AS women, we journey through three defining periods in our lives: our regular menstrual cycles, perimenopause, and, eventually, menopause. Each stage represents a unique phase of physical and emotional evolution, requiring us to understand, adapt, and thrive through these transitions.

World Menopause Day, recognised on October 18, proved to be an opportune time to demystify menopause, share insights on, and encourage women to view it as an empowering phase of life, where proactive health management can significantly enhance well-being.

What is menopause and when does it happen?

Menopause marks the end of a woman’s reproductive years. It is defined by the permanent cessation of menstrual periods, typically occurring between the ages of 45 and 55, with the average age being around 51. It is often misunderstood as a sudden event, but menopause is a gradual transition that begins with perimenopause, a stage that can last for several years.

Perimenopause is the transitional period leading up to menopause, where hormonal changes — particularly fluctuating oestrogen levels — begin to manifest in various physical and emotional symptoms. Many women enter perimenopause in their 40s, though some may begin experiencing it in their late 30s. Perimenopause and menopause together are natural biological stages that every woman will experience, yet they affect each individual differently.

Perimenopause vs menopause: What’s the difference?

Perimenopause is characterised by irregular menstrual cycles, hormonal shifts, and symptoms like hot flashes, night sweats, mood swings, and sleep disturbances. These signal the body’s preparation for menopause but do not indicate the end of reproductive function.

In contrast, menopause is a defined point — the moment when a woman has not had a period for a full year. Many women approaching menopause report a range of symptoms, some of which may be disruptive to daily life, with symptoms like vaginal dryness, decreased libido, cognitive changes (often referred to as ‘brain fog’), and shifts in mood continuing for some time after menstruation has ceased.

Impact on mental health and relationships

The emotional and psychological toll of menopause can be profound. Mood swings, heightened anxiety, and even depression may become more pronounced during this period. The ‘brain fog’ that many women experience can contribute to feelings of inadequacy or low self-esteem, affecting personal and professional relationships. Recognising these symptoms and seeking support — whether through health-care providers, mental health professionals, or peer groups — can make a significant difference.

Relationships may also be impacted by the physical changes brought about by menopause, particularly the challenges of decreased libido and vaginal dryness. Open communication with partners and health-care professionals can help women navigate these changes, maintaining intimacy and emotional connection.

Managing symptoms: The role of hormone replacement therapy (HRT)

Hormone replacement therapy (HRT) can be life-changing for women, offering significant relief for many women by replacing the hormones that decline during menopause, but it should be approached with caution and tailored to each individual case. It is particularly effective in alleviating symptoms such as hot flashes, night sweats, and mood fluctuations, improving overall quality of life. However, HRT is not without risks, including a slightly increased chance of breast cancer and cardiovascular issues when used long-term or initiated later in life. Therefore, it is essential for women to consult with a menopause-educated physician to weigh the benefits and risks based on their individual health history and if chosen, regularly review its necessity with their health-care providers.

Lifestyle changes for a healthier transition

While HRT can be an option for managing menopause symptoms, lifestyle changes can also play a crucial role in easing the transition. Maintaining a healthy diet, regular exercise (especially strength training and weight-bearing exercises), and stress management techniques like meditation or yoga can help mitigate symptoms. Adequate hydration and quality sleep are also vital to overall well-being.

Additionally, long-term health considerations, such as bone density and cardiovascular health, become particularly important during and after menopause. The decline in oestrogen levels can increase the risk of osteoporosis and heart disease, making regular check-ups, a balanced diet, and consistent physical activity essential.

Embracing the menopause journey

Menopause should not be viewed as the end of vitality but as a new beginning. It is a time to focus on personal goals, health, and self-care, free from the demands of monthly cycles. By breaking down the myths and misconceptions surrounding menopause, we can change societal perceptions and empower women to embrace this phase with confidence, knowing that with the right support and management it can be a time of renewal and opportunity.

Let us recognise the importance of proactive health management and encourage women to navigate this phase with grace, strength, and a sense of possibility.

Dr Dainia Baugh is chair of the HIC Foundation and internist and menopause specialist, Heart Institute of the Caribbean (HIC).