What, specifically, can I expect to go through before menopause?

If you are living your life in balance you should expect to go through the change without any problems.

Symptoms such as hot flashes, insomnia, anxiety, pounding heart, vaginal dryness, lack of sexual enjoyment, lack of concentration, forgetfulness, and irregular bleeding have been related to perimenopause - the time preceeding menopause.

These symptoms are usually not related to perimenopause but how stressfull your life is. They are usually the tip of the iceberg and the root cause should be found. In some cases, a medical condition as well as the side effects of certain medications can be the culprit.

Can I predict when I will go through menopause? Does it have anything to do with when I started menstruating?

Natural menopause typically occurs around age 51; for approximately seven percent of women, it occurs prior to age 40.

Genes may play a role in determining at what age a woman goes through menopause. One study demonstrated that women whose mothers had experienced early menopause, had a six-fold higher probability of entering menopause early.

There is no correlation between when a woman goes through menopause and when she started her menstrual periods. When a woman asks me to predict when she will go through menopause, I usually tell her to ask her mother.

What, specifically, can I expect to go through after menopause?

Each woman’s menopausal experience is unique and should be addressed individually. About ten percent of women haven’t any problems whatsoever, while about 25 percent of women nay have debilitating symptoms such as hot flashes, insomnia, anxiety, pounding heart, vaginal dryness, lack of sexual enjoyment, lack of concentration, forgetfulness, etc.

In many cases, these symptoms are the tip of the iceberg and the root cause should be found and dealt with.

Why am I so afraid about reaching menopause?

Most women see menopause as a series of problematic symptoms that will occur, rather than as a time to account of what to do and where to go for the rest of their lives.

Menopause is not the end of something, but the beginning of a woman’s mid-life. We all have to go through it. There is a tremendous amount of confusing information regarding menopause.

Women need to know what will work for them, what the side effects will be, and what the risks are.

In order for the mid-life years to be active and productive, women need to live their lives in balance, deal with unresolve childhood issues, and work together with their health-care provider concerning every avenue of prevention.

It is the most appropriate time to ask questions and get reliable answers.

Women should be involved at every step in developing a health-care program for themselves, for now and over the long-term—an informed plan of care that would yield greater comfort with the plan and more sustainable long-term personal benefits. 

If I do not want to take HRT, what are my alternatives concerning aging healthily?

For the short-term, there are many alternative health approaches such living your life in balance and know how to deal with stress, herbal remedies, mind-body interventions, and a regular exercise routine, which can help alleviate menopausal symptoms.

The best treatment would be one designed specifically for an individual taking into account any symptoms that that person is experiencing.

For the long-term, a healthy lifestyle has been shown to be associated with healthy aging. These include stress management, healthy nutrition, smoking cessation, alcohol consumption in moderation, and keeping one’s weight, blood pressure under control.

Are there "natural drugs" I can take instead of HRT prescription drugs?

Many women believe in "natural" approaches in order to avoid the side effects of standardized HRT. "Natural" means that molecular structures have been modified in the laboratory to match those found in the human body.

Natural products may not necessarily be more effective or less toxic than their more traditional counterparts.

Furthermore, the production of so-called natural modalities may not be any more natural or, just as importantly, profit-driven than that of conventional hormones.

Some companies falsely label their products "natural," because using the word helps sell products!

There are some products, both alternative and conventional, that are manufactured by the same multinational companies—profit-driven corporations with aggressive marketing plans.

An example would be the idea of using "natural progesterone creams," which are sold over-the-counter.

Women should be aware that some creams made from wild yam extract only contain progesterone precursors, though are being touted as natural progesterone cream.

The human body does not produce the enzyme needed to convert vegetable substances into progesterone.

Will menopause affect my sex life?

Some women have described a new relationship after menopause as being "the most emotionally and sexually satisfying."

On the other hand, because some women equate menopause with signs of aging, they may lose interest in sex.

Many women have acknowledged that their sexual desire increased with age—sex got better. Factors such as cultural background, religious beliefs, socioeconomic status, plus availability of partners affects the frequency and quality of a woman’s sexual activity.

According to Masters and Johnson, sex drive is not related to estrogen and should not automatically decrease at menopause.

Sex drive does not decrease with age, except as a reaction to stressors within the environment, a decrease in general health, energy, the lack of a partner, or moral injunctions against masturbation.

Estrogen replacement therapy may increase libido and improve other menopausal symptoms. In some cases, sexual functioning may take up to 6–12 months to improve.

Testosterone, when added to estrogen therapy, enhances sexual activity and satisfaction among postmenopausal women to a greater degree than estrogen alone.

See the Q and A Archive for more information about menopause, sex and the midlife woman.