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Your Top 10 Questions About Menopause Answered

If you’re like us, you cruised through your 20s and 30s with nary a thought to what nature had in store for your body. And then your 40s hit you with a rude awakening in the form of weight gain, erratic periods, skin problems, digestive issues, sleepless nights — and so much more your mother never told you about. If you’re like us, you suddenly had a bunch of questions.

Which is why, dear reader, we have answers.

1. What is menopause exactly?

Menopause is when your ovaries shut down and you no longer have a period. To qualify for menopause you must have no bleeding for 12 months. None. If you bleed even just a little, the 12-month counter begins again.

2. What’s the average age of menopause?

Most women are in natural menopause by 51. A normal range is 45 to 55. Some women experience the onset of menopause at a younger or older age.

3. How long does menopause last?

Forever. Once your ovaries shut down, you’re in menopause for the rest of your life. On average, the period before menopause, called perimenopause, lasts 5 to 7 years for white women, less for Asian women, and up to 10 years for black women. A small percentage of women may have hot flashes for 15 or 20 years or even longer. (Sorry!)

4. What are the signs of menopause?

The list is long and quite unpleasant. During perimenopause, you may experience some or all of the following: hot flashes, chills, night sweats, irritability, dizziness, mood swings, and excessive crying. Your hair might start to fall out, you might gain weight, you could have stiff joints. You might forget things — including how much you used to like sex.

5. What are hot flashes?

Hot flashes signal a change in hormones. During perimenopause, estrogen and cortisol (the stress hormone) become erratic and cause the body to quickly heat up.

6. When do hot flashes start, what causes them, and how long do they last?

Hot flashes start during perimenopause and can be caused by hot food and drinks, caffeine, alcohol (particularly red wine), spicy foods, and anxiety. A hot flash typically lasts 30 seconds to 5 minutes.

7. What are cold flashes or chills?

When the part of your brain responsible for regulating temperature is overactive because of hormone fluctuations, this can raise your body’s thermostat set point. When that happens, it causes you to feel very cold. Chills can occur immediately after hot flashes or by themselves.

8. What about sex during menopause?

Sleep difficulties, fluctuating emotions, weight gain, and more can all impact your libido. But you can enjoy sex during menopause. It all comes down to your sexual state of mind, being able to embrace your changing body, and maintaining vaginal lubrication. You can do the latter with an over-the-counter lubricant, or your doctor may prescribe a vaginal ring that provides a slow release of estrogen to help remedy vaginal dryness.

9. Can I still get pregnant after menopause?

Once you’ve missed your period 12 months in a row, you’re very unlikely to get pregnant. However, leading up to that point, you certainly could. Take the appropriate precautions.

10. What’s the best way to deal with the miserable symptoms?

We’re not doctors. We’re just women experiencing our version of life, and our experience has shown us again and again that a clean diet low in sugar and rich in protein combined with daily exercise and at least eight hours of sleep each night combat misery of all kinds — including that associated with menopausal symptoms. Mediation or breath work helps lower stress levels and regulate emotions. Doing things that bring you joy with people who bring you joy is also a great way to manage hard times. Some women swear by hypnosis. Others find cognitive behavioral therapy (think cold thoughts), acupuncture, or a combination of these things helpful.

That said, hormone therapy is the gold standard of treatment and is much safer than many women think, particularly if they are under age 60 or within 10 years of the start of menopause. For women who can’t or don’t want to take estrogen, natural supplements such as black cohosh may help. Low-dose antidepressants may also help decrease hot flashes and have the added benefits of improving sleep and overall quality of life — although alone they don’t work as well as hormone therapy. Always consult your doctor before trying any new treatment for perimenopause symptoms.

Photo: Juan Monino

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