5 Signs of Menopause, According to Doctors

The signs of menopause go far beyond hot flashes. We asked OB-GYNs for their health tips and tricks to manage the most common signs of menopause, no sweat.

Hot flashes aren't the only sign of the change.

By Karla Walsh, Woman's Day

Some women celebrate it. Others fear it. Whatever your emotional and mental state about menopause, it’s certainly a big time of transition. It’s also clear, diving in to the symptoms and signs of menopause, that what some refer to as “the change” would be more accurately deemed “the changes.”

According to Alyssa Dweck M.D., a gynecologist and assistant clinical professor at the Mount Sinai School of Medicine in New York and medical advisor to ChromaDex, menopause often starts at age 51. But signs of menopause start years before your final menstrual cycle. This phase, generally lasting four to eight years, is called perimenopause and can vary widely from woman to woman. Some are even asymptomatic, meaning they float right through perimenopause and menopause with no other signs of menopause besides an MIA period.

By definition, menopause is the absence of menses for 12 months. Yet it might take years and years to complete, says Arianna Sholes-Douglas, M.D., F.A.C.O.G., founder and owner of Tula Wellness and Aesthetics Center in Tucson, Arizona and the author of The Menopause Myth. So how do you know when you’ve come out the other side and are officially postmenopausal?

“You are finished with menopause when you have not had a period for a year," Sholes-Douglas tells Woman's Day. "If you stop having cycles for 10 months and then have another one, the clock starts all over again."

The most common signs of menopause, explained by Dweck and Sholes-Douglas here, all relate to the hormonal shifts occurring in the body at the time.

Menstrual Changes

The first, and most recognizable sign of menopause, is a change in the cadence, length, and heaviness of your period. Not all women experience shorter periods, either—they can be longer or closer together.

Minor shifts are normal, due to the hormonal fluctuations throughout menopause, but the National Institutes on Aging suggests speaking to your OB-GYN if you experience spotting, have periods extremely close together (say, every two weeks) or notice very heavy bleedings. In some cases, these could be symptoms of another gynecological health change.

Vaginal Dryness

Vaginal dryness, which is collectively known as genitourinary syndrome of menopause (GSM), is an extremely common and normal issue, says the North American Menopause Society. Caused by lower levels of estrogen, dryness often results in pain during intercourse, occasional bladder infections and, at times, the urgent need to urinate.

Try a lubricant or vaginal moisturizer to mitigate symptoms, and talk to your doctor if the dryness impacts your usual activities persistently. He or she may prescribe a low-dose vaginal estrogen because it’s important to maintain as regular of a sexual activity schedule as possible—both for the well-being of your partnership and for the health of your vagina. (Skipping sex can make things even dryer.)

Lower Libido

Caused by discomfort related to the aforementioned dryness or by a drop in testosterone and estrogen levels, lower sex drive may be a sign of menopause you experience. (Though it's worth noting that some women actually observe increased sexual desire during perimenopause and menopause.)

If you're lower libido is affecting your relationship, there are several expert-approved ways to boost your sex drive. You can also talk to your OB-GYN, as they may be able to pinpoint an underlying physical or mental cause. That said, sex is not the be all, end all of a relationship and it's OK to put it on the back burner while you adjust to this change.

Disrupted Sleep or Insomnia

Occasionally triggered by hot flashes, sleep issues are a result of lower estrogen and progesterone levels, explains Sholes-Douglas.

Struggling to get shut-eye? Start with some little tricks to help you sleep. And if you’re still struggling after that, speak to your doctor about alternate solutions since a lack of sleep can impact everything from your relationships to your diet to your mood (more on that ahead).

Mood Shifts

Researchers haven’t landed on the exact cause for the down-in-the-dumps feeling that can sometimes accompany menopause, but Sholes-Douglas believes the irritability and/or depression might be a factor of lower levels of estrogen, progesterone, or testosterone in your body.

Whether you experience one or all of these signs of menopause, there are a few simple steps you can take to mitigate the impact on your daily routine. Ask your doctor if a vitamin D supplement might be useful for bone and general health (many people are deficient) and make adjustments to your lifestyle, if needed. But, more importantly, Dweck says you need to "be proactive."

“Eat a healthy diet — I recommend the Mediterranean diet—exercise regularly with cardio and weights and reduce stress in any way you can," Dweck says.