You’ve seen it before. The woman next to you suddenly starts fanning herself and loosening her shirt collar. She’s experiencing something familiar to most women in midlife: hot flashes.

Maybe this woman is you. If not, it could be someday. You may not be destined for hot flashes, but menopause is a given. And it doesn’t just happen overnight.

What can you expect with menopause? What symptoms will you have? How can you make the transition easier? The American College of Obstetricians and Gynecologists (ACOG) provides answers to your questions about menopause.

Q: What is the difference between perimenopause and menopause?

A: Beginning in your 30s and 40s, the amount of estrogen produced by the ovaries begins to fluctuate. The years leading up to menopause are called perimenopause, and are usually marked by a change in your menstrual cycle. When the ovaries stop producing hormones, and you have had no menstrual period for a full year, you have reached menopause.

Q: What symptoms can I expect?

A: You may experience some of the following common symptoms in the years leading up to menopause:

• Menstrual cycle changes – Your cycles will likely sputter before they stop. You may have periods that are longer, shorter, heavier or lighter than usual, or you may begin to skip periods.
• Hot flashes – A hot flash is a sudden feeling of heat rushing to the upper body and face. It can last from a few seconds to several minutes, many times a day or just a few times a month.
• Sleep problems – This is a classic sign of menopause and can cause fatigue. You may have trouble falling asleep, you may wake up earlier than usual, and/or you may have night sweats.
• Vaginal dryness – As estrogen levels decrease, the lining of the vagina may become thinner, dryer, and less elastic.
• Urinary issues – The urethra can become dry, inflamed or irritated, causing more frequent urination and increasing the risk of urinary tract infections.
• Emotional changes – Sudden shifts in hormones may cause mood swings, anxiety, irritability, depression, fuzzy thinking and forgetfulness.

Although each women experiences menopause differently, symptoms usually decrease in severity and frequency over time, and eventually stop, after you reach menopause.

Q: When will menopause happen for me?

A: The average woman reaches menopause at age 51. But, you may start the transition as early as your 30s or as late as your 60s. Perimenopause can last from a few months to more than 10 years prior to your final menstrual period. A good indicator of when you’ll begin menopause is when your mother did.

Q: Will menopause ruin my sex life?

A: Menopause doesn’t play as big a role in sexual problems as once thought. While some menopausal women see a dip in libido, for others, the issue is vaginal dryness (caused by a drop in estrogen), which can make sex painful. Ask your doctor about water-based lubricants, vaginal estrogen or other options.

Q: Is weight gain inevitable with menopause?

A: Weight gain is not inevitable, it’s just more difficult to prevent. As your metabolism slows down and fat storage in your body redistributes, it can be more difficult to control your weight (especially around your waist). But it can be done! A proper diet, portion control and regular exercise helps.

Q: What are treatments for menopause?

A: There are many treatment options available, usually targeted to reduce the specific symptoms you are experiencing, such as hot flashes or insomnia. Hormone therapy (estrogen with or without progestin) can help relieve menopause symptoms and protect against bone loss, although there are risks involved as well, so ask your doctor if it’s right for you.

Q: What health risks should I be concerned about after menopause?

A: After menopause, the risk of chronic diseases increases due to decreased levels of estrogen. This includes an increased risk of heart disease and stroke, osteoporosis and bone fracture.

Q: What can I do to stay healthy after menopause?

A: A healthy lifestyle can help you make the best of the years after menopause. The following are some ways to stay healthy during midlife:

• Eat a balanced diet rich in vegetables, and enough calcium and vitamins A, C, D and E.
• Exercise regularly to reduce hot flashes, slow down bone loss, and improve your mood, among other benefits. Weight-bearing exercise, such as walking, can help keep bones strong.
• Dress in layers, and keep cold water nearby for when hot flashes strike.
• Avoid hot or caffeinated beverages at bedtime, and keep your bedroom cool.
• Quit smoking.
• Listen to your body. Write down your symptoms and share with your doctor.
• Try Kegel exercises to help with an overactive bladder.
• Try stress reduction techniques like yoga, deep breathing, meditation or acupuncture.
• Visit your doctor once a year to have regular exams and tests.

Menopause marks the end of the reproductive years, but it’s also the start of something new. Sometimes referred to as “adolescence in reverse,” menopause is a developmental milestone in a woman’s life. It’s what you make of it. And there is an upside … no more periods!

Learn more about women’s health services at Edward-Elmhurst Health.

What experiences can you share about menopause? Let us know in the comments below.