officially diagnosed after 12 consecutive months without menstruation, though symptoms often persist for years before and after this period.

Menopause is a universal phenomenon, but there are many misconceptions about it — from symptoms to treatments. 

These are some of the common myths and more unusual signs.

When does menopause happen?

Women in North America tend to experience menopause between 51 and 52 years old, while the global average is closer to 48.

If it occurs before age 45, we call it early menopause. Smoking, a hysterectomy and a family history of early menopause are risk factors for it.

Menopause that occurs after age 55 is considered late-onset menopause.

The time leading up to menopause is called perimenopause. It typically begins in the late 40s and can last for several years.

Perimenopause is different for every woman. Periods may become longer or shorter, heavier or lighter or skipped altogether. Menopause-like symptoms are common during this time.

What are the major symptoms of menopause?

Some women can have a variety of symptoms while others have none.

We categorize symptoms in three ways — physical, psychological and urogenital.

Physical symptoms include hot flashes and night sweats, which are classic signs of menopause.

Disrupted sleep and heart fluttering are in this group too.

Sudden feelings of intense warmth are a common menopause symptom. Stock photo

Brain fog and mood changes like anxiety, depression, irritability and bouts of rage are among the psychological symptoms.

Women who have had premenstrual syndrome, premenstrual dysphoric disorder, postpartum depression or a difficult puberty may be more susceptible to mental health struggles during menopause.

The final category covers vaginal dryness and changes to urination habits.

Estrogen, the primary female sex hormone, drops significantly during menopause. Declining estrogen is responsible for the thinning and drying of the tissues in the urogenital tract, including the vagina and vulva. That’s why sex may be painful.

What are some novel symptoms?

Some signs are more subtle, like itchy skin and joint aches.

Estrogen is key for maintaining skin moisture and elasticity, so skin becomes thinner and more prone to dryness and irritation in menopause.

A reduction in estrogen can also contribute to increased joint pain and stiffness since it plays a role in keeping joints healthy.

How long do symptoms last?

We used to believe that menopause symptoms only lasted a year. That’s a myth.

In fact, these symptoms can linger from four to 10 years.

And we’ve noticed cultural differences in symptom duration.

Black women typically have more severe symptoms that last longer, like up to 10 years, whereas Hispanic women often experience them for around eight years.

White women’s symptoms usually persist for seven years, while Asian women generally have symptoms for four to six years.

Why do menopausal women gain weight?

That’s the million-dollar question — and the No. 1 complaint.

Menopausal women usually put on six or eight pounds in their bellies.

Weight gain stems from hormonal and lifestyle changes and the natural loss of lean muscle.

Dr. Samantha Dunham said a major myth of menopause is that symptoms only last a year. Sometimes they last up to 10 years.

Women tend to store fat in their hips and thighs. The decline in estrogen during menopause can cause a shift in fat distribution, leading to weight gain primarily in the lower belly.

Their shape changes from a pear to an apple because of the extra belly fat.

Menopausal women are also often not exercising as much, which affects their weight. Plus, they’ve been losing lean muscle since their 30s — a process that accelerates with age and changes in metabolism.

So if their pants suddenly don’t fit even though they didn’t do anything wrong or differently, it can be really annoying.

Should menopausal women take hormone therapy?

Most women can take estrogen and progesterone to treat menopause symptoms like hot flashes, night sweats, heart fluttering and even sleep disruption. Sometimes they ease joint aches.

Hormone medications also have protective benefits. We know they help reduce the risk of fracture over time.

Osteoporosis is a big problem for women as they age — hormone therapy supports the bones. There’s also some cardiovascular protection.

Hormones are most safe when they’re given close to the time of menopause. The further away from menopause, the hormones become more risky than beneficial.

Are there natural ways to reduce menopause symptoms?

Lifestyle changes can help.

Sleep, a healthy diet, exercise, stress management and social connections are crucial for navigating the menopause transition.

Do only severe menopause symptoms need treatment?

One menopause myth is that some symptoms aren’t worth treating.

We know that women feel better in the long run when their symptoms are addressed through hormonal treatment, non-hormonal treatment or lifestyle changes.

It’s important to remember that every woman has her own experience. No matter your situation — you will acclimate and you will thrive.

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Dr. Samantha Dunham is co-director of NYU Langone’s Center for Midlife Health and Menopause. She is also a clinical associate professor in the Department of Obstetrics and Gynecology.