Menopause: Overview
Menopause is when a woman has gone 12 consecutive months without a menstrual period, but it is vastly more complex than its simple definition. The average age at which a woman starts menopause is around 51.
According to leading experts in menopausal care, menopause is a major life and health transition that can affect much more than reproductive health. Symptoms extend far beyond hot flashes and can affect nearly every aspect of a woman’s physical, emotional, and cognitive life. It can influence sleep, mood, cognition, sexual health, heart health, bone health, and overall well-being.
Dr. Sarah Richina, Director of UPMC Magee-Womens Midlife Health Center, advocates for personalized, interdisciplinary care that combines lifestyle strategies, education, screening, and individualized treatment options to improve women’s long-term health.
“What we see and hear a lot is patients coming in and saying, ‘I don’t feel like myself,'” Dr. Richina tells SN Health, noting that menopausal changes can bring a “period of vulnerability.”
When treatment is needed, Dr. Richina tailors recommendations to the individual.
Options may include:
- Hormone therapy treatment (HRT)
- Non-hormonal medications
- Lifestyle interventions
- Sleep-focused treatments
Her treatment philosophy is:
“Start low, go slow, and one thing at a time.”
This allows women to see what is helping and minimizes unnecessary side effects.
Menopause is not something women simply have to endure. By prioritizing sleep, strength, nutrition, preventive health, and individualized care, women can successfully navigate menopause and build a strong foundation for healthy, confident aging.
Perimenopause
Perimenopause is the natural transition before menopause when hormones begin to fluctuate, periods become irregular, and symptoms of menopause may start to appear.
This phase can last, on average, “around four or five years,” says Dr. Sara L. Stockman from Magee-Womens Department of Obstetrics, Gynecology and Reproductive Sciences. “But we do know that there is a subset of women who can be in a perimenopausal period for 10 or more years,” she adds.
During perimenopause, women may experience symptoms such as hot flashes, night sweats, mood changes, sleep problems, and irregular periods, which means the menstrual cycles come and go.
Dr. Stockman, recognized for her research, which she began as a Senior Fellow at Massachusetts General Hospital, notes that women are talking more openly about these symptoms than previous generations did, helping researchers better understand the full experience of menopause.
“The menopausal state is really a depletion of our sex hormones, the estrogen, progesterone, and a portion of our testosterone, because testosterone is made not only in the ovaries, but in the adrenal glands,” Dr. Stephanie McNally, Medical Director for Katz Institute of Health at Northwell Health, tells SN Health.
“So there are other sources of testosterone in our body, but essentially we’re talking about those main sex steroid hormones that are gone at any significant levels in that menopausal transition,” Dr. McNally says. “That’s the difference, erratic and then absent in the menopausal state.”
