5 Signs of Menopause That You Should Know

Some women may be anxious about menopause (sometimes referred to as “the change.”) They may be worried about symptoms such as hot flashes or night sweats. Others may look forward to relief from painful periods and the concern over getting pregnant. No matter what your outlook on menopause, we want you to know that this is a natural stage in a woman’s life.

At Chapel Hill OBGYN, we’ve supported women through every stage of their reproductive health — from their first Pap smear to menopause. Our goal is to help you manage menopausal symptoms and be a trusted partner in your care. We understand that menopause is a unique experience for each woman, and treatment should be personalized to meet your specific needs. If you’re experiencing symptoms of menopause or think you’re approaching this stage, we encourage you to schedule an appointment with us for guidance and support.

However, there are several signs of menopause of which you should be aware. We’ll review those and discuss some of the treatment options to help relieve you of symptoms.

What Are the 5 Main Signs of Menopause?

1. Irregular or Lack of Periods

Perhaps one of the most prevalent signs of menopause. Technically, you’ve officially entered menopause if you’ve gone for 12 months without a period. While menopause can occur in your 40s or 50s, the average age of onset among American women is age 51. 

During perimenopause —the time before reaching menopause—you may skip periods or have shorter cycles. However, it’s important to realize that as long as you’re having periods, even irregular ones, it is possible to get pregnant. 

2. Symptoms of Hormonal Changes

After menopause, the level of estrogen in your body decreases. Once this occurs, you could have the various telltale symptoms and signs of menopause. These include:

• Hot flashes
• Night sweats
• Sleeping problems

Often,  there are a lot of options to help menopausal symptoms, including some lifestyle adjustments  that can go a long way toward easing menopausal symptoms. 

3. Vaginal Dryness

During menopause, the vaginal tissue grows thinner and drier. This can lead to constant discomfort and irritation. While this affects roughly half of all postmenopausal women, as many as 90 percent won’t seek symptom relief or treatment, according to information from Harvard Medical School. 

A chronically dry vagina can be a sign of vaginal atrophy and one of the signs of menopause. It can make sex uncomfortable or even painful. 

With help, this is easily treatable. We encourage you to contact us so you can avoid the frustrations of dealing with a dry vagina. 

4. Mood Changes

Hormone fluctuations can affect your mood. It’s not unusual for postmenopausal women to experience:

• Irritability
• Anxiety
• Forgetfulness
• Depression
• Difficulty concentrating (“brain fog”)

We want you to understand that your mental health is as important as your physical health, and if you are experiencing these signs of menopause—particularly if they are to the point that they interfere with your day-to-day life—we encourage you to seek help from a mental health professional. 

5. Weight Gain Due to Slowed Metabolism

It’s the ugly truth: Menopause can slow your metabolism. Your hormones may also affect your appetite, making it more difficult to manage portion control. 

Obesity can lead to a host of health problems, putting you at risk for conditions such as Type 2 diabetes, heart disease, high blood pressure and strokes. We’ll work with you to guide you through this challenging time and help you reach your weight and fitness goals. 

How Are Signs of Menopause Treated?

There are several treatments for menopausal symptoms, and we tailor our health care plan to address your individual situation. This can include:

• Complementary and alternative medicine
• Nonhormonal prescription medications
• Hormone replacement therapy

Our OBGYNs in Chapel Hill and Durham Serve You Throughout Your Life Stages 

We have been consistently ranked as the top OBGYN practice in the Triangle area. We’re dedicated to our patients and treat them as individuals—we understand that no one course of care is right for everyone. 

If you believe you’re entering menopause or you’re having difficulties with menopausal symptoms, we encourage you to schedule an appointment with us. 

Still have questions about menopause? That’s okay. We know there’s a lot of information to process, and many online resources can be unreliable at best. 

Therefore, we’re going to take a moment and address some of the most frequently asked questions about menopause we receive. 

We Answer Your FAQs About Menopause

“We want our patients to know that we are here for them through all phases of life,” said Dr. Miller. “Menopause can be a challenging time. It can present some new health issues. During this time of transition, it’s even more important for us to work closely together to ensure you’re living the healthiest life possible.”

Frequently Asked Questions About Menopause

What Is Menopause?

We touched on this a bit earlier, but to recap, menopause is the time of life when you no longer have periods because your ovaries have stopped making significant amounts of estrogen and progesterone.

Menopause is a natural progression in a woman’s life. It’s not a disease.

Technically, menopause is confirmed when you have not had a period for 12 months.

Perimenopause is the phase that precedes menopause.

What Is the Average Age of Menopause?

This occurs, on average, at age 51. However, it can range between the ages of 45 and 55.

It’s also important to note that a woman may enter menopause early, particularly if she’s had to have a hysterectomy or other procedure that has affected her reproductive system.

What Can I Do About Menopausal Symptoms?

Many women experience symptoms such as insomnia, hot flashes and vaginal dryness that often accompany menopause.

We’ve helped hundreds of women address postmenopausal symptoms by creating a tailored approach to personalized health care.

Often, estrogen therapy  is very successful.

Natural supplements such as black cohosh, soy and other herbal remedies have been used to relieve menopausal symptoms—but we would like to provide a word of caution. These products are not regulated by the Food and Drug Administration, therefore there is limited data regarding the safety and efficacy of some of these products.

Does Menopause Cause Depression?

Not necessarily.

The hormonal fluctuations which are common during perimenopause and early menopause are unpredictable. These changes plus disrupted sleep, loss of fertility, and changes in body image can all contribute to new or worsening depression. Many women do report increased moodiness, stress, anxiety and depression during perimenopause and menopause.

If you’ve had bad cases of PMS or PMDD, you may be at greater risk of developing depressive symptoms.

If you have been diagnosed with bipolar disorder or depressive disorder, menopause may exacerbate these underlying medical issues.

We want you to know that we care about both your physical and mental health. If you are stressed or anxious, please let us know. We will work together with you to alleviate your symptoms and help you.

If you are having any of the following symptoms, please reach out to us:

• Persistent feelings of sadness, hopelessness or irritability
• Low appetite or overeating
• Oversleeping or insomnia
• Overwhelming fatigue and lack of motivation
• Loss of interest in activities previously enjoyed
• Difficulty making decisions and absorbing information
• Thoughts of suicide

Will Menopause Cause Me to Gain Weight?

Again, not necessarily. However, on average, women gain five pounds after menopause, which may be due to lower estrogen levels.

A slower metabolism and loss of muscle mass are common in menopause and can also contribute to weight gain.

The best option is to continue living a healthy lifestyle through healthy nutrition and regular exercise. If you’re already doing so, we salute you! If you’re not sure where to start, we’ll be happy to help. Remember that even the smallest improvements can have an impact on your overall health.

How Does Menopause Affect My Overall Health?

This is a fantastic question. The hormonal changes that mark menopause also signal a good time to reassess and reevaluate your health care.

For example:

Less estrogen in your system means you could be at greater risk for osteoporosis which can lead to serious bone fractures.

In addition, research shows that low levels of estrogen in your body could possibly affect cholesterol build-up in your arteries. As a result, you could be at greater risk of a heart attack or stroke.

We encourage all our patients who have entered menopause to schedule an appointment for us to evaluate your health risks for:

• Osteoporosis
• Urinary incontinence
• Vaginal pain or itching

What About Sex After Menopause?

Many patients continue to have active and satisfying sex after menopause, although it can present some challenges.

Sometimes, vaginal dryness that occurs after menopause can make sex uncomfortable. You may also find your sex drive waxing and waning during this time.

We believe that your sexual health is an important facet of your overall health. We will work with you to improve your experience with sex after menopause.

If you’re worried about your sex drive we can help. Just talk to us!

Compassionate Care for Every Age

Whether you’re having your first gynecological exam, are interested in IUD insertion or you’re nearing menopause, our doctors and health care professionals are dedicated to providing the personalized treatment you deserve with access to the state-of-the-art care and equipment you’d expect at larger research universities.

Contact us to schedule your appointment today. We would consider it an honor to be partners in your care.

We’re already reviewed some extensive information about menopause, but now, it’s time to delve deeper into menopause treatments, which ones are effective and which ones may be right for you.

Effective Menopause Treatments

What is the best treatment for menopause? This depends upon each person’s individual situation and medical history. By working closely with our healthcare providers, we can provide the most effective plan tailored to fit your needs.

What Happens to Your Body During Menopause?

During menopause, your ovaries stop producing estrogen, which leads to common symptoms including hot flashes, night sweats and, the most obvious symptom, absence of a period.

You may also experience these symptoms in the years leading up to menopause, which is perimenopause:

• Difficulty sleeping
• Night sweats
• Mood swings
• Hot flashes
• Vaginal itching and dryness (which may lead to painful sex )

What Triggers a Hot Flash?

Technically, a hot flash occurs when the lack of estrogen causes your body’s internal “thermometer” (a part of the brain called the hypothalamus) to become hypersensitive to any change in your body temperature—no matter how slight.

For more help, you may want to consider these lifestyle recommendations.

(We go into more detail on hot flashes later in this article)

What Is the Best Treatment for Menopause?

Every woman is different. Based on her medical and family history as well as the intensity of her symptoms, several options are available for treatment.

Complementary and Alternative Medicine:

There are many products recommended for management of menopause. Not all of these have scientific evidence to back up their claims. However, some studies do show effectiveness for acupuncture and certain herbal products. We can help you navigate your options here, picking the best regimen tailored for safety and effectiveness.

Nonhormonal Prescription Medications:

Medications such as low doses of certain antidepressants or gabapentin can reduce hot flashes and night sweats by 50-70%. We can also help women sleep through their hot flashes with certain insomnia medications.

Hormone Replacement Therapy:

The North American Menopause society is the largest and most respected professional organization on the topic of menopause. They state that, for most symptomatic women, the benefits of HRT outweigh the risks of its use.

HRT provides the most effective relief of menopausal symptoms. We recommend the lowest effective dose of hormone replacement for the shortest duration needed. Many women “outgrow” their menopausal symptoms over time and find that they do not need HRT more than a few years.

Information around HRT use can be confusing and difficult to sort through. We can help sort through this information and provide clarity regarding the exact risks and benefits that treatment may provide.

Our Mission: To Help You Live the Healthiest Life at Any Age

Life is full of transitions, whether you’ve decided to try to become pregnant or you are entering the beginning stages of menopause. One thing remains the same: our unwavering dedication to you.

We consider patients like members of our own family, as we have treated generations of patients who have entrusted us with their care.

Are you experiencing hot flashes, insomnia or other indicators of menopause? Contact us today to schedule an appointment.

We’d like to examine hot flashes closer. While many women experience them, just how much do you know about hot flashes? What are the most effective ways to find relief? Do they ever “fade away” the longer you’re in menopause?

We’ll deal with many of those questions in our next section about where you can find expert relief.

The Five Best Ways to Get Relief from Hot Flashes

Even if you haven’t entered menopause, chances are that you’ve heard someone complain about the inconvenience and discomfort of hot flashes. Roughly 75 percent of all menopausal women experience them, and for 80 percent, the hot flashes continue for two years.

“This is by far the most common—and often most troublesome—symptom of menopause, although sometimes they may start before a woman has her last period,”  said Dr. Melinda Everett, WHNCP. “We want our patients to know that they don’t have to continue to experience hot flashes. We have effective solutions to help you.”

What Causes Hot Flashes?

Hot flashes likely result from different factors centering around hormonal changes. In addition, fluctuations in your hypothalamus may also be a contributing element. The hypothalamus is the part of your body that helps regulate its temperature.

When Are You More Likely to Get a Hot Flash?

Most hot flashes occur when you are in a heated environment, such as a warm room or outside on a hot day. Women who smoke are more likely to get a hot flash after smoking and experience more hot flashes than women who don’t smoke. Hot flashes also frequently occur at night.

How Do You Know You’re Having a Hot Flash?

If you feel a sudden warmth that is most intense around your  face, chest and neck, you could be having a hot flash. These are also accompanied by sweating and red skin.

The Five Best Ways  to Get Relief From Hot Flashes

While hot flashes are inconvenient, they are rarely dangerous. Following are five tips to help you minimize the discomfort of hot flashes and level out your hormones to minimize their frequency.

1. Participating in hormonal therapy

Decreased estrogen levels can contribute to hot flashes, therefore, hormonal therapy can be quite effective. Depending upon your individual situation, you may be able to take estrogen alone or you may need to take progesterone with it. If you have had a hysterectomy, you will be able to take estrogen alone. However, if you still have a uterus, you should also take progesterone with estrogen. By adding progesterone, you help protect yourself from developing endometrial cancer.

If you have any concerns or questions, we encourage you to ask our physicians or our wonderful nurse midwives.

2. Taking antidepressants

Sometimes, low doses of antidepressants can treat hot flashes, particularly Effexor, Paxil and Prozac. (Cleveland Clinic) Research suggests that antidepressants are effective because they modulate serotonin. (American Psychiatric Association). Serotonin is a chemical that is vital for brain and nerve cell function.

3. Adjusting your diet

Avoiding spicy foods, alcohol and caffeine can reduce the number of hot flashes. Isoflavones, which are found in soybeans, chickpeas and lentils, are plant-based estrogens. While not as effective as regular hormone therapy, they may provide moderate relief.

Please speak with us before trying any alternative therapies or taking supplements such as black cohosh. It’s important to remember that just because something is natural, that doesn’t mean it is safe. Natural supplements may interact with other medications.

4. Taking anti-seizure medications

Gabapentin is moderately effective–women can experience a 50 to 60 percent reduction in hot flashes– but it can cause dizziness, drowsiness and headaches. It’s found in medications such as Neurontin and Gralise. Some women do not consider this option because of the potential side effects. Speak with us to see if this would be an appropriate choice for you.

5. Taking medications to treat high blood pressure

Clonidine, which goes by the name Catapres and Kapvay, can also provide some relief. However, it also has side effects which can include dry mouth, constipation, drowsiness and dizziness. We will work with you to determine if the benefits outweigh the disadvantages of the side effects.

We Offer a Customized Approach to Provide Relief from Hot Flashes

The world is full of erroneous information. From internet ads claiming to have the cure for hot flashes to old wives tales that are dubious at best. This is why it is so important to establish a good relationship with your Chapel Hill OBGYN professionals so we can be partners in your care and help you separate fact from fiction.

We have treated generations of women, and we are proud of our compassionate, specialized and state-of-the-art care. We welcome the privilege of treating you. Please contact us today to schedule an appointment.

What Are the Best Hormonal Treatments for Menopausal Symptoms?

Estrogen can fluctuate in the years leading up to menopause (called perimenopause). Once you enter menopause and your ovaries are no longer producing estrogen, it’s highly likely that you’ll experience the classic symptoms of hot flashes and night sweats. These symptoms can be relieved through hormone replacement therapy (HRT).

“The decision on whether or not to have HRT is an individual one, and we will help you evaluate the benefits and risks in order to come up with a solution that will help you,” said Dr. Pat Chappell. “We also urge our patients to speak with us before taking any herbal or alternative remedies, as these can sometimes interact with other medications.”

What Are the Benefits of Hormone Therapy?

Primarily, hormone replacement therapy helps alleviate the most common symptoms of menopause, which are:

• Hot flashes
• Night sweats
• Vaginal dryness
• Insomnia
• A thinner vaginal lining, which can result in painful sex
• An increased risk of urinary tract infections

In general, hormone replacement therapy involves taking estrogen since your ovaries no longer produce it. It is also recommended that you take progestin with the estrogen, as there is a greater risk for uterine cancer when using estrogen alone. However, if you’ve had a hysterectomy and no longer have a uterus, then estrogen-only therapy may be the right choice.

“Determining the type of HRT that is right for you involves carefully evaluating your health care history, any chronic medical conditions you have, and examining what type of approach will give you greatest relief from your symptoms,” said Dr. Pat Chappell.

What Are the Different Types of Hormonal Treatment?

Typically, we offer both systemic therapy and local estrogen therapy.

During systemic therapy, estrogen is released into your entire bloodstream and can be used by tissues and organs. It may be delivered as a pill or a patch. This type of therapy is most effective for preventing bone loss, which can help reduce the risk of hip and spine fractures.

Local estrogen therapy is designed to target vaginal symptoms. If you are struggling with many of the symptoms listed above, then this is often the best course of treatment. This therapy can be delivered in the form of vaginal tablets, rings or cream, which will release small doses of estrogen.

Can I Use Alternative Treatments for Symptoms of Menopause?

We mentioned this a bit earlier in our article, but it bears repeating: While supplements such as soy, black cohosh and others have been used to provide relief from menopausal symptoms, these products are not regulated. Therefore, there are no safeguards to ensure that all products have safe ingredients and effective dosages. (American College of Obstetricians and Gynecologists) In addition, it’s important to realize that these herbal treatments may interact with other medications you’re taking.  If you are considering using natural alternative treatments, we encourage you to speak with us first.

We Offer Comprehensive Gynecological Care for All of Life’s Stages

We’ve served several generations of women—some even in the same family! We have the combined benefit of state-of-the-art medical technology with a caring team of physicians, nurses, midwives and other health care professionals dedicated to providing compassionate, comprehensive health care at every stage in your life’s journey. 

For more than 40 years, Chapel Hill OBGYN has served patients in the Triangle area, sharing the joy of little miracles and supporting them during challenges. Our board-certified physicians and certified nurse-midwives bring together the personal experience and convenience of a private practice with the state-of-the-art resources found at larger organizations. To schedule an appointment, please contact us for more information.