Beyond all of the cultural stereotypes about menopause, or the general lack of understanding, is the fact that every woman will undergo this natural shift at some point in her life. Consistently throughout my practice, I have witnessed so much unnecessary suffering that arises when we aren’t individually and collectively educated about what menopause is and how to support ourselves or a loved one during and after this transition.
This blog is meant to be an introductory overview of menopause so that you can gain a greater understanding of what it is and feel empowered to advocate for appropriate care.
What Is Menopause?
Menopause is a natural stage of life, not an illness, but the years leading up to it can bring real changes that deserve understanding and care. Medically speaking, menopause has occurred when someone has gone a full 12 consecutive months without a menstrual period, which typically occurs around age 50-51.
It marks the end of what are considered the reproductive years, which begin with menarche (the first menstrual period) and end with menopause, meaning the body is no longer naturally able to become pregnant. The time leading up to menopause, when women often experience changes in their menstrual cycles and physical symptoms related to hormonal shifts, is called perimenopause. It often begins in the mid-to-late 40s and can start about four to six years before the final period. However, the duration and age at which someone enters perimenopause are unique to each person! Some circumstances can result in menopause occurring earlier than average, for example, after surgery or cancer treatment, and these individuals may need additional support.
The transition from perimenopause into menopause is generally understood in stages. In the early stage, menstrual cycles start to vary in length by a week or more. As someone enters the later stage of perimenopause, periods start to be skipped entirely, and 60 days or more can pass between them. After a full year without a period, menopause has occurred, and you are now in post-menopause.
All of these shifts are occurring because of hormonal fluctuations and changes, primarily involving estrogen and progesterone, as well as testosterone. People are often surprised to learn that hormone levels do not simply drift downward in a straight line, which is part of the reason why identifying perimenopause and menopause can be tricky for many. Estrogen and progesterone rise, dip, and fluctuate in an uneven pattern during the transition. That unevenness helps explain why symptoms can come and go, and why two people can have very different experiences, even from month to month.
Whether you or someone you know is experiencing very difficult symptoms or none at all, having an awareness of how the body is changing can help you identify supportive lifestyle and dietary changes, as well as appropriate medical options, including hormone replacement therapy (HRT).
Common Signs and Symptoms
No one experiences every symptom, and some people have very few. These are some of the signs and symptoms that research points to most often.
Hot flashes and night sweats
Up to 80% of women experience hot flashes or night sweats during the transition, and most who do rate them as moderate to severe.
Sleep changes or difficulties
Between 40% and 56% of women in perimenopause, menopause, and postmenopause report sleep changes and/or difficulties, compared with about 31% of women in the late reproductive years. Roughly one in four has sleep problems severe enough to meet the criteria for insomnia.
Mood and focus changes
Some people experience changes in mood, anxiety, irritability, or symptoms of depression during the menopausal transition. Research suggests that certain individuals may be more vulnerable to depression during perimenopause, particularly those with a history of depression or other contributing factors. However, these experiences are not inevitable, and not everyone will experience significant changes in their mental health.
Changes in energy levels and concentration.
Physical changes
Joint pain, stiffness, and vaginal dryness.
Weight gain and other metabolic shifts.
Vaginal and urinary changes.
How to Support Yourself and Others
One of the first steps I often focus on when supporting clients with symptoms related to these transitions is creating space for their concerns to be fully heard and understood. Many women I work with have struggled with symptoms long before they were able to access care, or even knew that they could. Addressing the emotional impacts of these transitions must always be considered when I work with clients to create care plans.
Just as perimenopause and menopause are unique transitions for each individual, care plans and lifestyle plans need to be personalized to meet the needs and health histories of each client. Making sure that you feel empowered with options and education is key to creating sustainable, supportive change.
Some of the initial things I look at and encourage others to consider when trying to support themselves or others during these transitions are:
Sleep health and possible interventions
Sleep hygiene
Supplements
Hormonal support
Medication
Stress management
Stress tolerance and management can be extremely challenging during these transitions, especially if someone is experiencing multiple symptoms simultaneously. Supporting stress management usually involves a variety of support and/or treatment options.
Blood sugar balance
Any condition that has to do with hormones also has a relationship with how balanced our blood sugar is! This becomes even more important depending on a person's health history, particularly if they also have conditions like diabetes or a history of PCOS.
Mental health support
When women experience changes in mood and energy related to hormonal shifts, it can be extremely isolating and impact almost every aspect of life. Some people may be more vulnerable to mood changes or depression during this time, particularly those with a history of depression, ongoing sleep difficulties, or other contributing stressors. These experiences are not inevitable, but they deserve to be taken seriously and supported.
Looking at things like support networks, expanding provider care, and potential medications can be life-changing for some. If low mood, anxiety, or hopelessness continues or gets in the way of daily life, please reach out to a healthcare professional. This is especially important if you have experienced depression before, as a history of depression is an important risk factor. If you ever feel you might hurt yourself, call or text 988 in the U.S. to reach the Suicide & Crisis Lifeline.
Bone health
Hormones play an important role in maintaining bone health, making this an important area of focus during and after the transition.
Heart health
The transition through menopause is an important time to pay attention to cardiovascular health. Research shows that this stage is associated with changes in cholesterol levels, blood pressure, abdominal fat, and metabolic health, which can contribute to cardiovascular disease risk.
Estrogen plays an important role in vascular health, and the hormonal changes associated with menopause can influence how the heart and blood vessels function. This makes it especially important to prioritize heart-healthy habits, including regular physical activity, balanced nutrition, stress management, and routine monitoring of blood pressure and cholesterol.
Being proactive about cardiovascular health during midlife can help identify risk factors early and support long-term heart health.
Hormone therapy
Menopausal hormone therapy (MHT), also commonly called hormone replacement therapy (HRT), is currently considered the most effective treatment for common menopausal symptoms such as hot flashes and night sweats. It can also help with symptoms of genitourinary syndrome of menopause, including vaginal dryness and discomfort, and has been shown to help prevent bone loss and fractures.
Hormone therapy isn't a one-size-fits-all approach. The potential benefits and risks depend on several factors, including a person's age, time since menopause, medical history, type of hormones used, dosage, and method of delivery (such as oral or transdermal). For many healthy women under 60 or within 10 years of menopause onset, the benefits may outweigh the risks when treating bothersome symptoms and when there are no contraindications.
It's important to work with a knowledgeable healthcare provider to understand your options and determine whether hormone therapy is appropriate for you. Hormone therapy is not recommended solely for the prevention of cardiovascular disease.
Mindfulness
Mindfulness practices, including meditation, mindful breathing, and other mind-body approaches, may offer meaningful support during the menopausal transition. A 2025 systematic review and meta-analysis of 19 studies involving 1,670 participants found that mindfulness-based interventions were associated with improvements in menopausal symptoms, sleep quality, anxiety, depressive symptoms, stress, and overall quality of life.
These practices can provide opportunities to slow down, develop greater awareness of the body, and build tools for navigating stress and emotional changes. While more research is needed to understand the full extent of their benefits, mindfulness can be a helpful complementary approach to supporting overall well-being during this transition.
Diet and nourishment
Creating a personalized dietary practice is always the goal, but in general, focusing on a whole-food diet that limits processed foods, added sugar, alcohol, and caffeine can make a big difference for many.
Movement and physical activity
Regular, sustainable movement that is appropriate for your body helps protect the bones, heart, and metabolism, and can support other factors like stress management, sleep, and mental health. Although exercise offers many important health benefits, research has not consistently shown that it directly reduces the frequency or severity of hot flashes. Rather than viewing exercise as a treatment for hot flashes, think of it as one valuable part of a broader approach to supporting your health during perimenopause and menopause. Work with your provider to create a plan that works for you and your body.
Supporting Someone You Care About
We do not live in isolation, and we don’t heal in isolation either. Perimenopause and menopause happen within relationships, families, workplaces, and communities. The support, or lack thereof, during these transitions makes a HUGE difference.
Research on partner and family support is still growing, and much of it is based on interviews and surveys rather than trials. Even so, a 2024 review describes partners as often being the closest source of support and reports that emotional support from a spouse is associated with less depression and anxiety during menopause. The same review notes that many partners want to help but are unsure how. The more we all work to raise awareness and prioritize education over stigma, the better off everyone will be.
Some things to consider when supporting someone:
Supporting yourself
Times of transition within relationships and families can be intense for everyone involved. They can also be a great time to re-evaluate what areas of your own life might need support so that you can show up with more capacity for your loved one or community member.
Learning about perimenopause and menopause
This blog is a great start, AND there is so much wonderful information available! Learning about this with the person you are supporting can be a wonderful opportunity to connect, support, and understand. This can help both people recognize what is going on and, hopefully, reduce potential relational strain.
Listen
Leading with curiosity and seeking to understand is always a great strategy, but it can be especially impactful while someone is going through a major life transition. Sometimes the person you’re supporting may just need to be heard.
Engage
This looks different for everyone and every context, but listening and then offering to help with identified actions can be a huge help. Some examples are:
Accompanying someone to appointments.
Working together to make household and/or workplace changes that make the transition easier.
Support and encourage rest
Since sleep and energy levels are often impacted during menopause, being aware of and supporting household and workplace changes that allow for more rest is crucial.
Be patient
Symptoms can last for several years, so ongoing kindness matters more than a one-time gesture.
Speak up
Around half of the population will go through these transitions at some point in their lives. Raising awareness, encouraging menopause-friendly work and home environments, and combating stigma can have a huge impact.
If you are the one going through this and your partner is unsure how to help, sharing this post can be a gentle way to start the conversation.
A Closing Thought
Perimenopause and menopause are a normal part of life, and they are also times when most people benefit from increased understanding, compassion, practical tools, and a strong support network. Whether you are in the middle of the transition, getting ready for it, in postmenopause, or supporting someone who is, you do not have to figure it out alone.
I always encourage having these conversations with your current healthcare team, and I would be honored to work with you to develop a functional, personalized care plan to help make your transition as supported as possible!
This post is for educational purposes and is not a substitute for personal medical advice.