Menopause. It used to be a word not to be uttered, cloaked in embarrassment, shame and inevitable ageism. Today it’s a hot topic. Long gone are the days when women quietly receded into the background to suffer their debilitating symptoms in silence.

Famous women such as Naomi Watts, Oprah Winfrey, Michelle Obama, Cameron Diaz and many more are speaking openly about their experiences, removing the stigma one important conversation at a time.

Women are finally leaning into learning about this incredibly significant phase of life, how to celebrate it and how to mitigate health risks associated with it.

Symptoms and Phases of Menopause

There are more than 30 symptoms women should be aware of during their menopause transition. They may suffer from some of them, or if very lucky, none of them.

However, because the menopause process involves the whole body and not just a woman’s reproductive system, if certain aspects of a woman’s health are not tended to during this transition, they may suffer negative long-term health outcomes.

But first, more details about this stage of every woman’s life.

  1. Perimenopause

Menopause is a lengthy process the female body undergoes, with perimenopause describing the years of life a woman spends transitioning into menopause. This phase typically lasts between 4 to 15 years.

For those of us privileged enough to reach middle age, the process will start at around 40 and last to the age of 58 at the latest, with most women reaching menopause around the age of 51.

More than 95 per cent of women will experience signs of perimenopause, however awareness of these symptoms is very low. According to the Society of Obstetricians and Gynecologists of Canada, you can expect symptoms such as:

  • Irregular and/or heavy, prolonged menstruation and worsening of PMS
  • Hot flashes
  • Night sweats
  • Palpitations
  • Sleep disturbances
  • Anxiety attacks
  • Difficulty concentrating
  • Fatigue
  • Irritability
  • Memory loss
  • Mood swings
  • Joint aches and pains, without swelling
  • Changes in eye and oral health

However, during perimenopause other dramatic changes are at play within a woman’s body that can profoundly impact bladder health, sexual health, heart and vascular health, lung health, cancer risk and bone health.

  • Menopause

Menopause is the time between the final menstrual period followed by 12 months without a period. During this year a woman can generally expect to experience the same symptoms she experienced in perimenopause, with the difference being the total cessation of menstruation.

After the one-year mark, a woman is in the post-menopause phase.

  • Post-Menopause

Post-menopause describes the period following a woman’s final menstrual cycle. Once a woman reaches post-menopause, she stays in this state for the rest of her life.

Fortunately, this means that the pain of suffering through menstruation is finally over, along with many of the nasty symptoms of perimenopause. Unfortunately, some menopausal symptoms don’t disappear immediately, rather they dwindle over time as the process carries on.

Many women continue to experience vasomotor symptoms and insomnia for upwards of 10 years in the post-menopausal period. Vaginal dryness becomes a permanent fixture of life, and recurrent urinary tract infections may become a problem if not treated.

Additionally, the decrease in estrogen can contribute to very real health problems in the post-menopausal phase. Osteoporosis, cardiovascular disease, cancer, depression, sexual dysfunction, decreased lung function and urinary incontinence can be experienced by women in post-menopause.

Finding a Qualified Menopause Care Provider

Even though Canadian women are feeling more knowledgeable about the topic, the same cannot be said for our medical community. It’s estimated that 41% of medical schools do not include menopause education in their undergraduate curriculum, with few residencies and fellowships available to train aspiring doctors. Unsurprisingly, there are significant knowledge gaps regarding menopause management among practicing physicians.

In light of this, ask your doctor if they are qualified to treat menopausal women. Don’t assume that your gynecologist is qualified to treat you. Menopause affects the whole body, not just the reproductive system. You may however want to consult a urogynecologist for pelvic-floor specific ailments.

While treatment of many of the aspects of menopause should be available through your family physician, if they are not qualified to treat menopausal women, ask for a referral to a menopause-specific clinic if there is one near you.

There are publicly funded clinics in Canada such as the Mt. Sinai clinic in Toronto or Ottawa Hospital Menopause clinic, however the wait list at these clinics is predictably long.

With this in mind, it may be worth exploring private clinics that are popping up in many cities around the country. To find a menopause specialist, search the North American Menopause Society’s Database or ask your friends if they can recommend one. Most menopause clinics are led by MD’s or NP’s who are certified in menopause care; read their online reviews for a full overview of the expertise of any healthcare provider you are considering.

It is imperative that women be aware of the process taking place in their bodies to mitigate the long-term health risks and enjoy this glorious phase of life in health and wellness.

By thoroughly educating ourselves and seeking out the most knowledgeable menopause healthcare providers, we can ensure that these years are the most joyful, creative and productive of our lives.

As Oprah Winfrey so eloquently said, “So many women I’ve talked to see menopause as an ending. I’ve discovered that this is your moment to reinvent yourself after years of focusing on the needs of everyone else.” Indeed.

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