Menopause Changes: What to Expect

Menopause may refer to a one-time event -- a woman's last menstrual period -- but menopause changes start well before and may continue afterward too. That transitional time is called perimenopause. Fluctuating hormones can cause irregular periods for several years (up to eight!) preceding menopause. You might even skip a month or two, only to have it come back when you least expect it. Additionally, approaching menopause can bring on a host of vague (and some not-so-vague) symptoms -- everything from mood changes to weight gain to rising cholesterol levels. Although no two women experience perimenopause in just the same way, and plenty of women pass through the phase with no troubles, it can help to know what changes might be ahead.

Most changes as you approach menopause are merely annoying, but some can affect your quality of life and others can look like more serious conditions. Consider seeing a doctor if you're worried about symptoms caused by menopause changes, particularly changes in sexuality, loss of libido, mood issues, weight gain, sleep problems, and memory or concentration.

Here are some of the more common menopause changes and some tips for how to reduce or alleviate them.

1. Sleep disturbances: Hot flashes, night sweats, and insomnia can interrupt sleep and increase daytime fatigue. Dress in light layers so you can adjust accordingly as hot flashes come and go, keep cold water or iced washcloths nearby to cool you down, and avoid triggers such as spicy food or alcohol. Keeping your bedroom cool can also help. If sleep disturbances and fatigue disrupts your ability to function, see your doctor.
2. Weight gain: Yes, it's true. Many women find that they gain weight more easily as they near menopause. Factors like hormonal changes and the aging process may be to blame, but your diet and exercise habits play a role too. Eating well and staying active -- boosting your exercise routine, if you can -- might help stave off the extra pounds.
3. Body changes: Declining estrogen levels can lead to changes in how your body looks and feels. You might notice changes in the shape of your breasts and a loss of elasticity of the skin. The lining of the vagina can become thinner and dryer, which can lead to pain during intercourse and increased vaginal infections. The urethra is also more sensitive, and you may feel like you need to urinate more often. To accommodate these changes, slather on the skin moisturizer, use lubricants during intercourse, and avoid caffeine and other substances that stimulate the bladder.
4. Changes in mood, memory, and focus: Menopause changes coincide with a time when many women are at the peak of their careers, raising kids, and perhaps caregiving for aging parents -- a difficult juggling act even in the best of times. Menopause symptoms add to this already full plate and can put women at a higher risk for mood changes, depression, and difficulties concentrating. Women who have had depression in the past may see a recurrence around menopause. Exercise, taking time for yourself, breaking tasks down into smaller steps, and talking to a friend or therapist can help.
5. Changes you can't see: Some menopause changes are less obvious, but still warrant attention. As women pass through menopause, their risk for heart disease rises. Some of this may be related to the aging process and rising cholesterol levels. Be alert to increased shortness of breath or heart palpitations that make you dizzy. Bone density loss is also common around menopause, increasing the risk of bone fractures. Weight-bearing exercise (such as light weight lifting, yoga, or walking) can help build strong bones.

Just like puberty, menopause is a transition time in which there are bound to be some ups and downs. But on the other side is a new phase of life, one that many women find full of zest and possibility.