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Dr. Nancy

Menopause Decoded

Menopause can be a confusing and distressing time for many women, and this can be made worse if you’re not sure what you can expect to happen to your body (and your mind) both during and afterwards. Unexplained weight gain, fatigue and brain fog can make you feel like you are crazy. One of the big questions that most women have is how long symptoms can last.

Menopause can make you crazy!

Once your periods have been absent for more than 12 months and you’re deemed to be in menopause, does that mean that all of your menopause symptoms will go away? Here’s what to expect in the run up to and during menopause.

What happens to your hormones during menopause?

You’ve probably heard that menopause symptoms are heavily linked to hormone changes but what exactly happens to your hormones during the menopause?

Estrogen is one of the main hormones involved in both reproduction and the menstrual cycle, along with progesterone. As a female, you’re born with eggs in the ovaries, which are released every month as part of the menstrual cycle.

Your ovaries also make estrogen and progesterone. As you approach menopause, your ovaries no longer need to release eggs and menstruation isn’t required either.

At the same time, your levels of both estrogen and progesterone go down. For most women, this is a gradual decline that happens in the years leading up to menopause – also known as perimenopause.

The ovaries ultimately stop producing them completely during menopause itself. Your adrenal glands continue to produce baseline levels of your sex hormones for the rest of your post-menopausal life.

Estrogen doesn’t just have an impact on your monthly cycle; it can also have pretty wide-ranging effects for your whole body. Your brain and nervous system are commonly affected, which is why menopause can make you feel “crazy” and bring about so many cognitive and physical symptoms from “brain fog” to hot flashes.

Common symptoms of low estrogen:

  • Painful sex

  • UTI’s

  • Irregular periods

  • Mood swings

  • Hot flashes

  • Breast tenderness

  • Headaches and migraines

  • Depression

  • Trouble concentrating

  • Fatigue

  • Weight gain

Common symptoms of low progesterone:

  • Low libido

  • Hot flashes

  • Headaches and migraines

  • Depression, anxiety or other mood changes

  • Irregular periods

  • PMS

  • Insomnia

  • Vaginal dryness

This shift within your hormonal symphony is exaggerated by the fact that your sex hormones aren’t the only hormones to be affected. Your levels of hormones such as serotonin and insulin alter too. This can leave you feeling tired, irritable and prone to mood swings and weight gain.

Do menopause symptoms disappear when periods stop?

If you’re not one of the lucky women who sail through menopause with very minor symptoms, you’ll no doubt be desperate to find out how long you can expect to have symptoms for after you’re officially in menopause.

There’s no easy answer to this as it can vary from woman to woman. For many women, symptoms are more intense during the peri-menopause and start to tail off once you reach the menopause and are considered to be “post-menopausal”. That’s not always the case though and some menopause symptoms can continue for quite a while after your periods stop, including hot flashes, mood swings and trouble sleeping.

On average, postmenopausal symptoms can last for 4-5 years. The good news? However long they last, they’re not usually as intense as pre-menopause so they’re likely to have less of an impact on your life compared to post-menopause.

Generally speaking, a “sudden” menopause (that is brought on by surgery, for example) can lead to more severe menopause symptoms, compared to a natural menopause that involves hormone changes occurring more gradually.

What can happen post menopause?

Even after symptoms die down completely, there are a few risk factors that can develop after menopause.

  • Heart disease

  • Type 2 diabetes

  • Bone loss

  • Weight gain, especially in belly

What can you do to support your body?

First, it is important to remember that menopause is a normal transition in life. It is not a disease that requires treatment.

Here are some suggestions to support yourself during this transition and beyond:

  • Stress management - it is critical to manage your stress to reduce the demand on your adrenal glands so that they can continue to produce ample, age-appropriate amounts of estrogen and progesterone.

  • Gut health – your liver and gut metabolize hormones and eliminate the metabolites from your body. Gut imbalances commonly lead to hormone imbalances.

  • Sleep hygiene – make sleep a priority! Strive to get a minimum of 8-9 hours of sleep per night.

  • Food strategy - it is very important to manage your food strategy and eat plenty of fruits, vegetables and healthy fats, while avoiding sugar and processed food options. It is not uncommon for caffeine and alcohol to exacerbate menopausal symptoms.

  • Move - daily movement and regular exercise play a central role in hormone balance. Walking helps to lower your stress hormones.

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