Menopause happens either when ovulation and periods end naturally, or because of a medical treatment such as surgery. Menopause doesn't show up out of the blue for most people, though. The years before natural menopause are a time of hormonal shift called perimenopause. Perimenopause and menopause are a given, eventually, for anyone with ovaries.
This transition out of our reproductive years isn't simple. Most of us will notice at least a few disruptions that may begin while our periods are still regular: hot flashes, night sweats, sleep changes, sexual changes, or mood problems, to name a few. These may be mild or difficult for different women. We may have to figure out how to deal with menstrual changes, and, if we are using contraception, decide when to stop. We also need to understand what being in menopause means for our overall health, and how to navigate the years ahead.
There was a time when every woman in menopause was considered to have a "deficiency" of hormones, and automatically prescribed the same hormone "replacement". Thank goodness that's no longer the case. We've learned that hormones aren't a "one size fits all" approach. For some people with menopausal symptoms they can help, and for others, they might hurt. There are a variety of other options for treating different menopause-related symptoms, including natural medications, prescription medications, and other specific therapies, so people who want or need to avoid hormones can do so while still treating their symptoms.
For people who choose it, we've learned a lot about how to use hormone therapy wisely. Like starting while women are close to menopause, and using the options that appear to have less risk, including bioidentical hormones. We also have new ways to provide hormones. For instance, some can be absorbed through the skin rather than swallowing and digesting them, which makes them safer.
Understanding hormones, menopause and perimenopause takes patience. Knowledgable practitioners can help provide safe options for their patients. Unfortunately, media reporting of women's health research tends to share risks with bold headlines while ignoring positive research outcomes. This leaves many women afraid to ask providers for help with their menopausal symptoms, believing there are no safe options. This could not be more wrong.
In this space I share my knowledge as a Nurse-Midwife and Certified Menopause Practitioner to help people understand a little more about their own bodies and health. I hope you learn something, and if you find you are struggling in one way or another, I hope you will reach out for help. There are lots of great people who are excited about providing excellent care to those in perimenopause and menopause, and you deserve that kind of care.