Formally, menopause is a period that begins once a woman’s body is done having menstrual cycles. A woman is said to have entered menopause once her body has not menstruated for 12 months, as long as no medical conditions or surgeries can be identified as the cause for the absence of menstrual cycles. Most women enter menopause in their early 50s, though menopause can begin as early as the 30s or 40s.

Menopause, when it begins naturally, is a normal and healthy part of the aging process. A woman’s menstrual cycle has been continually cycling since she entered puberty. As she ages, the body naturally begins to slow down its reproductive cycle, until the ovaries fully stop releasing eggs, bringing the recurring cycle to a full stop.

The hormone estrogen is required for a woman’s natural reproductive cycle to occur. As a woman gets older, particularly once entering her 40s and 50s, her ovaries will slow the production of estrogen. Lower estrogen levels will produce menstrual changes which can vary for each woman. For many, there is a time of irregular menstrual cycles before the cycles fully come to an end.

While menopause is an entirely natural and normal biological process, it may manifest symptoms and side effects that can be challenging to navigate on both a physical and emotional level.

There are four individual stages of menopause. As a woman’s body adjusts to the fluctuating levels of estrogen and other hormones, she will likely experience a variety of physical changes throughout these stages.

Premenopause is the earliest stage of the menopause journey. Women are still considered fertile during this stage, though their reproductive hormones are slowly beginning to shift. Most women do not notice any obvious symptoms, but they may experience a slight irregularity in their cycle from time to time. This is typically the clue that the body has begun its hormonal shift.

Perimenopause is often referred to as the “menopause transition” phase. This stage is characterized by more obvious symptoms as a woman’s estrogen and other sex hormone levels begin to drop more significantly. However, perimenopause is still a slow process and can take eight to 10 years before a woman fully enters the menopausal stage. During this time, a woman is still having menstrual cycles and can get pregnant, though her cycles will likely just be more irregular. She may go several months without a cycle and then have several periods closer together, as the cycles typically become shorter during perimenopause.

A woman reaches the menopause stage when her ovaries have stopped producing estrogen and the body is not releasing eggs for at least 12 consecutive months. If necessary, health care providers may run a variety of blood and urine tests to identify hormone levels to diagnose a woman as having reached menopause.

The postmenopause stage begins once a woman has entered the menopausal stage, and it will continue for the rest of her life. For many women, menopause symptoms will begin to slowly diminish. However, for some, the symptoms don’t disappear as quickly or fully as they might hope. Some women may experience symptoms for five to 10 years or longer after entering postmenopause. There are ways to manage symptoms and decrease their impact on a woman’s day-to-day life.

If a woman of menopausal age experiences any of the following symptoms, she may be transitioning into one of the stages of menopause:

Menopause is a normal stage of life, not a condition that requires treatment. However, there are ways to treat symptoms that may impact a woman’s quality of life.

Hormone therapy and prescription medication are what most providers will offer to a woman who is looking for treatment for her menopause symptoms.

Prescription medications such as estrogen creams and pills, or birth control and antidepressants are utilized to manage hot flashes or mood swings. Patients need to discuss these medications with their providers to understand what they are intended to do, as well as the potential side effects they may experience.

Hormone therapy essentially boosts the body’s hormones to attempt to bring balance back, therefore lessening the bothersome symptoms a woman may be experiencing.

There are two types of hormone therapy:

It must be mentioned that hormone replacement therapy does have drawbacks. Research shows that hormone therapy can increase the risk of conditions such as heart disease, stroke, blood clots, and breast cancer. It also can increase inflammatory markers, such as C-reactive protein, in the body. Some integrative practitioners use bioidentical hormones rather than synthetic ones to treat menopausal hormone concerns. Women often see good results with bioidentical hormone replacement therapy (BHRT), but there are still drawbacks as hormones work on a negative feedback loop. Careful monitoring is essential.

Many patients seek an alternative to hormone therapy and prescription medications and turn toward a more functional approach. This approach to wellness seeks to offer whole-person, integrative care to understand what is occurring in the body.

Lifestyle changes such as diet, exercise, herbs, and supplements are more natural efforts to make to manage menopause symptoms. Oftentimes women who work with a functional medicine provider come up with a plan that is unique to her physiology so she can move through menopause with ease and empowerment.

Regardless of the approach, these considerations are important for practitioners and patients to discuss as they seek to set up the best plan for the management of menopause symptoms.

Lab testing can be an invaluable resource in seeking to treat and manage menopausal symptoms.

Additional methods of measuring a woman’s overall health and identifying any areas of concern throughout the stages of menopause include a DEXA scan, a breast exam, and a pelvic exam.

Entering the stages of menopause can be an unsettling time for women as their bodies move past the child-bearing years. This is entirely normal and something every woman experiences to some extent. Supporting her body as a woman walks through the menopausal years is not only a way to ease symptoms and increase quality of life, but also gives a woman a sense of control and confidence as she navigates learning to thrive in her changing body.