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Navigating Menopause


Menopause is a natural stage of life for women as they age. Understanding all the facts can help you prepare for it, learn what to expect, and determine how to build a network of information and support to guide you through it gracefully.

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What is Menopause?

Menopause is a significant life stage in which a woman’s menstrual cycle and fertility end. It’s a natural process associated with reduced functioning of the ovaries, resulting in decreased reproductive hormones, mainly estrogen and progesterone. Menopause is medically diagnosed when a woman has gone 12 months without a menstrual period. 

Menopause typically happens when a woman reaches her 40s or 50s, but there are several distinct stages of menopause that can bring some body changes and symptoms in your thirties and last into your late 50s. 

Additionally, it’s important to distinguish between natural and induced menopause. Induced menopause can happen at any age if the ovaries are surgically removed or damaged due to medical reasons. Examples include cancer treatments like pelvic radiation and chemotherapy. Unlike natural menopause, which is gradual, induced menopause is abrupt, and symptoms are often sudden and intense. 

What are the Stages of Menopause?

There are three stages of natural menopause: Perimenopause, Menopause, and Postmenopause.

  • Perimenopause, also referred to as the menopause transition, is a span of time leading up to menopause. It typically begins in a woman’s late forties, when her menstrual cycle begins to shift. However, women in their thirties can begin to feel body and hormonal changes associated with perimenopause. These changes occur when the ovaries produce fewer eggs, causing estrogen and progesterone levels to fluctuate and decline.
  • Menopause is the official end of a woman’s menstrual cycle and reproductive years, marked at 12 months after her last period. The ovaries no longer produce eggs, and pregnancy is no longer possible.
  • Postmenopause post-menopause is anytime after the time at which a woman can be declared in menopause. It does not necessarily imply symptom improvement. 

What Age Will I Be When I Become Menopausal?

Menopause typically occurs between the ages of 40 and 58, with an average age being 52. Although, some women may experience menopause as early as in their 30s or as late as their 60s. 

How Long Does Menopause Last?

After transitioning from perimenopause to menopause, a woman may experience symptoms for an average of one to seven years, but it's important to remember that menopause is a permanent state. Some symptoms, like hot flashes, tend to be present and then improve, while other symptoms, like vaginal dryness, can be progressive. To help manage symptoms, it’s important to talk to your Moreland OB-GYN as soon as you notice changes, so they can be addressed in the early stages. 

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Premature Menopause

Premature menopause is when a woman experiences menopause before age 40. Unlike natural menopause, premature menopause is considered abnormal. It can result from genetics, autoimmune disorders, or medical procedures. If there is no obvious medical or surgical cause of premature menopause, a woman may be experiencing primary ovarian insufficiency, a condition where a woman’s ovaries stop functioning prematurely. 

Health risks associated with premature menopause include an increased risk of osteoporosis and heart disease. Women experiencing premature menopause are also at high risk of depression, anxiety, and psychological distress. Talking to both a gynecologist and psychologist can help a woman cope with the physical and emotional effects of premature menopause.

Are you under 40 years old and think you are experiencing premature menopause? Contact us today to set up an appointment.

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Perimenopause is when the amount of estrogen produced by the ovaries begins to decline, usually beginning several years before menopause. During this time, a woman may notice symptoms resembling those related to menopause like hot flashes, mood swings, changes in periods, including heavier or lighter periods and periods lasting shorter or longer than they have in the past, and vaginal dryness. The average length of perimenopause is four years, although some women report this phase lasting for only a few months, while others find it lasts much longer (up to 10 years).

Learn more about the signs of perimenopause and how to alleviate symptoms and get the most out of life as you transition into menopause. 

What are Common Symptoms of Menopause?

Signs and symptoms of menopause can vary among women, although some of the most common include:

  • Flushed face and neck, perspiration, and a rapid heartbeat often followed by a cold chill. These episodes are called hot flashes. In most women, hot flashes are characterized by a sudden rush of heat from the central to upper body.

  • Vaginal dryness due to the decrease of estrogen levels, which may also cause sexual discomfort and a decrease in libido. 

  • Night sweats (hot flashes that occur while sleeping) and insomnia. Trouble sleeping can have several causes, but if it’s something you don’t normally experience, it could be a symptom of menopause.

  • The loss of estrogen causes fat distribution to shift to the waistline, resulting in weight gain around the waist.

Learn how to avoid painful sex by treating vaginal dryness

woman having hot flashes due to menopause

Hormone and Body Changes During Menopause

A woman’s body goes through major hormonal changes during menopause, resulting in a number of noticeable body changes. 

Hormonal changes associated with menopause include:

  • Decrease in estrogen and progesterone 
  • Increase in follicle-stimulating hormone (FSH) 
  • Increase in cortisol, triggered by stress and anxiety
  • Decrease in leptin, the hormone that regulates appetite 
Body changes you may notice from this shift in hormones include:
  • Body weight changes 
  • Lower libido or sexual interest 
  • Pelvic floor function disturbances 
  • Fogged brain or forgetfulness 
  • Trouble sleeping 
  • Vaginal dryness
  • Dry skin and hair 
  • Joint and bone pain 
  • Mood swings
  • Headaches  

Want a better understanding of the main hormones in your body and their functions? Click here to learn more! 

Menopause and Your Thyroid

Some women develop hypothyroidism during menopause. This is thought to result from the fluctuating estrogen levels, which creates an inflammatory environment ideal for developing autoimmune diseases, such as Hashimoto's disease. It’s also important to know hypothyroidism and perimenopause have very similar symptoms, including an altered menstrual cycle, mood swings, weight gain, and hair loss. 

Learn more about your thyroid, thyroid disease, and how you can get tested for hypothyroidism.  

Menopause and Bone Health

Because estrogen helps maintain bone density, the decrease in estrogen that occurs just before and after menopause can result in bone loss and eventually lead to osteoporosis, a disorder in which the bones become weak, brittle, and more likely to break. If you are approaching the perimenopause stage of your life, it’s important to stay on top of your bone health.

Did you know a bone density test is quick and painless? Learn more about osteoporosis and how you can schedule and prepare for your first bone density test! 

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Menopause Symptom Treatment Options

There are many hormonal or non-hormonal treatments that help relieve the symptoms of menopause. 

Non-Hormonal options include:

  • Lifestyle changes and paying attention to what is triggering your symptoms — if you can pinpoint a habit making hot flashes more frequent or severe (stress, alcohol, caffeine, etc.),  you’ll know what to avoid. Eating a healthy diet, getting enough sleep, and stress management are also proven to help alleviate the severity of hot flashes and other unwanted symptoms. 
  • Antidepressants, specifically serotonin-reuptake inhibitors (SSRIs), have been found to be effective treatments for hot flashes. 
  • Over-the-counter lubricants can help to reduce friction at the time of sex and help alleviate sexual discomfort. Staying sexually active can also help by increasing blood flow to the vagina. 

Hormonal options may include the following:

  • Topical estrogen cream is just one of many prescription treatments available for vaginal dryness. It is used as a localized treatment for vulvovaginal discomfort.
  • Systemic estrogen hormone therapy can also help with hot flashes and vaginal discomfort. This type of therapy has an increased risk of certain serious health conditions, including blood clots, strokes, and breast cancer. Talking to your doctor can help you monitor your treatment and discuss if the benefits outweigh these risks. 
  • Bioidentical Hormone treatment gives back some of the hormones the body no longer makes after menopause, mainly estrogen and progesterone. It’s a hormone replacement treatment where the hormone given has the same molecular structure as the hormones your body produced prior to menopause.

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Postmenopause Health and Aging

You don’t have to live with the uncomfortable symptoms of menopause. Hot flashes, vaginal dryness, mood fluctuations, sleep difficulties, and weight gain are not simply a part of getting older and something you just have to get used to. 

Your provider at Moreland OBGYN can offer you the support you need while making the transition to and through menopause. We’ll evaluate both the physical and emotional effects you are experiencing and work with you to develop the best plan to manage your menopausal health.

Learn more about how you can alleviate menopause symptoms and get the most out of your life after menopause. 

Woman making healthy choices

Tips for Staying Healthy Through Perimenopause, Menopause and Beyond

Living an active and healthy lifestyle will be more important than ever as you enter menopause. The following are examples of how certain lifestyle changes can better your health and life while managing menopause symptoms.

  • Preventive health - The healthy choices you make today positively impact your future health during and after menopause. 
  • Exercise - Having a regular exercise routine can help strengthen the heart, bones, and muscles and help maintain a positive body weight and mood. 
  • Diet - Eating a balanced, healthy diet can help ensure you get all the nutrients your body needs. It’s important to drink a lot of water and focus on getting enough calcium, iron, and fiber. 
  • Weight - Maintaining a healthy body weight can help prevent heart disease associated with ageing. 
  • Sleep - Developing a relaxing bedtime routine and a regular sleep schedule can help you get a good night's rest. 
  • Stress - Find ways to relax through yoga, meditation, talk therapy, or massage therapy. 
  • Sex Life - Depression, insomnia, and vaginal dryness can lead to a loss of sexual desire. Talking to your OB-GYN doctor will help you develop a treatment plan for your specific need.
  • Alcohol - Avoid drinking. Alcohol can make menopause symptoms like hot flashes, depression, and insomnia worse. If you do drink alcohol, make sure you drink in moderation. 
  • Smoking - You can add menopause to the countless reasons why you should quit smoking. Smoking has been shown to intensify and prolong unwanted menopause symptoms. 
  • Screenings and vaccinations - Staying up to date on your health screenings and vaccines can help you catch or prevent any health concerns that may complicate menopause-related symptoms. 
  • Health check-ups - Even after menopause, your OB–GYN is a great resource to answer any of your health questions or concerns. It’s important to continue your annual check ups to ensure your mind and body stay healthy. 

How to Find the Right Menopause Provider


Finding a doctor who specializes in menopause is critical. Moreland OB-GYN is committed to being a premier destination for women seeking health care related to menopause. 

Moreland OB-GYN has the distinction of having Menopause Practitioners certified by the North American Menopause Society on staff, dedicated to helping women through this significant change in their life.

What is a NAMS Menopause Practitioner?

All NAMS menopause practitioners must pass a competency examination before getting certified. Our certified providers have proven their knowledge of the stages of menopause, the symptoms of menopause, and the treatments available for women who reach out for help. 

Let Moreland OB-GYN Help You Transition Gracefully Through Menopause

Moreland OB-GYN is proud to be a leading women’s healthcare provider, serving outstanding care at our fourteen locations across southeastern Wisconsin. We work with every patient to deliver compassionate patient care focused on shared decision making and an exceptional patient experience. 

We hope you'll contact us to answer any of your menopause questions. Our caring team of providers will take the time to listen and supply the resources and information you need to live your best life before, during and after menopause. 

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Menopause FAQs

How will I know when I’ve reached menopause?
Menopause is, by definition, when a woman has gone 12 consecutive months without a menstrual period due lack of ovarian activity, rather than another medical reason.
My periods are fluctuating, should I have my hormone levels tested?
Your age and the symptoms you describe may be enough to diagnose perimenopause. Although, if you are 40 years old or under, your doctor may order blood work to test your hormones and rule out any other health condition, such as ovarian failure and thyroid disease.
When can I stop using contraception?
Even when your menstrual cycles are less frequent or have ceased, there is still a potential of ovulation and pregnancy during this time. Contraception should be continued until you are confirmed to be in menopause. If you are under 50, two years after your last period is the ideal time to stop contraception; if you are over 50, one year after your last cycle is the best time to stop contraception.
How can I reduce vaginal dryness?
If over-the-counter lubricants and moisturizers are not helping to alleviate the discomfort from vaginal dryness, your doctor can prescribe a low-risk, topical estrogen therapy. Vaginal rings, tablets, inserts, and creams can help promote vaginal lubrication and improve the thickness and elasticity of your vulva and vagina.
Will I experience the same symptoms as my mother, sister, or friends?
When it comes to menopause, every woman has a unique experience. While there are some common menopause symptoms, the degree and frequency of these symptoms varies from woman to woman.
Do hormone therapies put me at risk for cancer?
Hormone replacement therapy may increase the risk of breast cancer, although the risk depends on the type of replacement therapy and the length of time a woman uses it. Vaginal hormone therapies do not increase cancer risk. Talking to your doctor will help you understand all of the advantages and disadvantages of replacement treatment and choose whether it is the best option for you.
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