Menopause is a normal hormonal transition that everyone with ovaries will experience, yet there are still many unknowns and misconceptions. It is defined as a point in time where you haven’t had menses for 12 months and on average occurs during your early 50s, however symptoms can start earlier during the transitional period leading up to menopause, known as perimenopause. Individuals may experience symptoms like hot flashes, insomnia, weight gain, brain fog, increased menstrual cycle irregularity, vaginal dryness, and irritability. With menopause, the risk for medical issues like cardiovascular disease, depression and bone loss increase. It’s important to know that you are not alone and you can get relief.
Progyny is here to help you every step of the way as you navigate each milestone, including menopause and midlife care. Check out our recent webinar, Let’s Talk About Menopause, and explore the answers below to frequently asked questions to help you understand what to expect and how to get the support you deserve.
If you are a Progyny member, you may have access to our menopause and midlife care benefit. Call 888.597.5065 to speak to a Patient Care Advocate for more information, guidance, and support.
How can I differentiate menopause symptoms from symptoms that are also commonly associated with other life stages or conditions?
We know the beginning of menopause, or perimenopause, can be confusing. When entering perimenopause you’ll experience a decline in estrogen and progesterone that can trigger physical symptoms such as irregular periods, hot flashes, vaginal dryness, and sleep disturbances. You may also experience psychological symptoms such as mood swings, irritability, anxiety, and sadness. Symptoms related to pregnancy can be similar but will often occur more abruptly. By being in tune with your body and tracking your symptoms regularly, you can identify any shifts or changes.
If you are experiencing any of the symptoms or noticed a change, speak to your OB/GYN or other primary healthcare provider. If you have access to Progyny’s menopause and midlife care benefit, connect with a menopause specialist to better understand how you can find relief.
How do I know when I am starting perimenopause? What should I expect?
Perimenopause marks the transition to menopause, and typically takes place in your 40s. For some women, perimenopausal changes can start even in their mid to late 30s. It’s driven by hormonal shifts, particularly a decrease in estrogen levels as the egg supply in the ovaries decline. During perimenopause, you may experience unpredictable shifts in your menstrual cycles such as longer or shorter intervals between each period and changes in blood flow.
These changes can have a profound impact on your body and overall well-being. Some common symptoms that you may expect include:
- Hot flashes – sudden waves of heat and sweating that can be disruptive of daily life
- Headaches – there may be an increase and they can vary in intensity and frequency
- Cognitive function – declining estrogen levels can cause forgetfulness or difficulty recalling words
- Breast tenderness – with fluctuations in hormones, some may notice increased breast tenderness
- Vaginal dryness – decreased estrogen levels can lead to vaginal dryness, causing discomfort and sometimes painful intercourse
- Mood disturbances – hormone fluctuation can bring about mood disturbances, including increased susceptibility to depression and anxiety
How can birth control affect menopause timing or symptoms?
Birth control does not delay or affect the timing of menopause; however, hormonal birth control such as oral contraceptives or a hormonal IUD, can mask some of the symptoms of perimenopause and menopause such as decreasing the quantity and intensity of hot flashes, and managing mood swings. If you are on birth control pills and unsure if you have started menopause, you can work with your doctor to conduct a blood test to check your hormone levels and confirm if they have reached a menopausal level. It’s important to remember that until you are officially in menopause and haven’t had your period for a year, you can still get pregnant, so it’s important to understand your options.
If my OB/GYN is not trained in menopause care, how can I find a doctor who is right for me?
Your OB/GYN or primary care provider (internist/family medicine doctor) could be a good place to start, especially if you have a great relationship with them already. Unfortunately the majority of OB/GYNs and other primary care providers are not trained in menopause. If your doctor is not giving the support you need, it may be time to go to a menopause care specialist who can help you more specifically with this phase of life.
If you are an eligible Progyny member, contact your Progyny Patient Care Advocate to understand if your employer offers Progyny Menopause and Midlife Care. This program provides nationwide access to specialized virtual care for all stages of menopause. Get the care you deserve, manage your symptoms, and boost overall health.
Why is weight gain a common symptom and how can I manage it?
As we age, our body composition changes. This means it becomes more difficult to build muscle regardless of activity levels and eating habits. Many times, this muscle loss gets replaced with fat. In addition to anabolic resistance, weight gain in women can be attributed to changes in hormones. Estrogen can help our body regulate fat and metabolism and when estrogen levels begin to decline in menopause, it can contribute to declining muscle mass and an increase in fat around the abdominal area. Estrogen also helps level appetite and dropping levels can lead to an increase in appetite which can impact weight.
Weight gain is a common symptom of menopause that many experience. There are a few different tips that could help with management of weight gain.
- Exercise – integrate strength training to build muscle mass along with moderate aerobic exercise such as walking or yoga into your weekly routine. Consistency is key!
- Get a good night’s sleep – decrease exposure to light (especially screens) around 2 hours before heading to bed, avoid stimulants like exercise/caffeine/alcohol too close to bed, establish a relaxing routine, and try to wake up and go to bed at consistent times each day. Make sure your bedroom is cool and dark.
- Find a diet that works for you – try minimizing processed foods and focus on following an eating plan that has a range of vitamins and minerals. Both a Mediterranean diet and the DASH diet are ways to incorporate healthy eating into your life and address issues associated with healthy weight maintenance and cardiovascular health.
What is hormone therapy treatment? Why would I choose this treatment path compared to others?
Hormone therapy is one of the approved treatment options for menopause symptom relief and standard hormone replacement therapy typically involves estrogen and progesterone. Hormone therapy can be helpful in improving many of the common symptoms including hot flashes, vaginal dryness, insomnia, and mood swings, and can also help decrease the chances of heart disease, diabetes, and osteoporosis. There are a lot of misconceptions around hormonal therapy, but it can be a safe treatment option. Your provider will want to follow up after starting hormone therapy after around 30 days to monitor symptom relief and make dose adjustments as needed.
Just as everyone’s experience with symptoms varies, your treatment plan is up to you and the support you need. If you have a family history of osteoporosis, high cholesterol, and/or heart disease, hormonal therapy may be a good choice. However, some people should not be taking hormones, including those who have had an estrogen receptor positive form of breast cancer, or have a history of blood clotting. There may be other beneficial ways to help with symptom management.
If hormonal therapy isn’t right for you, there are non-hormonal medications and supplements you can take to support symptom relief. Talk to your provider to learn more. It’s also important to focus on your diet, exercise sleep, stress management, and to ensure you have a support system around you.
For more information, explore our Menopause Education Page.