Midlife can often mark a new chapter of life for many people. For some, there's more time to focus on things like spending time with grandchildren, exploring new hobbies, practicing self-care, and maybe even taking that trip you've been dreaming about. But if you’re a woman who’s going through menopausal changes, you may feel like your body changes are overwhelming or a source of anxiety. Where did all these new physical symptoms come from? Why is my sleep being disrupted? Why has my libido changed? How do I get more energy?

You can take charge of your menopause journey and turn it into a positive experience. The first step is learning more about what menopause is, why it’s happening, and what you can do to feel better.

What is menopause?

Menopause is not a disease or disorder. It’s a natural, normal aging milestone when a woman’s menstrual periods permanently stop and she can no longer become pregnant. Technically, you have reached menopause once you have not had any menstrual bleeding or spotting for 12 months in a row.

The years leading up to menopause are referred to as perimenopause or pre-menopause. During this time, the supply of mature eggs in your ovaries decreases. Ovulation becomes irregular, and your ovaries slow their production of the hormones estrogen and progesterone. This dramatic drop in estrogen levels is thought to be the cause of most physical symptoms of menopause.

What is the normal age for menopause?

The transition to menopause commonly begins between the ages of 45 and 55. It lasts an average of seven years, but it can extend to as long as 14 years. According to some studies, the age a woman’s mother went through menopause can offer some indication as to when she will go through this transition.

While menopause usually occurs naturally, some women may enter early menopause if they have had both ovaries surgically removed, been exposed to radiation, or were treated with chemotherapy. Menopause is also more likely to happen early in women who smoke, have never been pregnant, and started their periods at age 11 or younger.

What are the symptoms of menopause?

The menopausal transition affects each person differently. Some women can breeze through this time with no changes except irregular menstrual periods. Others, however, experience a variety of physical symptoms ranging from mild to debilitating. Menopause symptoms can include:

• Unexplained weight gain
• Sleep disturbances
• “Brain fog” and other cognitive issues
• Hot flashes (or hot flushes) and/or night sweats
• Vaginal atrophy – thinning, drying, and inflammation of vaginal walls
• Increased facial hair or hair loss on scalp
• Heartbeat irregularities
• Increased anxiety
• Decreased libido
• Fatigue
• Irritability and other mood changes

Menopause can also trigger less-obvious physical changes as well. The significant drop in estrogen may cause loss of bone density and increase your risk for osteoporosis. Plummeting estrogen production can also raise your cholesterol levels and elevate your risk for heart disease and stroke. That’s why it’s essential to maintain a healthy lifestyle and see your doctor regularly during this transition.

How are menopause symptoms treated?

Not all women need to treat their menopause symptoms. But if symptoms are severe enough to impact well-being, medical and lifestyle interventions can provide some degree of relief. A few common approaches to menopause treatment are listed below.

Hormone therapy (HT)

HT involves the use of estrogen and/or progesterone to increase the levels of these hormones in your body and ease your menopause symptoms. HT is delivered via pills, creams, transdermal (skin) patches, and other methods. It can be in the form of estrogen alone or a combination of estrogen and progesterone.

Since hormone therapy is believed to increase a woman’s risk for blood clots, stroke, and certain cancers, it’s not for everyone. Be sure to discuss the pros and cons of HT with your health care provider before deciding on this treatment approach.

Non-hormonal medications and supplements

Certain prescription medications have shown effectiveness in treating menopause symptoms. These include gabapentin (Neurontin) and clonidine (Catapres) for treating hot flashes and selective serotonin reuptake inhibitors (SSRIs) for treating both hot flashes and depression. Other non-hormonal treatments for menopausal symptoms include vaginal lubricants to reduce discomfort during sexual intercourse, and moisturizers that soothe irritated vaginal tissue.

Some people choose to take supplements to help relieve their menopause issues—such as black cohosh and red clover. But studies on the efficacy of supplements for menopause symptoms have been largely inconclusive. Also, herbal remedies aren't necessarily without side effects or drug interactions, so be sure to talk to your health care provider before adding one to your regimen.

Lifestyle changes

If you prefer to avoid HT and prescription medications, you may find success managing your menopausal symptoms through simple lifestyle changes and habits. These changes might include:

• Managing stress through relaxation techniques (e.g., yoga)
• Exercising regularly
• Reducing caffeine and alcohol consumption
• Quitting smoking
• Eating a balanced, nutrient-rich diet
• Practicing good sleep hygiene
• Maintaining a healthy weight

Maryon Stewart is a British author and broadcaster who has been showing women how to control their menopause symptoms naturally for 28 years. “Making dietary and lifestyle changes is a viable option for women at the time of their menopause,” she tells NCOA.

With a little science-based knowledge, it can be the beginning of a whole new, fulfilling chapter in a woman’s life,” Stewart said.

Be your own menopause advocate

October is World Menopause Month—and a great time to focus on your midlife health and wellness. If you're struggling with this transition, make it a priority to have an honest conversation with your health care professional. Together, you can review your menopause symptoms, discuss your family and medical history, and weigh your options for safe and effective treatment.

Having trouble finding a supportive provider to talk to about menopause? Locate a menopause clinician in your area using the North American Menopause Society directory.