Our in-depth menopause coverage tackles topics like hormone therapies, mental health solutions, and expert advice.
In the United States alone, over 1 million people with uteruses experience menopause every year. But despite the prevalence of this later-in-life event, menopause has frequently been a silent matter and an isolating experience. And when it is discussed, menopause is often portrayed as a wholly negative experience. In reality, however, people undergoing menopause experience a wide variety of emotions, symptoms, and treatments. Some people even enjoy the perk menopause can provide!
Since its inception, Katie Couric Media has aimed to truly explore the diversity of menopausal experiences. Katie Couric herself has been very open about her menopause journey, even going so far as to discuss her own hormone treatments and complicated feelings with a variety of experts.
With that passion in mind, we were motivated to create a variety of content to address different aspects of the menopausal experience. We talked to experts about everything from the brass tacks of treatment options to the best ways to navigate new bodily changes (vaginal dryness and weight gain included). We discussed the ups and downs of mental health, the unfortunate racial disparities, and emerging, cutting-edge technologies that can help.
If you’re at all overwhelmed, don’t worry — we’ve carefully broken down the subject into digestible pieces, sorted by subject. You’ll find all the tools you need to get started on your own unique and important journey below.
Jump to understanding menopause.
Jump to symptoms of menopause.
Jump to sex and menopause.
Jump to do men go through menopause?
Jump to managing and treating menopause.
Jump to cultural and social perspectives of menopause.
Understanding menopause
What is menopause?
Simply put, the Mayo Clinic defines menopause as “the time that marks the end of your menstrual cycles. It’s diagnosed after you’ve gone 12 months without a menstrual period.” After undergoing this shift, a menopausal person will no longer be able to have children. According to the World Health Organization, “Menopause is caused by the loss of ovarian follicular function and a decline in circulating blood [estrogen] levels.”
This transition into menopause does not abruptly occur overnight; the period before menopause is called “perimenopause.” During perimenopause, “the supply of mature eggs in a woman’s ovaries diminishes and ovulation becomes irregular. At the same time, the production of estrogen and progesterone decreases.” People typically feel symptoms during perimenopause.
When does menopause start?
While the average age of menopause is 51, early menopause occurs between the ages of 40 and 45 and affects 5 percent of women. Premature menopause can occur as early as your mid-30s. And late menopause can hit anytime past your mid-50s.
Can you test for menopause?
It’s possible to test for menopause via saliva, urine, or blood tests (with blood tests considered the most accurate method). Menopause tests aren’t completely accurate, however, since hormone levels may fluctuate: Katie’s OB-GYN Rebecca Brightman, MD, explains, “During perimenopause, hormone levels of FSH, LH, and estradiol fluctuate, so testing is like trying to take a shot of a moving target…one day a woman can look like she is in her peak reproductive years and another she can look as though she is menopausal.’”
To learn more, read our guide on menopause tests.
Early signs of menopause
Most commonly, a sign of perimenopause is vasomotor symptoms — otherwise known as “hot flashes.” Other perimenopausal symptoms include night sweats and troubled sleep. Impaired concentration, mood swings, and vaginal dryness may also occur. Irregular periods are common as well.
Early menopause, on the other hand, is defined as menopause that begins from ages 40 to 45. Like perimenopause, people experiencing early menopause may feel symptoms like hot flashes, irregular sleep, vaginal dryness, and mood swings.
Symptoms of menopause
Common symptoms may include:
“Hot flashes,” i.e. vasomotor symptoms: A hot flash typically feels like a sudden rush of warmth across your upper body; the flush may cause sweating.
Difficulty sleeping: Menopausal people may experience restless, disturbed sleep.
Mood swings: According to the American College of Obstetricians and Gynecologists, mood changes during menopause can be caused by shifting hormone levels; fatigue and stress can also be caused by physical symptoms.
Vaginal dryness and pain during sex: Due to hormonal changes during menopause, you may experience vaginal dryness and subsequent pain during sex.
Does menopause make you tired?
Menopause often causes discomfort that can keep you from getting ZZZs. Mary Jane Minkin, MD, explains that one’s risk of sleep apnea increases 4 percent each year, starting in the perimenopausal period; research suggests that lowering progesterone levels may cause this heightened risk. Declining levels of progesterone and estrogen cause hot flashes, which can easily wake you up (or prevent you from getting to sleep in the first place). Some people also begin to experience restless leg syndrome during menopause.
Find out more on how menopause affects sleep quality.
Does menopause cause weight gain?
Changes in estrogen during menopause can cause redistribution of body fat; menopausal people often accumulate more body fat around their midsections. But aging is also a culprit — muscle mass decreases with age, which slows one’s metabolism. Weight-bearing exercise may help manage this weight gain.
Found out more about metabolic changes and weight gain during menopause.
Menopause hair loss and skin impacts
Hormonal changes can cause hair loss during menopause; however, there’s also a hereditary component to hair loss. According to Brianna Diorio, Ph.D., “very low estrogen levels after menopause can lead to decreased hair thickness and more hair shedding.” Dr. Diorio recommends a hair growth nutraceutical and scalp care products to support the internal foundation of damaged hair and decrease product buildup.
Within the first five years of your final period, you also may lose up to 30 percent of the collagen in your body. This can affect your skin, causing inelasticity and wrinkles. To combat these effects, try regenerating or directly adding collagen and hyaluronic acid to your skin. If possible, look for products that work beneath the skin barrier. Low-weight hyaluronic acid, peptides, fruit enzymes, antioxidants, and algae are ingredients that help hydrate and replenish skin.
Find out more in our guides to how hormones affect your skin, how hormones affect your hair, and how to handle menopausal hair loss.
Bleeding after menopause
Vaginal bleeding after menopause can be caused by a range of issues. Common causes of post-menopausal bleeding include friction from sex (due to vaginal skin becoming thinner), a thickening of your uterine lining, or even cancer. Polyps can also cause vaginal bleeding, as can some medications, like blood thinners.
If you notice bleeding, speak to your OB-GYN so that you can narrow down and treat the cause.
Menopause and joint pain
Joint pain is a common symptom of menopause. According to Dr. Brightman, “Estrogen binds to receptors in muscles and joints. In doing so, it protects their structure and function.” When estrogen levels drop, that protection decreases, which can result in distressing aches. Menopausal hormone therapy can reduce this pain; resistance training and stretching may also help.
Up to 20 percent of bone loss in women occurs during menopause. This loss can lead to fractures. Dr. Brightman recommends boosting bone density by getting an adequate amount of calcium through your diet — though supplements are available if this isn’t possible. Dr. Brightman also advises getting an appropriate amount of vitamin D, but speaking to your doctor before taking supplements. Weight-bearing exercise can also help since higher muscle mass is correlated with higher bone density.
Learn more about joint pain during menopause and bone loss during menopause.
Menopause and stress
Menopause often causes stress, both directly and indirectly. Fluctuating estrogen and progesterone levels can affect stress hormones like cortisol. Alongside chemically heightening stress, menopause symptoms can indirectly cause stress — hot flashes, for instance, can cause so much discomfort that you might feel emotionally affected.
You can relieve some of your stress by avoiding certain foods, meditating, exercising, and working on sleep quality.
Learn more tips on managing stress during menopause.
Sex and menopause
Sex after menopause
Dr. Brightman says that hormonal changes during menopause are responsible for corresponding changes in your sex life: “We know that estrogen improves blood flow to the urogenital tract. It’s not just the vagina, it’s everything surrounding the vagina. Skin all over our body gets thinner, but there are many estrogen receptors on the skin of the vulva. It’s prone to itching and tearing, and the vaginal wall becomes less stretchy. It loses its elasticity. All of these things can factor into sex becoming more uncomfortable.” Using lubrication or vaginal estrogen options (creams, suppositories, and rings) can make sex more comfortable.
Read more about sex during menopause.
Why can’t I orgasm anymore after menopause?
Loss of libido is also common after menopause, due to declining testosterone levels in most women. Talk to your doctor; they may be able to recommend different means of lightly boosting your testosterone.
Reaching orgasm may become particularly challenging; according to John Hopkins Medical Center, decreased blood flow to your genitals is likely responsible. Since your body has changed, a little experimentation (trying new positions, introducing sex toys for couples, etc.) may help you discover new ways to enjoy yourself. If you’re feeling self-conscious because of menopausal weight gain, Suzanne Gilberg-Lenz, MD, recommends eating more antioxidants and foods high in nitrates. These foods can reduce factors like bloating and water retention to make you feel a bit more comfortable. If you have a partner, always be sure to communicate with them so that you can go on this journey of rediscovery together.
Read our tips for maintaining intimacy during menopause.
Do men go through menopause?
Not all men experience a “male menopause,” but some will experience a hormonal decline called andropause. During andropause, testosterone production drops.
As mentioned, not all men will undergo this change, and the shift isn’t associated with a menstrual cycle. Plus, male reproductive organs don’t shut down during andropause.
That said, andropause is associated with symptoms such as:
- low energy
- depression or sadness
- decreased motivation
- lowered self-confidence
- difficulty concentrating
- insomnia or difficulty sleeping
- increased body fat
- reduced muscle mass and feelings of physical weakness
- gynecomastia, or development of breasts
- decreased bone density
- erectile dysfunction
- reduced libido
- infertility
Treatments include exercising regularly, maintaining a healthy diet, getting adequate sleep, and managing stress levels. Hormone therapy is available but is controversial because of potentially damaging side effects.
Managing and treating menopause
Menopause supplements
Mastaneh Sharafi, Ph.D., RD says that there are several nutrients that menopausal women should be getting in their multivitamins. Dr. Sharafi says that omega-3 DHA, vitamin D, folate, vitamin B12, and vitamin K2 are essential nutrients for menopausal women. As Ritual’s VP of scientific and clinical affairs, Dr. Sharafi recommends Ritual’s Essential for Women 50+.
Dr. Sharafi recommends forgoing calcium supplements in favor of supplementing your diet with calcium-rich foods like “plain yogurt, cheese, milk, seeds and nuts, kidney beans, spinach, and turnip greens.”
Find out more about menopause supplements and their efficacy.
Treatments for menopause
Hormone replacement therapy can relieve many symptoms of menopause, though discussion with your physician is always key. According to Dr. Brightman, you should start HRT within 10 years of your final period, and before the age of 60.
Typically, people with a uterus will begin a mix of estrogen and progesterone. For women without a uterus, only estrogen may be necessary. You may be prescribed rings, vaginal suppositories, patches, creams, or oral estrogen and progesterone. There’s no “one size fits all” approach to HRT, so you must talk to your doctor about which options might work best for you.
While over-the-counter supplements that claim to treat menopausal symptoms are available, Dr. Brightman says, “There are very few that have really proven clinical efficacy.”
Read our guide on hormone replacement therapy and when to start HRT treatment.
Is it safe to postpone menopause?
While there’s no evidence that delaying menopause is inherently unsafe, experts are split on whether delaying menopause is even possible. According to Taz Bhatia, M.D., the use of birth control pills and ovarian tissue cryopreservation and transplantation could potentially delay menopause.
Stephanie S. Faubion, M.D., M.B.A. disagrees. “We can’t take the natural ovary and make it not fail,” she says. “We have not figured out how to do that.” According to Dr. Faubion, ovarian tissue cryopreservation and transplantation can only help those undergoing planned menopause — i.e. during cancer treatment. Dr. Faubion insists that this technology can’t apply to natural menopause: “We can’t take a healthy ovary and make it not age… It’s not yet possible to delay natural menopause using medication or technology.”
Read more about the debate on delaying menopause.
Menopause diets
While so much of the menopausal transition is unfortunately out of your control, it is possible to reduce or exacerbate side effects through diet. Registered nutritionist Samantha Cassetty says that consuming dairy products, fruits and vegetables, quality proteins, whole grains, and phytoestrogen-containing foods may alleviate menopause symptoms. Processed foods, sugar, and starchy foods may exacerbate menopausal symptoms. Caffeine and alcohol may also intensify hot flashes.
Discover more tips on the best foods for menopause.
Cultural and social perspectives of menopause
The non-white experience of menopause
Menopause doesn’t necessarily affect everyone equally — compared to white people, Black and Latina people reach menopause at earlier ages and experience worse hot flashes for longer. According to Nanette Santoro, MD, the chronic stress of undergoing experiences like systemic racism may contribute to these heightened symptoms. Additionally, Black and Latina women are less likely to be prescribed hormone replacement therapy, which likely reflects discrimination from medical professionals or unequal access to healthcare. That said, there are no physiological differences between people of different races and ethnicities undergoing menopause and people of color are not at fault for these disparities.
While healthcare providers should question their own motives for brushing off health disparities, experts say that menopausal individuals of color can and should seek out support groups.
Learn more about the non-white experience of menopause.
Improving your mindset during menopause
Regardless of ethnicity or race, you may struggle with very negative emotions surrounding the menopausal experience. Dr. Gilberg-Lenz recommends reframing that mindset, as much as you are able: “It’s not a disease — it’s a puberty of mid-life.” Give yourself the space and time to grieve, but don’t hesitate to team up with the right doctor — Dr. Gilberg-Lenz recommends the North American Menopause Society, which has a physician finder.
If you’re frustrated with menopausal weight gain, Dr. Gilberg-Lenz recommends avoiding the temptation to overexercise, which can lead to increased odds of sustaining injuries. Instead, you can take steps to emphasize your health and how you feel rather than what you see on the scale.
Dr. Gilberg-Lenz also says that support groups are important resources that everyone should use. Dr. Guilberg-Lenz offers menopause bootcamps, but you can also find support groups on Facebook or Meetup.com.
Despite all of these tools available, you may find that you’ve internalized stereotypes and other harmfully negative thoughts about menopause. If so, you’re not alone; author Jancee Dunn writes that she had to undo decades of internalized gendered ageism that made her compulsively pessimistic about menopause. Dunn ultimately decided to be open about her experiences to relieve the stigma around menopause; plus, she vowed to stop making defeatist jokes about the change. Dunn points out that a gloomy perspective on menopause may worsen symptoms. Which is a pretty good incentive to look on the bright side.
Find out more about reframing your mindset around menopause and the dangers of stereotypes.
