Menopause is the natural change of the female body that marks the end of a woman's menstrual cycle due to lower hormone levels. The exact time cannot be predicted and can vary greatly from person to person. Usually, between 45 and 55 years, every woman comes to an age when the supply of eggs diminishes. Hormone levels start changing and the female cycle becomes irregular. These hormonal changes have serious effects on the entire female body.

At the age of 40, the ovaries begin to age. This means that they no longer release an egg every month for possible fertilization and the chances of getting pregnant start to decrease. The fertile phase is considered to be over only after no spontaneous menstruation occurs for at least one year. As long as eggs are available in the ovaries, pregnancy is still possible.

Every story is different, just like we are. Possible symptoms include irregular or heavier periods, hot flashes, heart palpitations, difficulty sleeping, mood swings, changes in libido, vaginal dryness, and joint aches. Hot flashes are sometimes preceded by warning signs like vertigo, heart palpitations or chest tightness. Some women experience fatigue, melancholy, loss of confidence, possibly aggression, anxiety or irritability. Concentration and memory problems may also occur. 

Not everyone suffers from these symptoms to the same extent. Some women suffer a lot from hot flashes but have no other symptoms, while others manage well during daytime, but have nighttime sweats and difficulty sleeping. Since every woman is unique and their stress levels and life situation always differ, we cannot generalize.

There is no specific blood test for menopause, but it is worth having a thorough blood test if you notice any symptoms. The results will help your doctor make an accurate diagnosis, as the levels of certain hormones may be telltale signs. You should ask for the examination of the following hormones: TSH (Thyroid Stimulating Hormone), FSH (Follicle-Stimulating Hormone), LH (Luteinizing Hormone) and oestradiol. If you have a cycle, whether regular or irregular, the best time for the test is between the second and fifth days of your cycle. If you no longer have a period, any day is suitable.

Consult your doctor before the test, as only they will be qualified to interpret the results and draw conclusions.

The process of menopause can be divided into three stages, each withtheir own characteristics and symptoms. The first stage is called perimenopause (peri- meaning around), the period immediately before and the first year after menopause. At this phase, the hormonal balance in women starts to change. The duration of perimenopause varies between two and five years and begins a few years before actual menopause.

The second is called menopause, when menstruation stops completely. This is determined 12 months after the last menstrual period. An adequate biological marker for the event does not exist.

The third stage is postmenopause, which comes after menopause or one year after the last spontaneous menstruation. It may induce hot flashes, depressed moods, sleep troubles, sexual problems and changes in libido, dryness of the skin, urinary tract and vagina, exhaustion, muscle and joint complaints, incontinence, and occasionally hair loss and osteoporosis or loss of bone density.

The first stage is called perimenopause (peri- meaning around), the period immediately before and the first year after menopause. At this phase, the hormonal balance in women starts to change: estrogen production decreases, cycle disturbances become stronger, and typical symptoms such as the notorious hot flashes of different severity and strength, mood swings, exhaustion, and muscle and joint issues may appear. The cycle might become irregular and longer. The duration of perimenopause varies between two and five years and begins a few years before actual menopause. Experts say that there is still a chance for pregnancy as spontaneous ovulation can occur occasionally.

Postmenopause comes after menopause or one year after the last spontaneous menstruation. It may induce hot flashes, depressed moods, sleep troubles, sexual problems and changes in libido, dryness of the skin, urinary tract and vagina, exhaustion, muscle and joint complaints, incontinence, and occasionally hair loss and osteoporosis or loss of bone density.

Since everyone experiences menopause in different ways and for varying lengths of time, there is no one right answer to the question of when hormone replacement therapy is warranted. The patient’s general medical state and personal preferences and the phase of menopause can be decisive factors when considering the use of HRT. Thorough testing is necessary for the doctor to recommend the type of HRT that will be the most adequate and presumably the most effective for you.

Hormone replacement therapy can be a great help for those who suffer more from the symptoms of menopause, but everyone’s body is different: the first thing you should do if you want to know what options are out there for your needs is reaching out to your doctor.

If the symptoms of menopause persist, see a doctor as soon as possible. After running several tests, they will be able to determine the most suitable and effective treatment option for you.

Every case is different, and the course of menopause may be influenced by many factors, such as the patient’s general medical state, family history and lifestyle. Menopause starts gradually, usually around the age of 45, but the symptoms are most likely to occur around the age of 50 to 51. It is advisable to see a doctor after experiencing the first symptoms so that after running the right tests, you can get personalized recommendations and choose the treatment option most ideal for you.

It is hard to say what exactly influences the length of the menopausal period because almost anything can affect it: the woman’s physical and mental state, family history and stress levels. How long menopause lasts and how intense it is varies from person to person. Some women experience severe symptoms, while others hardly notice anything. For this very reason it is often hard to make an accurate diagnosis.

Depending on the severity of the case there are several different ways of alleviating the symptoms of menopause. It is a good idea to start with lifestyle changes, such as reducing stress (even if it may seem almost impossible), eating a varied diet, exercising regularly and dedicating time to rest and recharging. In addition, dietary supplements may also be useful.

Since menopause is a natural change in female hormone levels, at the end of menopause, i.e. one year after the last period, hormone replacement therapy may be used. This means that we supply our body with the hormones it no longer produces to the extent it used to through medications

The North American Menopause Society (NAMS) recommends the use of a moisturizing cream or lubricant as the primary treatment for vaginal atrophy. The use of a vaginal moisturizer or lubricant and regular sexual intercourse help in the treatment of vaginal atrophy.

Many factors are at play when it comes to hot flashes, but one thing is certain: the exact time they happen cannot be predicted. Some people do not experience them at all, some women have multiple in a week or even in one day, not to mention the nighttime counterparts of hot flashes, night sweats. Since they are related to hormones your body stops producing once your ovaries start to age and the menstrual cycle stops, if you suffer from hot flashes, you should see a doctor about your problem and consider hormone replacement therapy.

Some lifestyle changes that can influence hot flashes may be worth trying before starting to take medications:

• Dress in layers, choose black or white clothes made of organic materials if you can.

• Have a change of clothes.

• Decrease or avoid alcohol, spicy foods and caffeine.

• Quit smoking.

• Try to maintain a healthy weight, avoid becoming overweight as this increases the severity and frequency of hot flashes.

• If you are open to them, try hypnotherapy or mindfulness meditation. According to American researchers, these can have positive effects in the early stages of menopause.

Hormone replacement therapy supplements hormones that a woman's body no longer produces because of menopause. The two main hormones used in HRT are estrogen and progestogen (synthetic progesterone). Types of estrogen used therapeutically include estradiol, estrone and estriol, and types of progestogen include hormones such as dydrogesterone, medroxyprogesterone, norethisterone and levonorgestrel.

Those who turn to HRT to alleviate the symptoms of menopause can either take both of these hormones (combined HRT) or just take estrogen (estrogen-only HRT). In every case, a gynecologist recommends a therapy based on the patient’s individual needs. Most women take combined HRT because taking estrogen on its own can increase the risk of developing womb (endometrial) cancer. Taking progestogen alongside estrogen counteracts certain mechanisms of how the body reacts to estrogen and minimizes this risk. Estrogen-only HRT is usually only recommended for women who have had their womb removed during a hysterectomy.

To alleviate the most common symptoms of menopause, such as hot flashes, heart palpitations, difficulty sleeping, mood swings, changes in libido, vaginal dryness, and joint aches, lifestyle changes are recommended at first. These include a balanced diet, regular exercise and the use of herbal remedies.

According to recent studies “mind and body practices may be of benefit in reducing stress and bothersomeness of some menopausal symptoms. In particular, hypnosis is a mind-body intervention that has consistently shown to have a clinically significant effect on reducing hot flashes.

Mind and body practices including hypnosis and CBT have been demonstrated to be safe for treating some of the most common and problematic symptoms of menopause (eg, vasomotor, sexual dysfunction, sleep regulation). Other mind and body practices (biofeedback, MBSR, relaxation techniques) may reduce stress and improve quality of life for women transitioning through menopause, but have not shown efficacy for specific menopausal symptoms.

Herbal products are frequently used. However, there is no consistent evidence to support their efficacy and safety.”

According to another study from 2019, there is limited evidence for the efficacy of natural products such as isoflavones in menopause management, and safety data are inadequate .As such, there are currently no official recommendations to support the use of natural products for managing menopausal symptoms.

Although they are not exclusively caused by menopause, hot flashes are one of the most common – and discomforting – symptoms in women who are affected by this phase of life. Basically, they are heat attacks or sudden feelings of warmth most intensely felt on the chest, neck, and face, accompanied by the reddening of the skin and sweating.

The hormone estrogen affects many of the body’s functions, one of them being the body’s heat-regulating system within the hypothalamus. This part of the brain is greatly affected by the falling estrogen levels in the blood during menopause. Medical science does not know the exact mechanics behind this phenomenon, but it is believed that the drop in estrogen confuses the hypothalamus, making it think that the body is overheating. This causes excessive sweating and skin reddening – the normal physiological response to high temperatures.

According to recent studies the prevalence rate of VMS, such as hot flashes, differs according to region and race. A lower prevalence rate of VMS is observed among Asians than Westerners. The prevalence rate is 74% in Europe, 36%–50% in North America, 45%–69% in Central and South America, and 22%–63% in Asia.

As is the case with its beginning, the end of menopause is also hard to determine. It cannot be linked to the appearance or disappearance of a certain event or set of symptoms; rather, it is influenced by several factors.

Medically speaking, postmenopause comes after menopause, or one year after the last spontaneous menstruation. It may induce hot flashes, depressed moods, sleep troubles, sexual problems and changes in libido, dryness of the skin, urinary tract and vagina, exhaustion, muscle and joint complaints, incontinence, and occasionally hair loss and osteoporosis, or loss of bone density.

Although the symptoms of postmenopause resemble those of menopause, many women report that when they reach this phase their symptoms subside and they feel better in general. The easing or disappearance of previously experienced symptoms signals the end of menopause. The body gets accustomed to the new hormone levels, which becomes the new normal. When the new hormone levels stabilize, the feeling of discomfort disappears.

Ovaries start to age at about the age of 40. Eventually, every woman comes to an age (usually between 45-55) when the supply of egg cells comes to an end, hormone levels change, and the cycle is no longer running reliably and evenly. Menopause itself is declared in hindsight, a year after the last menstrual period.

The body grows accustomed to the new hormone levels following menopause. As they become the new normal, life can continue, but without the unpleasant symptoms.

Our body is constantly changing. During menopause you may feel that you are gaining some weight. This is caused by hormonal changes. Estrogens are female sex hormones, which can also be found in men in smaller amounts. Estrogens play a role in the development of secondary sex characteristics as well as in other processes associated with the development of the body. For instance, they are responsible for the fat storage of cells. Changes in estrogen levels may result in mild weight gain, which may show up as excess belly fat. With a varied diet and regular exercise you can keep it under control.

You can try several lifestyle changes, as these small conscious adjustments may bring relief. Exercise multiple times a week. Choose a sport that you like and that feels good, be it a team or individual sport. Maintain a healthy, varied diet and make sure you consume enough protein and fiber. Rest, sleep well and have a good work-life balance. Try meditation and spend time with people who are at the same life stage and are open to talking about it. Knowledge sharing and community can be very supportive, and there may be existing support groups in your area that you can join. Alternatively, you can create your own; this way you can help not only yourself but others as well.

According to recent studies about 10% of women are more likely to have depressed mood during the menopause transition, which tends to be time-limited, and there are two-way interactions between mood and hot flashes and night sweats

What can you do? Focus on the things that make you happy. Be with people who can make you laugh and recharge you with positive thoughts and good vibes. Take long walks, start new hobbies, do things for the first time, and do sports. If these tips are not working for you, consult with your MD or a psychologist, and later on, a psychiatrist who can prescribe antidepressants or mood boosters if needed.