Menopause is a natural transition in every woman’s life, yet it remains a topic that’s often hushed, misunderstood, or stigmatized. According to the National Library of Medicine, menopause impacts about 1.3 million women in the United States each year. For many women, it’s a time marked by physical and emotional changes that they’ve never experienced before, which can feel overwhelming. The more we openly discuss menopause, the more we can equip women with the tools they need to manage their symptoms and embrace this new chapter of life with confidence.
Understanding the Menopause Experience
Menopause marks the permanent end of a woman’s reproductive years, typically occurring between the ages of 45 and 55, with the average age in the U.S. being 51. Officially, menopause begins after 12 consecutive months without a period, signaling a significant drop in hormones, particularly estrogen. But the process doesn’t happen overnight—symptoms can start years earlier, during a phase known as perimenopause.
It’s important to remember that everyone’s menopause journey is different. Some women may breeze through with minimal symptoms, while others experience intense physical and emotional ups and downs. That’s something I always emphasize to my patients: menopause doesn’t signify the end of life or beauty—it’s just a new chapter. Each woman’s experience is valid, and there’s no “right” or “wrong” way to navigate this transition.
Physical and Emotional Symptoms
Menopause brings a wide range of symptoms that vary from woman to woman. Some of the most common physical symptoms include hot flashes, night sweats, vaginal dryness, sleep disturbances, and weight gain. These can be frustrating and often leave women feeling disconnected from their bodies. Emotional symptoms, such as mood swings, anxiety, and brain fog, add another layer of complexity to this phase.
One of my patients, Anne*, came to me feeling completely lost. She is 52 and has recently entered menopause. She had always been active and full of energy, but suddenly she found herself struggling to stay awake during the day, sleep throughout the night, and having intense hot flashes. “I feel like I’ve lost control of my own body,” she told me. “I don’t know who I am anymore.” Anne’s experience is similar to so many other patients that I’ve treated. The physical changes that come with menopause can leave women feeling like they’re losing control, leaving them to question even their identity.
Hot flashes are perhaps the most well-known symptom of menopause. These sudden, intense feelings of heat can be incredibly disruptive, especially when they occur at night, leading to night sweats and sleep disturbances. Vaginal dryness is another common issue that can affect a woman’s sex life, causing discomfort during intimacy. However, the psychological toll is just as impactful, with many women reporting mood swings, irritability, and even depression.
Many of my patients report that they do tend to blame themselves, feeling guilty for their negative moods or fatigue. So I feel like it is crucial to emphasize that these emotional shifts are directly linked to the hormonal changes happening in the body and are not a reflection of their character or strength.
Every Woman’s Journey is Different
One thing I’ve learned from working with women over the years is that no two menopause experiences are exactly alike. While some women struggle with intense physical symptoms, others might find the emotional changes to be the most challenging part of this transition. For many, it’s a mix of both.
I recall recently working with Sara*, who was going through menopause while juggling a highly demanding career and raising two teenagers. She wasn’t experiencing the typical hot flashes or weight gain, but she was overwhelmed by brain fog and forgetfulness, leaving her feeling completely inadequate at work and as a mother. “I used to be so sharp and on top of things,” she shared. “Now I feel like I’m constantly dropping the ball with my kids and my job, I just can’t win.” For Sara, the emotional symptoms were far more challenging than any physical changes. So, addressing her concerns meant focusing on her mental well-being and finding ways to manage stress in addition to balancing her hormones.
Conversely, another patient, Maria*, struggled deeply with physical symptoms like joint pain and thinning hair. She was a fitness enthusiast who put a lot of time and energy into her body but now felt like her body was betraying her. “I used to feel strong and excited to train, and now my body aches all the time. I don’t recognize myself anymore.” Maria’s journey required a focus on physical rehabilitation and tailored treatments to help her manage the discomfort in her joints while maintaining her desired active lifestyle.
Both Sara and Maria had completely different experiences with menopause, yet both felt like they were losing a sense of their own identity. This is why it’s so important to emphasize that menopause is a personal journey, and no two women will go through it the same way.
Embracing Menopause – It’s Not the End
While menopause signals the end of fertility, it doesn’t mark the end of life, purpose, or joy. In fact, many women find that once they’ve navigated the initial discomfort of menopause, they enter a new phase of empowerment. For some, it’s an opportunity to reconnect with themselves, pursue new passions, or take better care of their health and well-being.
Menopause doesn’t have to be a negative experience. In my practice, I always tell women that this stage of life is about transformation, not decline. There are many ways to manage symptoms and embrace this new chapter with grace and confidence. Whether through lifestyle adjustments, medical treatments, or simply finding a supportive community, there are tools to help every woman thrive during menopause.
An Integrated Approach to Menopause
Because menopause affects every woman differently, taking an integrated, holistic approach is essential. Addressing the physical, emotional, and psychological aspects of menopause can help women feel more in control and confident as they move through this transition.
Mindset and Lifestyle
Mindfulness and Stress Management: Techniques like meditation, yoga, and deep breathing can be incredibly beneficial for managing stress, improving sleep, and enhancing overall well-being. While these practices take time to incorporate into daily life, they offer long-term benefits that help women feel more grounded.
Healthy Diet and Exercise: A balanced diet rich in nutrients, paired with regular physical activity, can support hormone balance and overall health. Women who stay active often report feeling more in tune with their bodies and experience fewer physical symptoms.
Sleep Hygiene: Prioritizing quality sleep is key to managing mood swings and maintaining energy levels. Establishing a bedtime routine and creating a calming environment can make a significant difference.
Bio-Identical Hormone Replacement Therapy (BHRT)
One of the most effective treatments I recommend to many women is bio-identical hormone therapy (BHRT). This treatment uses plant-derived hormones that are chemically identical to those produced by the human body, making them a natural and personalized option to balance hormones. This therapy helps to alleviate symptoms like hot flashes, night sweats, mood swings, and vaginal dryness. At about two weeks into hormone replacement therapy, patients report feeling an increase in stamina, libido, and overall quality of life.
I can’t count how many of our BHRT patients have told me that I saved their life. While that may be a little dramatic since all I do is help to balance their hormones and give them coping strategies, many women come to us for BHRT as a last resort because they’ve tried all the other medical options recommended by their doctor. These women are basically at their witts end and they come to us as their final hail mary attempt to feel some semblance of normalcy again and I couldn’t be more proud and honored to help them do so.
Embracing The Change
Menopause is a time of change, but it doesn’t have to be a time of loss. By understanding the symptoms, adopting healthy lifestyle habits, and exploring treatment options like BHRT, women can navigate menopause just a little easier. This stage of life is not the end—it’s a new beginning, filled with opportunities to embrace one’s body, mind, and spirit in a deeper, more meaningful way.
Menopause doesn’t define who you are—it’s a brand new chapter in your story. It’s clear marking of a new beginning typically leads women to think more about how they want the rest of their story to go. With the right support and resources, every woman can thrive during this transition and emerge stronger than ever.
*Names have been changed by author.
Bette Smith and Teresa Reynolds photographed by Danielle Barry, Creative Director. Floral designs by Still Waters Flower Farm and Killer Blooms.
Additional resource:
Peacock K, Carlson K, Ketvertis KM. Menopause. [Updated 2023 Dec 21]. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2024 Jan-. Available from: https://www.ncbi.nlm.nih.gov/books/NBK507826/
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