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Home > Women's Health > Menstrual Health > 10 Things No One Ever Tells You About Menopause

10 Things No One Ever Tells You About Menopause

March 24, 2021 - Updated on August 24, 2021
6 min read
By Mary Claire Haver, MD | Obstetrician/Gynecologist

In this article:

  • Menopausal Changes You Should Know
  • Dietary Changes to Relieve Menopausal Symptoms
  • Final Word

Menopause is the time 12 months after the last menstrual cycle of a woman. The average age of menopause is 51. (1)

things no one tells you about menopause

In a recent study of women presenting to their health care providers with menopausal complaints, the chief complaints were:

  • Hot flashes (in approximately 40% of women)
  • Night sweats (17%) (2) 
  • Mood changes (16%)
  • Vaginal dryness (13%)
  • Insomnia and sleep disturbances (12%)
  • Weight gain (12%)

The prevalence and severity of symptoms usually escalate as the reproductive stage progresses.

Menopausal Changes You Should Know

Aside from the ceasing of menstruation, these are the changes that you may experience during menopause.

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1. Hot flashes continue for years

experiencing hot flashes marks the advent of menopause

Perimenopause refers to the period when the hormone fluctuations leading to menopause begin – typically about 7 years before menopause.

During that time, the symptoms of menopause may begin, with hot flashes being one of the most common ones. Hot flashes may also continue for 5 years after menopause and, in some women, for a total of 12 years.

2. Extreme tiredness

Mood and energy levels can also be affected by the same hormonal changes that trigger other menopausal symptoms such as hot flashes and night sweats, thus contributing to fatigue. (3)

3. Weight gain

weight gain can be experienced during perimenopausal process

During the perimenopausal process, females are generally expected to gain about 2–5 pounds (1–2 kg), but some may gain even more, especially if they are already overweight or obese. (4)

Interestingly, even in women who have minimal weight gain, there is a tendency to accumulate belly fat and lose muscle mass. Another aspect that leads to perimenopause weight gain may be the increased appetite and elevated consumption of calories that happen in response to hormonal shifts.

Perimenopausal women also have substantially higher levels of the “hunger hormone,” ghrelin, (5) relative to premenopausal and post-menopausal women.

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Leptin and neuropeptide Y, hormones that regulate fullness and appetite, can also be affected by low estrogen levels in the late stage of menopause.

4. Reduced hair quality

Analysis shows that the hair loss after menopause is due to a hormone deficiency. (6) Specifically, it is attributed to a reduction in estrogen and progesterone production. When estrogen and progesterone levels decline, hair grows slower and becomes even thinner.

A decline in these hormones also allows the relative rise of androgens, or a group of male hormones. Androgens shrink hair follicles and also contribute to hair loss. (6)

5. Sleep problems

As estrogen levels drop in menopause, the menopausal symptoms of hot flashes and sweats (the vasomotor symptoms) disrupt sleep for most women. (7) Many women are anxious about getting to sleep and then exhausted from poor sleep and early-morning wakening.

6. Bone loss

menopause can be a common reason for osteoporosis

Osteoporosis is a condition of low bone mass where bones become brittle, raising the risk of fractures. In older adults with little to no signs of damage, bones in the shoulder, back, and wrist are extremely vulnerable to fractures of fragility.

In women, osteoporosis is more widespread and menopause can speed up bone loss, allowing the bones to break down more rapidly. (8) The most common reason for osteoporosis is menopause. One in two postmenopausal women has osteoporosis and most will suffer a fracture during their lifetime.

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7. Extreme skin dryness

extreme skin dryness can be experienced during menopause

Estrogen keeps collagen healthy and promotes healthy oils in the skin. It also helps retain moisture in the skin. As estrogen levels drop, so do collagen levels and the ability to maintain moisture in the skin.

8. Frequent mood swings

During the menopause transition, women who have suffered from extreme premenstrual syndrome (PMS) or chronic depression before perimenopause are more likely to experience major mood swings or depression. (9)

Other variables that arise during this stage of life can also add to the issue. For instance, you may have trouble sleeping at night if the shifting hormones cause hot flashes (as they do for 75% of women), which can lead to a sad, nervous, or anxious mood.

9. Increase in bad cholesterol

Menopause is responsible for the sharp rise in cholesterol levels at this age, (10) not the normal aging process. And this appears to be true of all females, regardless of race.

Many, many women show a very striking spike in cholesterol levels as they reach menopause, which in turn raises the risk of future heart disease.

10. Memory issues

The theory that estrogen deficiency during perimenopause induces memory loss and that memory increases during menopause is reinforced by research on the effects of estrogen on memory.

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A major research, for instance, confirms the observation that hormonal changes during perimenopause frequently induce a reduction in verbal memory. (11) It is found that these symptoms are different from the normal effects of aging.

The research also found that during perimenopause, people couldn’t understand as well. Following menopause, women returned to the learning rate they displayed before perimenopause.

Dietary Changes to Relieve Menopausal Symptoms

The following dietary changes have been shown to improve insomnia, hot flashes, mood swings, and the risk of diabetes and heart disease:

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  • Added sugar intake of <25mg/day
  • A diet that focuses on whole grains, legumes, and fresh fruits and veggies
  • Limiting foods sweetened with high-fructose corn syrup

Final Word

Staying active, eating healthy, and stress management are key to having a comfortable menopause. Your lifestyle and diet affect the way your body functions and can help it cope better with this transitional phase.

Try to exercise regularly, make the right food choices, and eat small portions to keep your weight in check. Most of the symptoms will subside with time, but some may stick around forever.

References
  1. Peacock K. Menopause. StatPearls [Internet]. https://www.ncbi.nlm.nih.gov/books/NBK507826/. Published February 4, 2021.
  2. Santoro N, Epperson CN, Mathews SB. Menopausal Symptoms and Their Management. Endocrinology and metabolism clinics of North America. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4890704/. Published September 2015.
  3. Clayton AH, Ninan PT. Depression or menopause? Presentation and management of major depressive disorder in perimenopausal and postmenopausal women. Primary care companion to the Journal of clinical psychiatry. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2882813/. Published 2010.
  4. Moorman PG, Schildkraut JM, Iversen ES, et al. A prospective study of weight gain after premenopausal hysterectomy. Journal of women’s health (2002). https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2851125/. Published May 2009.
  5. Ibrahim Abdalla MM. Ghrelin – Physiological Functions and Regulation. European endocrinology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5819073/. Published August 2015.
  6. Goluch-Koniuszy ZS. Nutrition of women with hair loss problem during the period of menopause. Przeglad menopauzalny = Menopause review. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4828511/. Published March 2016.
  7. Bansal R, Aggarwal N. Menopausal Hot Flashes: A Concise Review. Journal of mid-life health. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6459071/. Published 2019.
  8. Ji M-X, Yu Q. Primary osteoporosis in postmenopausal women. Chronic diseases and translational medicine. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5643776/. Published March 21, 2015.
  9. W Freeman E. Treatment of depression associated with the menstrual cycle: premenstrual dysphoria, postpartum depression, and the perimenopause. Dialogues in clinical neuroscience. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3181677/. Published June 2002.
  10. Derby CA, Crawford SL, Pasternak RC, Sowers M, Sternfeld B, Matthews KA. Lipid changes during the menopause transition in relation to age and weight: the Study of Women’s Health Across the Nation. American journal of epidemiology. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2727246/. Published June 1, 2009.
  11. Epperson CN, Sammel MD, Freeman EW. Menopause effects on verbal memory: findings from a longitudinal community cohort. The Journal of clinical endocrinology and metabolism. https://www.ncbi.nlm.nih.gov/pmc/articles/PMC3763981/. Published September 2013.

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