Wondering if menopause has begun? While testing for menopause is not usually required, there are several signs that this process has started.
An early sign of perimenopause is a disruption of your normal menstrual cycle. Your period may come earlier or later than usual, you may skip months, or experience heavier menses. Additionally, symptoms such as hot flashes are a good sign that menopause is on its way.
In some cases, your doctor may order a blood test to assess your level of hormones and diagnose menopause.
Hormone tests for menopause include:
Follicle-stimulating hormone (FSH) and estradiol (a form of estrogen): the level of FSH increases and estradiol decreases during menopause. An elevated level of FSH in the blood may confirm menopause.
Thyroid-stimulating hormone: testing for this hormone can detect low thyroid activity (hypothyroidism), which can cause similar symptoms to menopause.
Additional blood tests often used to confirm menopause include:
Saliva tests and over-the-counter urine tests are also available to test FSH levels. However, they are generally less reliable since levels of FSH rise and fall during the menstrual cycle.
Menopause treatments
While menopause is completely natural, it doesn’t mean it’s particularly enjoyable for a lot of people.
According to a 2013 study, women experiencing menopausal symptoms reported significantly lower quality of life and significantly higher work impairment and healthcare utilization than women without menopausal symptoms.
If you’re struggling with menopause, talk to your doctor or a healthcare professional about finding a treatment that will work for you.
There several treatment options for menopause that can offer relief for many of the symptoms. These include:
1. Hormone replacement therapy
Hormone replacement therapy is an effective treatment for relieving hot flashes.
This treatment replaces hormones, such as estrogen, that your body is no longer producing in menopause. Hormone replacement may also help with:
Vaginal symptoms
Night sweats
Bone weakening
Treatments like this can come with side-effects, like an increased risk of heart disease and cancer. Fortunately, you can take a low dose to minimize the risk.
It is important to discuss the benefits and risks associated with hormone replacement therapy with your doctor before starting treatment.
2. Medication
Several non-hormone medications are approved for menopause, including:
Selective serotonin reuptake inhibitors (SSRIs): an antidepressant, such as paroxetine, that is approved for hot flashes, anxiety, and depression.
Gabapentin: a nerve drug use for hot flashes in menopause.
Clonidine: a blood pressure drug that can help with hot flashes.
Selective estrogen receptor modulators (SERMs): a medication that can mimic and block estrogen's effects. This is commonly used to treat hot flashes and vaginal dryness, as well as infertility and hormone-responsive cancers.
Over-the-counter medicines: at-home treatments for menopause symptoms include vaginal moisturizers and lubricants.
Sleep medications: insomnia in menopause can be eased with medications like melatonin.
Ospemifene: this is an oral medication that can help treat vaginal dryness and painful intercourse.
3. Vitamins and supplements
Increasing your intake of vitamins or nutritional supplements can help minimize the symptoms and potential complications of menopause, like osteoporosis.
Vitamin D promotes healthy bone renewal, restores hormonal balance, and helps to relieve menopausal symptoms with aging, which is associated with a reduced ability to absorb vitamin D.
Vitamin D is produced by the body in response to sun exposure. To get your recommended daily dose of 600 international units (IU), spend 15-20 minutes outdoors per day. You can also take a supplement or eat foods high in vitamin D such as sardines, tuna, and salmon.
Other natural supplements and nutrients that may help limit menopause symptoms include:
Soy: this is about one third as potent as estrogen in reducing hot flashes. Further, long-term soy consumption has been shown to reduce menopause-related inflammation.
Flaxseed: in ground form, this may help with menopausal symptoms. One recent study showed 40 grams of flaxseed consumed daily may be similar to hormone therapy in reducing hot flashes and sleeping problems.
St John’s wort: Derived from a wild flowering plant, Hypericum perforatum, the leaves and flowers are harvested and brewed in a tea, or taken in a pill form. It has been used historically to treat menopausal mood swings and reduce depression and anxiety. Scientific studies show St John’s wort is effective for treating mild depression but works no better than a placebo for treating severe depression.
Ginseng: The root of this traditional Chinese herb may promote health during menopause. It has been shown to help reduce the occurrence and severity of hot flashes and night sweats during menopause. One study found ginseng can lower the risk of cardiovascular disease in menopausal women.
4. Lifestyle changes
There are several lifestyle changes that may help to ease symptoms of menopause. These include:
Exercising regularly and eating a healthy diet to manage your weight, as obesity may worsen symptoms of menopause.
Staying socially and mentally active to avoid cognitive decline associated with menopause.
Limiting alcohol and smoking, as these habits may increase your risk of hot flashes and other complications.
Taking care of your skin by applying moisturizer daily to reduce dryness. Avoid swimming and bathing excessively and use a medically-approved vaginal moisturizer to care for vaginal tissue.
Mind-body therapies for menopause
If you’d rather avoid the potential risks of hormone replacement therapy, there are several mind-body treatments available that have been clinically proven to reduce the symptoms of menopause.
1. Hypnotherapy
Hypnotherapy involves focused relaxation and visualization in an absorbed state of attention. It has been used in medicine to treat various conditions such as irritable bowel syndrome (IBS) and smoking addiction.
Hypnotherapy can help you manage and reduce the symptoms of menopause. A hypnotherapist will often use cool imagery to counteract the hot flashes during menopause.
While this might sound too good to be true, hypnotherapy for menopause has been shown in multiple studies to improve symptoms and has been proven to reduce hot flashes by up to 74%.
2. Yoga
Several studies have shown that yoga is effective and safe for reducing menopausal symptoms. Women have also reported stretching and relaxation techniques in yoga may help improve and stabilize mood and improve quality of life during menopause.
You can try a gentle yoga class once or twice a week to begin practicing. Once you have mastered the basics, you can practice more often at home.
3. Acupuncture
Acupuncture may provide relief from menopausal symptoms.
One meta-study has shown that acupuncture reduces the severity, but not frequency, of hot flashes. However, some researchers argue that acupuncture benefits for menopause are purely the result of the placebo effect.
Sex after menopause
Menopause may affect some aspects of your sex life, though some women don’t notice any changes at all.
The most common changes in menopause include:
Vaginal tissue becomes thinner and dryer due to lower hormone levels. This condition is called vaginal atrophy and may lead to pain during intercourse. You may also notice vaginal bleeding after menopause due to a lack of lubrication during sex.
Lower sex drive due to reduced reproductive hormone levels. It may take longer to become aroused.
Emotional changes that may make you feel stressed or irritable, and less aroused.
While a decrease in libido can be normal as you get older, if you are frustrated by changes to your sexual health talk to your doctor. They can offer advice and treatments to help get your sex life back on track.
Is sex painful after menopause?
1 in 5 women, not taking hormone replacement therapy, will experience painful sex after menopause.
Falling levels of estrogen can cause changes to the vaginal tissue, which may make it more susceptible to bleeding, tears, or pain during intercourse.
Your doctor can help you identify several ways to improve your sexual health during menopause, such as:
Exercising: physical activity boosts energy levels, lifts mood, and improves body image – all of which can increase sex drive.
Increasing sexual activity: if you choose to have sex regularly, it can increase blood flow to your vagina and keep the tissues healthy.
Pelvic floor exercises: these can help to increase blood flow to the vagina and strengthen the muscles involved in orgasm.
Allow more time to become aroused: natural moisture from being aroused can help lubricate tissues and make sex less painful.
Choosing the right lubricant: Silicone-based lubricants offer longer-lasting lubrication and won't dry out during intercourse.
Can you get pregnant after menopause?
In short, yes. During perimenopause, your ovaries are beginning to produce less estrogen and progesterone and fertility is declining.
However, because your ovaries are still releasing eggs, you can still get pregnant at this time.
Once you are postmenopausal, your hormonal levels will fall and your ovaries will stop releasing eggs. When this happens, you can no longer fall pregnant.
The Wrap Up
Menopause is the natural end of a woman’s menstrual cycle and fertility that comes with age. Many women experience symptoms of menopause in the years before and during menopause, most commonly hot flashes, mood swings, and sleeping difficulties.
You may benefit from various treatments, such as hormone replacement therapy, if menopausal symptoms are interfering with your quality of life. However, many symptoms of menopause can be managed with lifestyle changes and mind-body therapies such as hypnotherapy. Your doctor can help you find the right strategies to manage menopause and reduce your symptoms.
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