Updated: Nov 9
What did you learn about menopause growing up? Hot flashes and moodiness? That’s all that we learned as well!
Menopause is not talked about enough and yet, over half of the population experiences this life stage. Interestingly, we call it “symptoms” of menopause as if it were a disease or illness and yet, we don’t say “symptoms” of puberty. Menopause is not a disease but a stage of life. Menopause is a natural biological process that marks the end of the reproductive phase for women and those assigned female at birth. It is defined as the point in time when an individual has not had a menstrual period for 12 consecutive months, signifying the end of ovarian reproductive functioning. However, the journey leading up to menopause, known as the menopausal transition or perimenopause, can bring about a range of physical, emotional, and mental changes. For some, this phase is relatively smooth, while others may experience significant changes that impact their daily lives. This blog post is an introduction to the menopausal transition, menopausal changes, and the ways you can manage and navigate this crucial life stage.
Why is this important?
According to BC Women’s Health Foundation, “Our healthcare system is failing mature women. Frequently unheard, dismissed, and overlooked by medical professionals, women over 45 are often left to navigate complex challenges associated with menopause, and subsequent concerns like osteoporosis and other chronic diseases, without the support they need.”
This is a common narrative for those in this stage of life, who are often caretakers themselves with not a lot of time or resources to advocate for themselves in healthcare. BC Women’s Health Foundation is launching a landmark initiative to propel multidisciplinary research that is directly tied to real-time patient care. Until now, women, trans, and non-binary individuals who are experiencing menopause and other aging-related concerns have not had the answers and have been suffering in silence.
Understanding the Menopausal Transition
Perimenopause, meaning "around menopause", refers to the time during which your body transitions to menopause. The menopausal transition typically starts between the ages of 45 and 55, but it can happen earlier. For individuals who start the menopausal transition earlier than 45 years old are often told "but you're too young to be going through menopause", which unfortunately contributes to the stigma, misdiagnosis, and mistreatment of symptoms. During perimenopause, hormonal fluctuations, specifically a decline in estrogen and progesterone production, play a central role in the body's transformation. The duration of menopause can vary, lasting approximately seven years and sometimes extending to fourteen years. Several factors, including lifestyle choices, smoking, the age at which it begins, and race or ethnicity, can influence its length and intensity.
The menopausal transition affects individuals in diverse and unique ways. Some common symptoms experienced during this phase include:
Changes in Menstruation: Irregular periods, shorter or longer cycles, changes in flow, heavy bleeding, spotting, and the resumption of periods after a year without one are all typical.
Hot Flashes: Sudden sensations of heat, typically in the upper body, accompanied by flushing of the skin, sweating, palpitations, and discomfort.
Bladder Control Issues: Incontinence, where there is a sudden urge to urinate or urine leakage during activities like exercise, sneezing, or laughing.
Sleep Disturbances: Difficulty falling asleep, waking too early, night sweats that interrupt sleep, and difficulties returning to sleep once awake.
Vaginal Health and Sexuality: Vaginal dryness, painful sexual intercourse, and changes in sexual desire are common concerns.
Mood Changes: Mood swings, increased irritability, and, in some cases, depression or anxiety can occur.
Physical Changes: Alterations in body composition, such as increased abdominal weight, muscle loss, skin thinning, and joint and muscle stiffness.
Other potential symptoms include aches and pains, headaches, and heart palpitations, as well as cognitive and memory changes. The severity and frequency of these symptoms can vary widely among individuals.
Diagnosing the Menopausal Transition
Diagnosing the menopausal transition typically relies on the cessation of menstruation for 12 consecutive months. However, if you are experiencing signs or symptoms commonly associated with menopause, a doctor may inquire about your age, family history, and conduct blood tests to to rule out other causes for your symptoms.
Several approaches can help manage the symptoms associated with the menopausal transition:
Lifestyle Changes: Simple lifestyle modifications such as avoiding caffeine, maintaining a healthy diet, prioritizing sleep strategies, and staying physically active can alleviate mild symptoms.
Medications: Individuals may consider hormone therapy (HT) or non-hormonal therapies, including medications like selective serotonin reuptake inhibitors (SSRIs) or serotonin-norepinephrine reuptake inhibitors (SNRIs) for mood-related symptoms.
Vaginal Treatments: For vaginal dryness and discomfort during sex, various vaginal therapies, including hormonal and non-hormonal options, are available.
Psychological Support: Seeking therapy or counselling can help address mood changes and emotional challenges that may arise during the menopausal transition.
Understanding the menopausal transition, its signs and symptoms, and the available management options is essential for health and well-being. As this post highlights, perimenopausal and postmenopausal care are critical components of healthy aging. To ensure that women and those assigned female at birth receive the support and information they need to navigate this phase effectively, it is essential to raise awareness, provide proper healthcare training, and integrate menopausal care into routine health services. By doing so, we can empower individuals to embrace this life stage with confidence and lead healthy, fulfilling lives before, during, and after menopause.
CAYA Health Centre's Approach
At CAYA, our physicians and allied health team want to support you through your perimenopause and menopause experience. Here is how our team can help:
Physician support: Noticing any of the signs of menopause? Book an appointment with one of our physicians to discuss treatment options and rule out any other medical-related causes.
Dietitian: Our dietitians can support you with lifestyle changes to support mindful eating during perimenopause and menopause. Whether you are interested in anti-inflammatory eating, supporting bone health, increasing energy levels, or micronutrients, our registered dietitians are here to help you find a plan that feels good for you.
Physiotherapy: Struggling with pain, or aches, or not sure how to incorporate exercise and gentle strength training into your regular routine? Our physiotherapists can support you with that!
Pelvic Floor Physiotherapy: Painful intercourse, pain with penetration, or genital pain and discomfort? What about urinary leakage or bowel/bladder concerns? Our pelvic floor physiotherapists can guide you through an initial assessment and strategies to help manage pain and discomfort.
Clinical Counselling: Our counsellors can support you through this transition by helping you identify potential stressors contributing to low mood and anxiety. They can guide you through strategies to help improve sleep, manage mood swings and regulate emotions. They can also support you in coping with feelings of sadness and loss that can come with going through menopause. Some of our therapists can also work with you regarding concerns about genital pain, avoidance of sex, and low sexual desire and arousal.
Massage Therapy: Lastly, our massage therapists can help relieve tension, aches, and pains that are sometimes associated with menopause. Working with your registered massage therapist, you can discuss the best approaches for treatment and help alleviate tension and stress.
If you are experiencing distress with the transition into, during, and post-menopause, please reach out to see how best we can support you. Yes, the menopausal transition is a natural and normal part of life and yet the suffering and isolation are not. You do not have to go through this alone!
The experience of menopause for trans men, non-binary, and gender-diverse individuals who were assigned female at birth is also unique and does not get enough attention. It is important to acknowledge that trans men and non-binary individuals also experience menopause and have their own challenges when navigating this transition. We will be posting another blog on this experience. Stay tuned!
Want to discuss your concerns with one of our doctors? Call us at 236-516-2292 or email us at firstname.lastname@example.org.
To book an appointment with our physiotherapists, pelvic floor physiotherapists, massage therapists, dietitians, or clinical counsellors, book here!
British Columbia Women’s Health Foundation (2019), In Her Words: Women’s Experience with Healthcare System in British Columbia.
National Institute on Aging (NIA). (2023). Menopause: Time for a Change [https://www.nia.nih.gov/health/menopause-time-change]
World Health Organization (WHO). (2023). Menopause. [https://www.who.int/news-room/fact-sheets/detail/menopause]