Whether you’re dealing with mood swings, hot flashes, vaginal dryness or some other symptoms, it’s completely understandable if you’re worried that what you’re experiencing is as permanent as the impending end of your period. After all, women and experts alike call them “symptoms of menopause.” But that’s a bit of a misnomer. What they actually signal is called the menopausal transition (aka peri-menopause). And that matters because—thankfully!—like all transitions, this phase and much of what comes with it is temporary.
As your body begins to change in peri-menopause (usually in your mid 40s), your hormone levels gradually decline until you eventually hit menopause (defined by a full 12 months with no period). But they don’t decline in a nice, orderly fashion. Quite the opposite. The only predictable part about this stage? It’s totally unpredictable! Hormone levels can spike and drop for years, causing symptoms to wax and wane (or linger). For example, you might have irregular periods and trouble sleeping…then everything seems hunky dory for a while…before hot flashes and vaginal dryness come on fast and furious. Symptoms, their intensity, and the length of peri-menopause also differ for every woman. Some of us find ourselves in the transitional, symptomatic phase for 12 to 15 years, others only for a few years or months. But, in general, as you get closer to menopause, you may notice that symptoms ramp up and peak as estrogen levels remain low for longer stretches.
The silver lining is that when symptoms are most acute you’re likely close to relief. In the years following menopause, symptoms start to subside, and most women adjust to the lack of estrogen beautifully. Over time, your true new normal emerges — and it’s way more bearable. Even though you may still experience hot flashes for a few years after menopause, they’re often less bothersome, according to one meta-analysis published in the Journal of General Internal Medicine. You’ll also feel more energetic—the anthropologist Margaret Mead referred to this phase as a “postmenopausal zest”— and your mood should stabilize as feelings of depression and anxiety fade.
Vaginal dryness is one symptom that won’t improve without treatment, however. So talk to your healthcare provider (HCP) or try a daily vaginal moisturizer or lube, which can ease discomfort and improve your libido. Also talk to your HCP if other symptoms persist or interfere with your life—no matter where you are in the menopausal transition. There are effective treatments! And he or she can guide you through your options.
Santoro, Nanette, M.D. “Perimenopause: From Research to Practice.” Journal of Women’s Health. 2016 Apr 1; 25(4): 332–339.
Politi, Mary C. Ph.D., et. al. “Revisiting the Duration of Vasomotor Symptoms of Menopause: A Meta-Analysis.” Journal of General Internal Medicine. 2008 Sep; 23(9): 1507–1513.
Dorfner, Micah. (2015, March 25) “Menopause Transition: What’s Normal?” Mayo Clinic News Network. Retrieved from https://newsnetwork.mayoclinic.org/discussion/menopause-transition-whats-normal/
Ferrari, Nancy. (2017, October 3) “Menopause-related hot flashes and night sweats can last for years.” Harvard Health Blog, Harvard Medical School. Retrieved from https://www.health.harvard.edu/blog/menopause-related-hot-flashes-night-sweats-can-last-years-201502237745
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