Journal / Menopause

Winona: What is Menopause?

Nancy L. Belcher

Medically reviewed by Nancy L. Belcher Ph.D, MPA

Written by Winona Editorial Team

Last updated November 25, 2021

Winona: What is Menopause?

Knowing What is Menopause; Symptoms and Physical Changes

This article will tackle what is menopause and those important things that you should know. Menopause is a normal and natural event that can start anywhere between 40-55 years of age. While there is no ‘treatment’ for menopause, there are ways to treat the often-chronic symptoms that result from menopause.

Menopause is a positive beginning, with opportunities to take preventive action against major health risks associated with decreased hormones as we age. Winona’s goal is to help you understand what is menopause and how to relieve your symptoms safely and effectively

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Causes of Menopause

  • Age.
    In your mid-30s, your ovaries start making less estrogen and progesterone (hormones that regulate the menstrual cycle). In your 40s, your periods may become irregular, and by your mid-50s you will likely not have periods any longer, and that what is menopause by age.

  • Surgical Menopause.
    If both of your ovaries are removed in surgery (oophorectomy), you’ll experience menopause immediately, regardless of your age.

  • Hysterectomy.
    A hysterectomy with the removal of the uterus, but not the ovaries, does not cause immediate menopause.

  • Chemotherapy and radiation therapy.
    Treatments can give you hot flashes and may lead to permanent menopause even after the treatment is over.

  • Primary ovarian insufficiency, also known as a premature ovarian failure.
    When the ovaries stop functioning before turning 40 years old, and the ovaries are not producing enough estrogen or progesterone hormones can cause menopause prematurely.

 Stages of Menopause


Common Menopause Symptoms include

hot flashesweight gain
night sweatsheadaches
vaginal drynesschanges in hair
mood swingslack of energy
declining libidoaging skin

Hot Flashes and sweats– Hot flashes are likely the most obvious sign of menopause. They are caused by a decreased production of the hormone estrogen and occur naturally as women approach menopause.   Hot flashes are sudden, transient sensations of warmth or heat that spread over the body, creating flushing and sweating, especially on the face and upper body. The experience can range from mild/light flashes to severe heat that lasts from 30 seconds to 10 minutes.   

Night Sweats – Severe hot flashes that occur during sleep and accompanied by profuse sweating are ‘night sweats.’  Many women experience severe night sweats, which cause disruptions to sleep and can lead to increased irritability, depression, and stress.

Irregular Periods – During perimenopause, the hormonal imbalance caused by decreasing levels of estrogen and progesterone will cause women to experience absent, short, or irregular periods. Skipping periods is common during perimenopause, and can occur every 2-4 months during this stage for about 1-2 years before menopause really begins.

Weight Gain & Metabolism Changes – Hormonal changes during menopause influence weight gain and the redistribution of fat.  With menopause, not only are the hormones estrogen and progesterone decreased, so is testosterone. Decreased testosterone can lead to less lean muscle, and increased fatigue. These two factors combined can result in a lowered metabolic rate. From menopause onwards, women need fewer daily calories. Hormone treatment can revitalize metabolism and assist with weight loss.

Skin Changes – When estrogen levels drop during menopause it shows (sometimes first) in your skin. Collagen is what keeps your skin toned, fresh-looking, and resilient. As estrogen drops, so does collagen production. You may notice your skin getting thinner, drier, less youthful-looking, and small wrinkles get deeper. Healing can also take longer, you may notice scratches and bruises last longer before they go away.

Fatigue  – One of the most common menopause symptoms is an ongoing, persistent feeling of weakness, tiredness, and low energy. With fatigue might come irritability, and decreased attention span because the hormone estrogen – which regulates energy use at a cellular level – is reduced. So, when estrogen levels drop during menopause, so do energy levels. 

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Loss of Sex Drive – In menopausal women, the main cause of low sex drive is hormonal imbalances. Libido can also be impacted by the other menopause symptoms, such as vaginal dryness, pain during intercourse, and/or depression.

Vaginal Dryness/Atrophy – When estrogen levels drop, the vaginal tissue becomes drier, thinner, less elastic and the vagina can become smaller.  Lack of lubrication can lead to sex becoming uncomfortable, and the vagina is frequently itchy, easily irritated, and more prone to infections.  

Mood swings / Irritability – Menopausal mood swings are very common. When estrogen levels drop, so does the production of mood-regulating neurotransmitters, resulting in fluctuating mood swings. Other menopause symptoms can also influence mood, such as fatigue. Fixing the underlying hormonal imbalance is one of the most effective ways of reducing menopausal mood swings.

Depression – Studies have shown that when a woman’s estrogen level drops, so do levels of a chemical in her brain, called ‘serotonin.’ This drop can lead to depression and mood disorders.  It is vitally important to seek the advice of a healthcare professional to help mitigate this menopause symptom.

Sleep Disorders – Menopause can cause women to wake-up many times during the night, tossing, turning, and suffering from insomnia. Women going through menopause may find that their sleep is less restful and actually falling asleep becomes increasingly difficult. Hot flashes, increased need to urinate, and anxiety can all lead to challenging sleep cycles.

Difficulty with Concentration & Memory – Many women are alarmed to discover they have trouble remembering, or they are experiencing mental blocks, or have difficulty concentrating as they enter menopause. This can be a concerning time for women and can have an adverse impact on all aspects of daily life.

Hair loss/thinning –Hair follicles need estrogen to continue to produce hair. As levels of estrogen decrease, hair loss can occur during menopause.  For some women, it is very sudden, and for others, it will be more gradual. Thinning hair on the head and the pubic area is very common. Hair may also become drier, more brittle, and may fall out more while brushing or shampooing. By treating the underlying hormonal imbalance, one can decrease hair loss during menopause.

The onset of Osteoporosis – While the bone loss is not as obvious as some of the other menopause symptoms, it is critical. Menopause can lead to osteoporosis which leads to thinning and weakening of the bones, and a general decrease in bone mass and density. Estrogen helps with calcium absorption into the bones. With a drop in estrogen levels, women will have reduced bone density from perimenopause onwards if not treated.

Dizziness – That spinning sensation, which may be accompanied by a feeling of light-headedness or unsteadiness, is unfortunate menopause episodes that can leave a woman disoriented.  This dizziness can be caused by fluctuations in estrogen hormone levels. 

Incontinence – Incontinence in menopausal women can be divided into three types.

  1. Stress Incontinence – you pee while laughing, coughing, sneezing, or with exertion. This usually happens when the internal muscles fail due to age, surgery, or childbirth.

  2. Urge Incontinence – you are trying to ‘hold it,’ but your bladder doesn’t listen and empties. 

  3. Overflow Incontinence – you are not fully aware your bladder is full and accidentally urinate. 

Rapid Heartbeat – That pounding, rapid heartbeat can scare women because of their sudden onset and how hard it is to calm them. Estrogen deficiency can cause this symptom by over-stimulating the nervous and circulatory systems, which can cause irregular heartbeat and palpitations. Stress, anxiety, and panic disorder are other causes of this symptom. This is a serious concern and could signify something more serious, so always report this to a doctor. 

Anxiety / Panic Disorder – Like depression, anxiety and overwhelming fear during menopause can be caused by the sudden drop in estrogen levels, which reduces the production of chemicals responsible for mood regulation, called serotonin and dopamine.   

Breast Pain & Loss of Fullness – Breast pain, soreness, or breast tenderness in one or both breasts is symptomatic of hormonal changes in menopause. 

Headaches – When the production of estrogen slows due to menopause, a woman may experience more and/or worse headaches just as they might have before their periods or at the time of ovulation. 

Achy Joints – Joint pain is one of the most common symptoms of menopause. Joint pain is often related to the effects of fluctuating hormone levels on the immune system. Estrogen helps prevent inflammation in the joints, so low levels of estrogen during menopause can lead to increased inflammation, and increased joint pain.

Digestive Problems – Hormonal imbalance disrupts the natural movement of food in the gut, and add on the other symptoms of menopause and the adverse effect on digestion are amplified.  

Tingling/Burning Extremities – or a feeling of “crawling skin”, a burning sensation like an insect sting, or super-sensitivity in their face, hands, arms, legs, and feet are caused by low estrogen levels.

Treatment & Care

  1. Understanding Menopause Treatment After menopause, hormone replacement therapy (HRT) is often prescribed to resupply the body with the hormones it no longer produces. 

  2. Treating Menopause Symptoms There are a number of different treatment options to consider if you’re suffering from symptoms of menopause.

  3. Hormone Replacement Therapy (HRT) HRT (also known as hormone therapy, menopausal hormone therapy, and estrogen replacement therapy) uses female hormones — estrogen and progesterone — to treat common symptoms of menopause and aging. Doctors can prescribe it during or after menopause.

  4. Estrogen Hormone Therapy There are many types of estrogen therapy in many different forms — pills, patches, suppositories, and more. The best type of hormone replacement therapy (HRT) depends on your health, your symptoms, personal preference, and what you need to get out of treatment. 

  5. Is Hormone Replacement Therapy Right for You? While postmenopausal hormone replacement therapy (HRT) is an effective way to treat menopausal hot flashes, it is not recommended for everyone. 

  6. Pros and Cons of Hormone Replacement Therapy  Here are the pros and cons of using hormone replacement therapy, as well as some alternatives.

  7. 10 Questions About Hormone Therapy During Menopause Ask your doctor about hormone therapy during menopause to find out if it’s right for you.

  8. Natural Remedies Learn about herbs, supplements, and other natural remedies that some believe help with menopause symptoms.

  9. Complementary and Alternative Therapies Supplements, herbs, and botanicals like black cohosh, evening primrose oil, and flaxseed are thought to relieve menopausal symptoms. Are they safe? What are the warning signs a product may not be legitimate? Find out.

“This article is for informational purposes only and does not constitute medical advice. The information contained herein is not a substitute for professional medical advice. Always talk to your doctor about the risks and benefits of any treatment.”