Understanding Menopause: Real Talk About What’s Happening And What You Can Do
Menopause is a major life transition, but for many women, it can feel confusing, frustrating and even a little scary. That’s why Dr. Molly McKenna recently gave a presentation all about understanding what’s happening in your body and treatment options available.
Here’s a recap of what she shared.
What Is Menopause?
Menopause marks the permanent end of menstrual periods after the ovaries stop releasing eggs. It’s officially diagnosed after 12 months of no bleeding.
The average age for menopause is 51, but symptoms and changes can begin much earlier.
Definitions:
- Perimenopause: The transitional time leading up to menopause, where hormone levels begin to fluctuate.
- Menopause: The moment 12 months have passed without a period.
- Postmenopause: The time after menopause.
- Primary Ovarian Insufficiency: When menopause-like symptoms occur before age 40.
What to Expect: Common Symptoms
Menopause doesn’t affect everyone the same way, but hot flashes are the most common symptom. Dr. McKenna estimates 95% of her patients have them.
Other common symptoms include:
- Vaginal dryness or discomfort (reported by 10–40%)
- Sleep disturbances
- Mood changes like irritability, anxiety, or depression
- Changes in libido
These symptoms are not just "in your head," they are a real response to shifting hormones.
Do You Need Tests?
Sometimes, blood work can be supportive, but it’s important to remember that hormone levels fluctuate daily and this is merely a snapshot in time. One helpful marker is an elevated FSH (follicle-stimulating hormone), especially levels above 15–25 IU/L during the menopausal transition.
But diagnosis is primarily based on your symptoms and menstrual history.
Treatment Options: You Don’t Have to Live with the Symptoms
Let’s be clear: You do not have to tough out these symptoms. There are several options available, depending on your needs and health history.
1. Lifestyle Changes
Healthy habits, like regular exercise, sleep hygiene and balanced nutrition, can help support your body during this time.
2. Non-Hormonal Medications
- SSRIs/SNRIs like Venlafaxine (Effexor) and Paroxetine (Paxil) can significantly reduce hot flashes (up to 62% improvement).
- Gabapentin, although off-label, has shown up to 45% symptom reduction in clinical trials.
- Fezolinetant (Veozah) is a newer, non-hormonal option.
3. Herbal and Natural Remedies
Some women report symptom relief from:
- Black Cohosh
- Evening primrose oil
- Ginseng
- Soy products
- Vitamin E
However, keep in mind the evidence for effectiveness is mixed.
4. Hormonal Therapy
Hormone therapy is still the most effective treatment for hot flashes, vaginal dryness, and bone loss prevention. Options include:
- Estrogen (oral, patch, gel, vaginal)
- Progesterone (needed if you still have a uterus)
Dr. McKenna emphasizes:
- Use the lowest effective dose for the shortest necessary time.
- Risks (like breast cancer) typically don’t increase until after 5+ years of use.
- Vaginal estrogen is a low-risk, localized option with no systemic absorption and it is safe for nearly everyone! This is one of Dr. McKenna’s favorite options.
Key Takeaways from the North American Menopause Society
- Hormone therapy is safe and effective for most women under 60 and within 10 years of menopause.
- Transdermal estrogen (patch or gel) may lower the risk of blood clots and stroke.
- Hormone therapy can be continued after age 65 if symptoms persist and benefits outweigh risks.
- Be cautious with compounded bioidentical hormones as they are not regulated by the FDA and may vary in dose or quality.
Menopause doesn’t need to feel overwhelming or isolating. Whether you’re in perimenopause, postmenopause or somewhere in between, you deserve real answers and personalized care.
Dr. McKenna and our team are here to support you every step of the way with compassionate care, up-to-date treatments and no judgment.
Have questions or symptoms you’re struggling with? Schedule a consultation with our team. You’re not alone and you don’t have to figure this out by yourself.
