The first sign that you’re entering the menopausal transition is usually a change in your menstrual cycles; periods can become closer together or further apart, and bleeding may be lighter or heavier, said Siobán Harlow, director of the Center for Midlife Science at the University of Michigan School of Public Health. These changes can be unpredictable and unnerving, and in women who experience heavier periods, it’s possible to have a dangerous amount of blood loss, warranting medical care, Dr. Harlow said.
At the same time, fluctuations in estrogen can cause someone to “start having hot flashes and night sweats, or get a migraine headache, or not sleep well, or feel super irritable,” Dr. Faubion said. They might then experience a few normal periods and a temporary relief, before returning to their original symptoms. Menopausal transition can also cause a variety of symptoms, such as depression, anxiety, brain fog and changes in skin and hair. Joint pain and vaginal dryness are just some of the other symptoms.
Once you go 60 days without bleeding, you’re in what’s known as the late menopausal transition; from here, most women will have their final period within two years, said Dr. Nanette Santoro, a professor of obstetrics and gynecology at the University of Colorado School of Medicine. In this stage, “symptoms tend to ramp up, so if they were annoying in the early transition, they get a little worse,” she said.
Hot flashes can sometimes be accompanied by night-sweats and are one of the most common symptoms of menopause. As many as 80 percent women experience them. A 2015 study of 1,500 U.S. women with frequent hot flashes and night sweats found that these symptoms lasted an average 7.4 years. They usually began several years before their last period and continued for an average 4.5 years. Women who began experiencing hot flashes earlier in the menopausal transition — before they hit the milestone of 60 days without a period — had to put up with these symptoms for longer, a total of 11.8 years on average. “If it begins early, it can be a very long, annoying menopause,” Dr. Santoro said, and given this, “you may want to seek help sooner rather than later.”
The 2015 study included several ethnic and racial groups. Women of Japanese and Chinese descent had the shortest hot flash durations (an average of 4.8 years and 5.4 years respectively) while Black women had the longest with an average of 10.2 years. In a February study, Dr. Harlow, along with her colleagues, examined evidence that Black women in the United States had, on average, a earlier menopause and a higher incidence of depression and sleep disturbances associated to menopause compared with white women. The authors proposed that these disparities could be linked, at least in part, to greater financial strain and life stress, experiences with discrimination and less physical activity — all of which, the authors noted in the study, “have roots in systemic racism.”
Source: NY Times
