A Look Back: Key Takeaways of a Menopause Series

Menopause is a transitional stage in every woman’s life. Although it can abruptly start with surgical removal of the ovaries, natural menopause begins with perimenopause, generally in a woman’s 40s. Hormones fluctuate, egg counts plummet, and symptoms can ensue. Perimenopause lasts an average of seven years. One year after a woman’s last period, she hits menopause (average age of 51 or 52). The next day, she enters the post-menopause stage.

Menopause-associated hormones (largely estrogen, along with progesterone and testosterone) are chemical messengers that direct hundreds of bodily functions, not just reproduction. Estradiol is a key estrogen produced in the ovaries. The wild ride these hormones embark on during the transition can have widespread effects beyond hot flashes and mood swings. Insomnia, weight gain, joint pain, depression, night sweats, anxiety, incontinence, low sex drive and acne are just a few of menopause’s unwanted guests. Symptoms can range from fleeting nuisances to career-ending cognitive difficulties.

Estrogen receptors span the brain. During the menopause transition, estrogen spikes and drops, often intensely. The fluctuations of the hormone, therefore, can affect key brain functions, such as planning and organizing by the pre-frontal cortex, memory and learning by the hippocampus, and emotional control by the amygdala. For some women, the powerful effect of estrogen on the brain can slide by nearly unnoticed. For others, the effects can play havoc in this period of their lives, causing everything from parenting problems to job struggles and from irritability to mental health scares.

New data and a better understanding of how to treat women with hormones have lifted the therapy back up from a hole dug by media armed with misinterpretations of a major study in the 1990s and early 2000s. Doctors today have updated products, improved delivery systems and a clearer picture of the risks and benefits of hormone therapy that for many women can be the best choice. For others, non-hormonal treatment options have continued to climb.

Just as you wouldn’t take your PC to a Mac expert or call an electrician for a leaky pipe, solving menopause problems should start with a gynecologist. And not just any OB/GYN. Find a menopause provider who stays on top of the latest menopause research and treatments. Certified providers are menopause experts also trained to take a team approach, working with providers who span the disciplines sometimes needed for the wide mix of possible symptoms.

See related stories in our menopause series.