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Navigating Through “the Change”

Menopause—when a woman gets her period for the last time—is a natural part of life. But it can also be a confusing one. What symptoms should you expect? How do you deal with them? And what should you avoid? Get the inside scoop from medical experts.

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1. “Listen to your body.”

When we think of menopause, hot flashes come to mind. But symptoms can be more subtle, like cognitive problems or sexual changes, and they may begin earlier than you expect. Perimenopause—the transition period leading up to menopause—can last many years. And it’s when women experience the most symptoms. Listen to your body and talk with your doctor. Being aware is the first step.

2. “Hormone replacement therapy isn’t evil.”

The media has widely reported the risks of hormone therapy. But experts say it’s safer than you may think. “The level of hormones in hormone replacement therapy is much less than in birth control pills, patches and rings, and the side effects are similar,” says gynecologist Margery Gass, MD. “If your clinician gives you the OK, hormone therapy can safely relieve symptoms in the short term. Women with bothersome menopausal symptoms should feel comfortable seeking treatment.”

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3. “Be wary of going "natural."

To avoid conventional hormone therapy, women are flocking to bioidentical hormones—hormones designed and tailored to mimic those made in a woman’s body. But be careful. “Even ‘natural’ hormones are made in a laboratory,” says Dr. Gass. “Compounded bioidentical hormones aren’t well regulated, but there are FDA-approved hormones that are well tested and meet the definition of bioidentical.” Bottom line? Use hormone therapy that has been tested and approved by the FDA.

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4. “You aren’t losing it.”

Can’t remember your neighbor’s name? Misplaced your phone (again)? You’re not alone. “Memory problems and other cognitive issues are normal during perimenopause. They don’t mean you’re developing dementia,” says Pauline Maki, PhD. “It’s a relief for women to learn it’s their hormones—not their head.” Write things down and keep a ‘to-do’ list. Mark things off as you complete them and try to minimize multitasking. This will help you keep track of everything you’re doing.

5. “Exercise is medicine.”

Want to sharpen your memory, boost your mood, and quell anxiety? “Research shows that you can reduce the cognitive and mood symptoms of menopause by engaging in yoga or cardiovascular exercise like brisk walking,” says Dr. Maki. “Maintaining strong social relationships helps, too.” Combine the two by asking a friend to go to a yoga class with you.

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6. “Keep the spark alive.”

A drop in estrogen during menopause can throw a wrench in your love life. Genital changes, including vaginal dryness and narrowing of the vaginal canal, are normal. But they’re not inevitable. “You can help maintain lubrication and vaginal size with regular intercourse or sexual stimulation,” explains Sheryl A. Kingsberg, PhD. “In this case, the saying ‘use it or lose it’ is true.”

7. “Don’t live with painful penetration.”

Although having sex more often can relieve some sexual symptoms of menopause, it may not resolve them all. “If sex is painful, seek help. Don’t suffer in silence,” says Dr. Kingsberg. “There are many safe, effective treatments for sexual problems, including low sexual desire. Menopause doesn’t mean the end to enjoyable sexual relations.”

8. “Find the right doctor.”

Still seeing your obstetrician for gynecological care? There’s nothing wrong with that. But if you want a doctor who is focused on your particular needs, consider visiting a North American Menopause Society (NAMS) Certified Menopause Practitioner (NCMP). “There are many healthcare issues that menopausal women should pay attention to. A specialist understands the hormonal changes you’re experiencing and can help,” says Dr. Kingsberg.

9. “Hang in there—this will pass.”

If you’re having a difficult time dealing with symptoms leading up to menopause, work with your doctor, but try to keep things in perspective. “Many symptoms of perimenopause—including hot flashes, forgetfulness, and moodiness—go away on their own soon after you reach menopause,” says Dr. Maki. “So while you might need to manage them now, take comfort in the fact that these symptoms won’t last forever.”

10. “Menopause can be positive.”

Society can paint a negative picture of menopause, but how accurate is it? “Menopause can be difficult for some women, but we’ve conducted polls on women’s attitudes toward menopause, and they are generally very positive. Women report improved partner relationships and a sense of personal fulfillment,” says Dr. Gass. “Women have gone through menopause for centuries. It’s a normal, healthy part of life.”

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