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What Are The Signs of Menopause?

In How Do You Know If Your Symptoms Are Perimenopause, I mentioned perimenopause is when the hormonal symphony between estrogen and progesterone no longer play in concert. As a result, we start feeling symptoms as early as in our 30s. But how do we know when we’ve reached menopause? What are the signs?

What is menopause?

Menopause, metaphorically, is when the symphony stops playing altogether.

Medically defined, menopause is the absence of a period for 12 consecutive months. It typically occurs between ages of 45-55. Estrogen and progesterone have reached low baseline levels and the ovaries no longer contain nor release eggs. Or the ovaries have been removed (hysterectomy).

At this time, FHS levels range from 25.8 – 134.8 IU/L. Typically an elevated level of FHS is a metric used to diagnose menopause.

Signs of menopause

  • Changes in your period: This includes irregular cycles that may be longer or shorter than usual, and you may bleed more or less than usual.
  • Hot flashes: They can last 30 seconds to 10 minutes, and happen hourly, daily, or just once or twice a week in lieu of fluctuating estrogen levels.
  • Bladder incontinence: Sneezing, laughing, exercising may induce leakage or you may just have the sensation that you need to urinate. And, we may experience bladder infections.  
  • Sleep disturbances: Reductions in both estrogen and progesterone show up in the inability to fall asleep, stay asleep, and/or fall back to sleep.
  • Vaginal dryness: The vagina loses lubrication thanks to a loss of estrogen, making intercourse painful and uncomfortable. This is extremely common and yet rarely discussed.
  • Vaginal and vulva changes: Not only do we lose natural lubrication, the tissues of the vulva and the lining of the vagina become thinner thanks to the loss of estrogen. Meaning, the vagina is less flexible or elastic. If you stop having sex on a regular basis in lieu of this, the vagina may become shorter and narrower inducing pain even if there is lubrication. Also, a dry vulva and vagina is prone to tearing and bleeding during sex or any penetration of the vagina.
  • Mood changes: Lower levels of progesterone are associated with mood swings. This is because progesterone attaches to the same receptor sites in the brain as GABA, a neurochemical which also a hormone that reduces anxiety or excitability. Additionally, stress and cortisol may play a role in mood changes.
  • Body changes: Bloating, weight gain – especially around the hips, buttocks, and mid-section, muscle loss and fat gain, joint stiffness and aches.

How to treat symptoms of menopause

Ah, the joys of this transition in our lives. How do we make it stop? Well, again, there is no one-size-fits-all approach. Many factors contribute to one’s symptoms, and interventions are bio-individual. However, there are nutritional, lifestyle, and supplemental interventions you can employ to start minimizing the symptoms.

Schedule a 20-minute free strategy session to learn more about how I can support you in designing a protocol that works for you!

Nall, R., & Kay, C. (2023, March 15). What are normal ranges of FSH levels, and what to do if they are high or low. Retrieved from MedicalNewsToday:

NIH National Institute on Aging. (2021, September 21). What Is Menopause? Retrieved from National Institute of Aging:

The North American Menopause Society. (2023). Changes in the Vagina and Vulva. Retrieved from The North American Menopause Society: