Incredible. Beautiful. Magnificent. From puberty to the menopausal transition, a woman’s body is a wonder. Womanhood is more than fertility and youth. All stages of female development are amazing – and the metamorphosis from childbearing to graceful aging is no different.

We take a deep dive with Amantia Kennedy, MD, FACOG, of WakeMed Obstetrics & Gynecology, into the menopausal transition and what women can expect as their bodies move into a new stage of freedom in womanhood.

Is it just a women’s thing?

First, it’s interesting to note that hormonal transitions in fertility apply to both men and women. While women go through menopause, men undergo andropause. Aging happens in all sexes, so women should feel confident that this is normal, anticipating the changes with intrigue and hope.

What exactly is menopause?

Menopause is the final period in a woman’s reproductive life. Women are designed this way, so it’s important and even comforting to understand that they are not alone, and their experiences are not an anomaly. The timing of menopause is based on a woman’s age and other factors. Some women will enter the transition in their early 40s, some mid-40s, and some late 40s. That transition into menopause, known as perimenopause, is characterized by irregular cycles and hormonal changes and fluctuations. Cycles may come a bit later than normal. Some women will skip a month. Once this starts, a woman will predictably achieve menopause within one to three years. Menopause is diagnosed after 12 consecutive months of amenorrhea (absent periods) due to the lack of hormonal production from the ovaries.

What are some common symptoms?

Estrogen levels vary throughout the menstrual cycle and fall after menopause. When production decreases, organs throughout the body are affected, leading to a range of symptoms.

– Hot flashes, also called vasomotor symptoms, are the most common symptom of menopause. They cause a sudden feeling of warmth, usually most intense on the face, neck, and chest.
– A woman’s skin may redden, and she may experience profuse sweating. Night sweats can also appear during this time which are essentially hot flashes at night, during sleep.
– Loss of muscle mass and weight gain happen naturally with aging. During the menopausal transition, muscle loss is accelerated due to the low estrogen levels. This results in more pronounced weight gain, particularly an increase in inflammatory visceral fat around internal organs.
– Brain fog happens because estrogen increases blood flow to the brain, and when those estrogen levels drop, the brain has to acclimate. When this change in hormonal fluctuation occurs during perimenopause and finally menopause, it affects the brain, and women, in turn, may feel off and forgetful. The good news is that this is temporary! Findings show menopause does not impact a woman’s cognitive ability or ability to process information.
– Sleep disturbances, including difficulties falling and staying asleep, can occur due to the fluctuation of the hormones.
– Depression and anxiety can be accelerated during menopause.
– Elevated heart rate is also common and can include heart palpitations and heart racing.

What help is available to treat menopausal symptoms?

The bottom line is that there is help. Psychiatrists, family practitioners, and gynecologists are very in tune with what’s happening during this time. It is important to talk with a doctor who has a special interest in menopause. Hormonal and non-hormonal remedies are available. Hormone therapy may include estrogen and progesterone for women who have a uterus, or estrogen alone may be administered to women who do not have a uterus. Non-hormonal therapies include newer medications on the market, specifically targeting the part of the brain that regulates the internal bodily thermostat. It can effectively reduce hot flashes and night sweats by 80%. Other non-hormonal medical treatments for women who either don’t want the hormones or have contraindications to hormones are in the antidepressant family. Antiepileptic medication can be very effective in low doses for management of night sweats and sleep disturbances. Antihypertensive medication is another option.

Dr. Kennedy emphasizes that menopause does not detract from a woman’s value and purpose. It is freedom from monthly period cycles, contraception, and the risk of becoming pregnant – which can positively impact intimacy. Women should take pride in aging and take precautions to age well, including being screened for diabetes and cardiovascular disease.

Dr. Amantia Kennedy is an obstetrician-gynecologist with WakeMed Obstetrics & Gynecology. Her clinical interests include infertility, menopause, and high-risk obstetrics as well as minimally invasive and robotic-assisted surgery. WakeMed Obstetrics & Gynecology provides a full range of services for women of all ages in Raleigh, North Raleigh, Brier Creek, Cary, Clayton, Fuquay-Varina, Holly Springs, Morrisville, and Wake Forest.