Category: perimenopause

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Navigating the Waves of Menopause: A Bali Retreat, Feb 2024

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You don’t feel like yourself, you feel out of control, and you don’t know what you don’t know.

Your hormones are changing and you’re not equipped to understand what’s going on in your body and mind, much less how to deal with it and improve how you feel and behave.

It’s not your fault.

Our western culture keeps menopause in secrecy and there’s no intergenerational exchange of experiences to help guide you through the transition. And your doctor may not be a good source of support either…

But I am.

I help you navigate the menopause transition and I encourage you to change your mindset about this phase of life.

 

I invite you to join me in the Navigating the Waves of Menopause: A Bali Retreat February 11-19, 2024, and discover the transformative power of menopause. 

 

PAUSE. RETREAT. RESET.

 

Discover the Power of Your Midlife Journey

Join us in the tranquil beauty of Bali, February 11-19, 2024 for a unique retreat designed specifically for women navigating the transition of menopause.

This is a safe space to pause, reset, and reclaim your life during this potent period of transformation.

 

A Transformative Experience

Led by me, Teresa Isabel Dias, a renowned Certified Menopause Practitioner (NCMP) and experienced Pharmacist, this retreat offers a unique blend of science-based education and coaching, wellness practices, and social connection to navigate every stage of menopause.

Leveraging my extensive professional healthcare experience, I am committed to guiding you back to feeling like yourself again.

I’ll  share my experiences, advice, and resources to help you navigate this transition with grace, strength, and a renewed zest for life.

 

In the Navigating the Waves of Menopause: A Bali Retreat you’ll:

 

  • take a PAUSE from your busyness and reconnect with the essence of your own existence
  • RETREAT (break free) from society’s limiting beliefs and negativity about menopause
  • RESET your perception of menopause to accept it as a natural transition, a profound phase of growth, and a chance to rediscover your inner self.  Become empowered for the next chapter of your life!  Embrace your individuality and recognize that you’re not defined by age or reproductive status!

 

Join us in Bali

Uncover the power of collective experience and the strength of shared stories on this menopause retreat. You’ll join other women, just like you, who are navigating this time of change and self-discovery.

 

For more information and to sign-up for this wonderfully transformative menopause experience, click  here.

 

 

Are You Frustrated by Conflicting Advice on Menopause?

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Are You Frustrated by Conflicting Advice on Menopause?

 

Because there’s still a lot confusion, misinformation, and controversy when it comes to the menopause transition, Lindsay Dixon BSP RPh interviewed me on her Friendly Pharmacy 5 YouTube Channel to address important and relevant issues that aren’t talked about often enough.

 

In this interview we dive into the influential findings and flaws of the Women’s Health Initiative (WHI) trial that still prevent many women from receiving adequate treatment during menopause, and I share my expert perspective on the persistent problem of conflicting advice surrounding menopause.

 

Discover how the Women’s Health Initiative (WHI) has played a role in shaping the landscape of menopause education and management, and explore the options available to women today. Watch The Menopause Journey: Symptoms, Treatments, Supplements, Expert Insights here.

 

CHAPTERS:

 

00:00 Why menopause is confusing for women and healthcare professionals

02:19 Menopause Educator Teresa Isabel Dias

02:53 Teresa’s Menopause Story

05:24 How the Womens Health Initiative Trial change our approach to Menopause

08:53 Menopause Education for Healthcare Professionals

09:50 Definitions of Perimenopause and Menopause

12:18 Signs of Perimenopause

15:17 How Menopause Affects the Brain

17:15 Difficulty losing weight after menopause

18:32 Muscle Mass and Menopause

19:36 Bone Health and Menopause

21:35 Treatments for Menopause Symptoms

22:48 Breast Cancer Patients and Menopause Therapies

25:23 Non-Hormone Therapy Position Statement: NAMS 2023

26:22 Bioidentical Hormones and Topical Therapies for Menopause

30:32 Knowing you personal Risk in regards to Menopause Therapies

34:12 Hormone levels as data sets for menopause

36:25 Heavy Period and Bloating with Menopause or Perimenopause

38:27 Normalizing and Navigating Menopause

41:06 menopaused.org

 

 

Teresa Isabel Dias BSc Pharm RPh NCMP

I am a pharmacist and North American Menopause Society certified menopause practitioner (NCMP) residing in Canada with over 25 years of healthcare experience in women’s health. Specializing in midlife hormonal changes, I offer guidance on managing physical, emotional, and mental challenges, aiding women to regain balance and vibrancy in their lives, both professionally and personally.

My educational programs and supportive resources have been deployed to prestigious institutions and corporations including the Open Societies Foundation, CAA, Royal Bank of Canada, Maple Leaf Foods, the University of Waterloo, University of Toronto, Brock University, and Stantec. I’ve also contributed to valuable articles to pharmacy associations and the Pharmacy Practice + Business magazine.

My holistic approach to midlife women’s health aims to ensure women not only navigate the challenges of menopause successfully but also continue to lead fulfilling, productive lives during this transformative phase.

 

RESOURCES:

Teresa Isabel Dias BSc Pharm RPh NCMP

Website
LinkedIn
Email
Instagram
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MenopausED Newsletter sign-up

 

Lindsay Dixon BSP RPh

Lindsay Dixon is a Registered Pharmacist residing in Canada. She’s the recipient of the Ben Gant Practice Innovation award from the BC Pharmacy Association in 2021 and was most recently selected by Pharmacy Practice & Business Magazine as the recipient of the Raise Your Voice Award in 2022.

On her Friendly Pharmacy 5 YouTube Channel Lindsay provides advice, from the perspective of a pharmacist, to viewers like you about important and relevant topics such as gut microbiome, vitamin D, brain health, vitamin K, migraine prevention, sleep and immunity, and much more.

The channel has almost 30,000 subscribers – join them, subscribe, and watch here.

 

RESOURCES:

Lindsay Dixon BSP RPh
Website
Facebook 
Instagram
Twitter
LinkedIN
Email: friendlypharmacy5@gmail.com

 

DISCLAIMER: Friendly Pharmacy 5 health videos are for medical information only, and are NOT intended to replace recommendations and individualized assessments from your Primary Care Provider.

Please consider supporting the Friendly Pharmacy 5 channel – your support allows pharmacist Lindsay Dixon to improve the content quality and create more content for viewers like you! https://www.buymeacoffee.com/LindsayD…

 

Did you like the video The Menopause Journey: Symptoms, Treatments, Supplements, Expert Insights?

 

Share with your friends and family.

 

The more we talk about menopause the sooner we’ll normalize it and the better women will be supported through this inevitable change.

 

For every challenge that (peri)menopause poses there’s a solution. I can help you!

Do you know another woman who might like to read this blog? Share it with her.

Looking for something to read this summer?

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If you’re looking for books about important topics related to woman’s midlife health and wellbeing to read this summer keep on reading.

I love reading and am always getting ideas (too many) for books from friends, articles, my book club, podcasts, and others.

Recently I received an email from a subscriber with a link to an article in The Guardian, a British daily newspaper – All the rage: the rise of the menopause novel.

 

I went down a “book hole” and researched some of the novels in the article and a few sound good, and interesting. I haven’t read any of them but I put a few on hold at the Toronto Public Library where I get (FOR FREE!!!) the majority of the books I read and listen to (on Libby App).

 

The authors are women, British and Irish, who wrote “novels to take on the menopause” because of their own journey through the hormonal changes of midlife.

 

Joanne Harris, the author of Chocolate (remember the book or the movie starring Juliette Binoche, circa 2000?) says “Why do we always have to hear about the princesses? Why do we not get to hear more about the wicked witches and the stepmothers because that’s what the princesses will grow into eventually?”  AHAHAHAHAHA!

 

“These new novels dare to imagine the lives of women at the point where they have crossed into the abyss of middle age. When, as Victoria Smith puts it in her blistering polemic Hags, also published this year, they are dealing with “the loss of the Fs that matter most to the patriarchy: fertility, femininity, fuckability”.

 

And I have my personal favourites list for non-fiction literature about health and wellness for women in midlife that elaborates on my P.L.E.A.S.E. Yourself! Six Tips For An Easier Menopause Transition (Positivity, Less stress (or better, stress management), Eating healthy foods, Awareness of what your body is going through, Sleep, Exercise).

 

If you haven’t yet, please grab this quick guide and learn techniques to minimize menopause symptoms here (scroll down a few times to get to the right page).

 

 Here’s my book list. Happy reading:

 

Menopause – The Change For The Better by Deborah Garlick

Managing Hot Flushes & Night Sweats. A Cognitive Behavioural Self-Help Guide To The Menopause by Prof. Myra Hunter and psychologist Melanie Smith

The XX Brain by Dr. Lisa Mosconi

A Woman’s Guide to Healthy Aging: 7 Proven Ways to Keep You Vibrant, Happy & Strong, by Vivien Brown, MD

Moody Bitches: The Truth About The Drugs You’re Taking, The Sleep You’re Missing, The Sex You’re Not Having, And What’s Really Making You Crazy by Dr Julie Holland (for all women still ovulating/menstruating!)

Sleep After Menopause by Maria J. Sunseri, MD

The Joy of Movement – How Exercise Helps Us Find Happiness, Hope, Connection, and Courage by psychologist Kelly McGonigal

Better Sex Through Mindfulness – How Women Can Cultivate Desire by Lori A. Brotto, PhD

The Menopause Manifesto: Own Your Health With Facts And Feminism by Dr. Jen Gunter

 

I confess that I usually listen to audiobooks because it takes me months to finish reading a book due to lack of time. Or rather, lack of making time for reading a book (“me time”) which I’m always preaching that you (and my clients) should do…but this is a theme for another blog…

 

Feel free to share this blog and/or the link to P.L.E.A.S.E. Yourself! Six Tips For An Easier Menopause Transition with friends

 

The more women know about menopause the fewer will suffer through it and the better our society will be. And if it starts by reading a book all the better…

 

As always, if you need help nevigating your menopause transition let’s talk. Connect with me here

 

I’m in the national news as a menopause expert! 

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Exciting news!  I’m in the national news as a menopause expert!

 

A few weeks ago I was interviewed by the CBC about my favourite topic, menopause.

 

And last week CBC published this story, What Doctors Recommend To Treat Symptoms of Menopause Transition quoting a number of menopause experts, yours truly included!

 

Here are some snippets from the article:

 

There are more than 30 symptoms of perimenopause identified by the Menopause Foundation of Canada, like hot flashes and heart palpitations. Those symptoms can sometimes continue until the end of life.

But it’s important that women raise these symptoms with their health-care provider, according to Teresa Isabel Dias, a pharmacist and a North American Menopause Society certified menopause practitioner (NCMP) based in Toronto.

That way a doctor can rule out any medical conditions that may have similar symptoms to the menopausal transition, she said.

 

On hot flashes and night sweats:

 

Dias suggests going to bed cold by using lighter blankets, wearing pyjamas made out of cotton and keeping a glass of water nearby. Women have also used a cold compress for relief.

But, she says, for some, those methods aren’t enough.

“If you really have a hard time with night sweats, you’re going to have to do something else.”

Hormone therapy — systemic estrogen therapy and estrogen-progesterone therapy for those with a uterus — are the standard treatments, according to Dias and [Dr. Shafeena] Premji.

 

On weight gain:

 

A big hindrance to getting active is the fatigue that may come with the change. Women may experience it because of sleep disturbance, stress or because of inflammation caused by the changing estrogen levels.

Dias says she recognizes it can be hard to get a workout in when you’re fatigued, but to try to exercise as much as possible and to eat well.

“All these adjustments help a bit,” she said.

 

And on hormone therapy:

 

Experts say it’s not a one-size-fits-all approach to menopause hormone therapy as every woman has their own risk profile. Speaking to a health-care professional is essential.

Menopause hormone therapy for most women will generally include estrogen and progesterone, Premji said. Women who have had a hysterectomy will only receive estrogen.

Premji and Dias say the general guidelines on who can take hormone therapy to manage symptoms are: women who are younger than 60 with no medical conditions that preclude them from taking hormones, and women who are less than 10 years post-menopause.

 

Subscribers to my newsletter, and women who have heard one of my talks, have already heard all this from me. But it’s heartening to see that these concerns are getting a wider hearing in the national media.

 

You can subscribe to my MenopausED Newsletter here.
You can chat with me about your menopause transition here.

 

Menopause on White Coat Black Art with Dr. Brian Goldman

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Thank you Dr. Brian Goldman CBC Radio Host   and  Colleen Ross, award-winning journalist and Senior Producer of White Coat, Black Art and The Dose podcast on CBC Radio,  for boradcasting about menopause.

Because menopause is still very much taboo women are caught by surprise when they start perimenopause (the years leading up to menopause).

 

In perimenopause hormones fluctuate and women feel many changes – physical, cognitive and emotional.

Memory lapses, anger, crying spells, difficulty sleeping, hot flashes, night sweats, irritability, body shape change, aches and pains, are common.

Most women are unprepared for this change. The majority feels very alone on this journey.

Millions of people (everyone born with ovaries) are going through perimenopause as you read this.

Primary care physicians aren’t trained about menopause.

Women have to find answers on their own.

 

Listen to White Coat Black Art with Dr. Brian Goldman: The Menopause Movement: Part I  podcast and learn more  here.

I’m a North American Certified Menopause Practitioner (NCMP) and I can help you connect the dots and answer your perimenopause questions. Connect with me here.
 

 

Menopause is just heating up. Going mainstream.

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Menopause is just heating up.

 

Menopause has FINALLY gone mainstream. It was talked about on primetime television in Canada.

ON THE (CBC, The National) NEWS. ABOUT. TIME.

So the mainstream media is finally catching on!

There are millions of women in Canada and all over the world going through menopause.

 

Feeling the changes.

 

Needing good information and care.

 

Let’s take menopause out of the shadows. For the sake of our mental, physical, and emotional health.

 

Women need to advocate for themselves.

 

For women to advocate for themselves, they must know SOMETHING about the menopause journey in order to ask the right questions of their health providers.

 

So, I feel compelled to do an online workshop to discuss menopause and help you be your own health advocate.

 

Join me on January 12th at noon for 45 minutes of Let’s Talk About Menopause.

 

Register free here 

Invite your friends
Invite your manager and CEO. Menopause is the last health taboo in the workplace
Bring your questions (and your lunch).

 

 

On The National, CBC’s flagship newscast, this week: 

Menopause is having a moment, and many say it’s about time. Watch here.

 

Everything you need to know about menopause (and perimenopause). Watch here.

 

Have questions for me about menopause? Ask here.

 

Would you like to have a Lunch & Learn about menopause at your workplace? Email me

 

Share my Breaking The Silence & Ending The Secrecy of Menopause – 3 Strategies To Improve The Workplace Learn How To Break The Silence & End The Secrecy Of Menopause with your HR or Health & Wellness departments at work.

 

For every challenge that (peri)menopause poses there’s a solution. I can help you!

 

Would you t like to read my MenopausED Newsletter?  Sign-up here.

New year’s goals. New year’s habits.

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As you may know from experience, most new year’s resolutions don’t see March. That’s because they’re usually more wishes than real resolutions. Instead of making a new year’s wish I encourage you to set a new year’s goal(s).

 

What should your goal(s) for 2023 be?

Business coaches and experts ask entrepreneurs like me to define our “why” in order to set business goals and lay out plans and tasks to accomplish them.

 

The answer to my why, “why do I work on women’s health and specifically in menopause?”, is

  • women need to be aware of menopause,
  • women need good science-based and reliable information,
  • women need to know where to get support.

 

But recently I read—in This Year I Will by M. J. Ryan—a better approach to setting and working towards my goals.

 

Instead of “what is my why?”, the question becomes “what do I most want?”

 

  • I want menopause to be normalized,
  • I want women to know what to expect during the menopause journey and beyond,
  • I want women to have access to good information and support.

 

It’s a subtle change but it has made a big improvement in how I now define and work towards my goals.

You can also ask “what to I most want?” to define your health and other personal goals.

 

What do you WANT in 2023?

 

When setting a goal, be specific about what you want to accomplish.

  • To achieve a goal you need to focus your attention and resources on what is most important so you can set your priorities.
  • How important is the goal to you and what you can do (alone or with help) to make it attainable?
  • The goal is meant to inspire motivation, not discouragement.
  • You can set goals, but if it lacks realistic timing, chances are you’re not going to succeed.
  • Write it down.
  • Share your goal intentions with others ( let me know what your menopause goal for 2023 is)

 

For better results when setting a goal make it S-M-A-R-T – specific, measurable, achievable, relevant, and timely.
For example, if  your goal for 2023 is to manage your menopause symptoms so you can enjoy a vibrant and productive life, then the S-M-A-R-T criteria may look like this:

 

 

Specific – I WANT to reduce my menopause symptoms.

 

Measurable – (What data will measure the goal? How much? How well?)

I WANT to decrease hot flashes/night sweats; I WANT to treat vaginal dryness & decrease pain with sex; I WANT to experience less brain fog, I WANT to minimize anxious thoughts, I WANT to increase my energy).

 

Achievable – (Is the goal doable? Do you have the necessary skills and resources?)

Do I need help? I know I can call Teresa Isabel to figure out my best course of action to improve my menopause symptoms.

 

Relevant – (How does the goal align with broader goals? Why is the result important?)

If I stop the night sweats I will sleep better and have more energy. If I initiate a treatment for vaginal dryness then my relationship with my partner will improve and we’ll feel closer to each other. If I control my anxious thoughts then I will feel more relaxed, work more efficiently, and enjoy my life better.

 

Timely – (When are you going to do this?) A vague “I’ll do it someday” or “soon” or “when I have time” is unlikely to succeed – it’s too easy to put things off indefinitely.

A timely goal sets a timeframe – I will do X (i.e. book a Discovery Call with Teresa Isabel in January), Y in February, and Z before my summer vacation. Something like that.

 

Go ahead:  Figure out your goal.

 

What do you most WANT for 2023?

 

Write down your S-M-A-R-T goal.

 

Allow me to help you decrease your menopause symptoms in 2023 and beyond so you can feel like yourself again and enjoy a vibrant, and productive life.

 

Let’s talk.

Connect The Dots

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What should you expect in perimenopause?

Expect the unexpected. And connect the dots.

 

In perimenopause (the years leading up to menopause) your ovaries start showing signs of aging (they age faster than you do!) and do not perform as predictably and regularly as they used to.

In perimenopause things start to change.

 

Many say perimenopause is puberty in reverse. In puberty you learned to live with sex hormones like estrogen (the predominant female sex hormone) and progesterone as your ovaries matured.  In perimenopause these hormones are fluctuating again and declining.

Because estrogen acts in so many tissues and organs in the body it’s common to experience many changes during perimenopause which can last 3-6 years or even longer for some.

It’s OK not to feel any changes other than the end of period.

6 in 10 women tend to experience several changes (aka symptoms).

 

2 in 10 experience severe and debilitating changes that can turn their lives upside down.

 

Most people know about hot flashes but most are not aware that sleep difficulties, brain fog, anxiety, mood swings, depression, anger, and loss of self-confidence can also be part of the perimenopause experience.

 

Changes can be physical, cognitive, and emotional. And as with many other changes in life, it may be hard to accept and to go through. But being prepared will make it easier and should reduce the accompanying fear and worry.

 

Menopause isn’t new but now women are working right through it. And it can be downright difficult to cope with. Add to that the fact that menopause is

  • overlooked by our healthcare system
  • overlooked by our workplaces
  • is a big taboo that no one talks about.

No wonder the majority of women feel isolated and think they are the only one.

You may be feeling alone but you’re not the only one.

 

I don’t mean to scare you with a long list of challenges. In fact, you probably won’t experience all these symptoms—definitely not all at the same time—and because perimenopause is a journey, your experience may change with time. And things do get BETTER in postmenopause when hormone levels stabilize.

My main goal is to help you connect the dots and empower you to be your own health advocate.

 

When you go to the physician and your complaints are dismissed, or you get a diagnosis that doesn’t sit right with you (depression and anxiety are common examples), I want you to connect the dots – think about all the things you’re experiencing and feeling. Being aware and connecting these experiences will help you see that what you’re going through is probably related to the hormonal changes of midlife.

Because, contrary to what you may have been told by a doctor—that this is just part of life and therefore you must put up with it—even though menopause is unavoidable, suffering is an option.

 

There are myriad options to improve your symptoms, make your journey easier, and help you feel like yourself again and enjoy a vibrant and productive life.

Let me help you find the best for you.

“Just get out there”

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A few years ago I celebrated my birthday by joining a guided kayak tour of Isla Espiritu Santo in Baja California.

The first night was memorable for all the wrong reasons.

 

We were camping on a beach and I just couldn’t get comfortable, my pillow wasn’t the right size, the ground wasn’t flat enough, and my thoughts were very negative. These thoughts kept popping into my mind:

“why the hell do I book myself into these adventures to have a good time and end up in discomfort”

“I’m too old for adventure vacations. I should know better and avoid the hassle”.

“I shouldn’t have booked a kayak trip to Greenland next summer if I can’t even enjoy camping in a nice warm beach”.

The first morning was also memorable but for a very good reason.

 

The first travel companion I met when I groggily and grumpily got out of my tent was Warwick, a 70-something year-old Australian man travelling alone and recovering from cancer. He greeted me bright-eyed and bushy-tailed with a happy “morning mate”. I grumbled some greeting back and he asked what was wrong (what could possibly be wrong on a sunny, picture-perfect, white sandy beach, right?). I explained I hadn’t had a good night. To which he replied:

“The older we get the harder it is to be comfortable.”
“Don’t let that prevent you from enjoying yourself. JUST GET OUT THERE!”

 

Warwick’s words changed my outlook on life F.O.R.E.V.E.R.

 

Since then, whenever I feel physically uncomfortable, I think of Warwick’s advice and it helps me to see the situation in a new perspective and with more positive mindset. That helps me to keep trying things that get me out of my comfort zone; and those things help me feel alive, youthful, and vibrant.

This week, with Warwick’s words in mind, I pushed myself to go cross-country skiing in the park after the first snowfall of the season; even though I felt more like staying home and not risking an injury. Of course, one hour later with rosy cheeks and a dripping nose, I was very glad I was OUT THERE.

Winter weather, for me and probably you, is here. Cold and snow are probably going to be around for a while.

Don’t let that keep you from going outdoors. The benefits for your menopause transition and overall health are immense.

 

  • There’s no cold, just improper outwear. Make sure you have boots or shoes that fit well and have a good grip. Ice cleats can give you extra traction when you’re walking on snowy or icy surfaces. You can buy these at department or sporting goods stores.
  • Walking on natural uneven terrain is better for your body, joints, bones, and muscles than on flat indoor surfaces and treadmills.
  • Natural light, early in the day, helps regulate your melatonin levels and improve your circadian rhythm. Combine that with avoidance of screens two hours before bed and your sleep might improve. What do you do instead of watching TV or being at the computer in the evening? Read a book, take a bath or shower, talk with a friend or partner, play a game, stretch, meditate, do breathing exercises, and go to bed early; the earlier sleep is the most restorative.
  • Movement burns calories and helps you maintain or lose weight, which tends to creep up in perimenopause.
  • Exercise releases endorphins, happy hormones, that make you feel happier and less moody and blue.
  • Walking fast is a form of cardio-exercise which is good for your heart
  • Walking is also good for your brain. Together with enough water intake (2 litres a day, before 7 PM) it improves cognition and decreases the brain fog that’s commonly reported during the menopause transition.
  • Walking and other weight-bearing exercises, along with optimal ingestion of calcium, vitamin D, and magnesium, is good for your bones. It helps decrease the risk of osteoporosis which otherwise rises greatly in the years following your last menstrual period.
If you haven’t built the habit of walking, I strongly encourage you do so.

 

Start small and safe. In time speed it up and increase the distance to 10,000 steps which research from the Universities of Australia and Denmark show is the ‘sweet spot’ for lowered risk of disease and death.

Whatever way you walk, some is better than none. Sitting is the new smoking.

 

Would you like to improve your menopause journey, feel like yourself again, and have a vibrant and productive life? Give me a call.

 

The Menopause Stages

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The menopause stages can be confusing. Premenopause. Perimenopause. Menopause. Postmenopause. What do all these words mean and why is it important to use them properly when describing where you are in the continuum of menopause?

Here are some reasons why it is important to know where you are in this journey:

• to know what to expect
• to get the most effective and safe symptom management since, for example, hormone therapy will differ if you take it in perimenopause versus in postmenopause.

Premenopause/Reproductive Years

Between puberty—when ovulation (and accompanying production of estrogen and progesterone), periods, and fertility start—and perimenopause are the reproductive years, whether or not a woman gets pregnant.

Perimenopause/Menopause transition

Female sexual hormones—estrogen (the predominant female hormone) and progesterone—start fluctuating in perimenopause, indicating the start of changes in ovarian function. Women who previously had regular menstrual periods may start noticing changes, such as shorter intervals between periods, lighter or heavier bleeding, shorter or longer bleeds, spotting between periods, and in some months even no bleeding at all. This is usually the first change women notice in perimenopause, but many women also report hot flashes, fatigue, aches and pains, difficulty sleeping, headaches, dry itchy skin, mood swings, anxiety, depressive feelings, low sexual desire, hair loss, weight changes, body shape changes, palpitations, irritability, foggy brain, bladder problems, dizziness, and others. Perimenopause can start in a woman’s late 30s or early 40s and last 2-6 years.
Perimenopause is a journey. The unpredictability of not knowing when the next period is going to come, when or if ovulation is going to occur, and experiencing spotting can be upsetting and frustrating for many women.
Women who are sexually active and don’t wish to get pregnant must use birth control until at least 12 months after the last period because ovulation is unpredictable in perimenopause but may still occur. Perimenopause can start in a woman’s late 30s or early 40s and last 3-6 years.

Menopause

Menopause is the end of ovarian function, the end of ovulation and fertility, and consequently periods stop as well.
How do you know when you are in menopause? Menopause is confirmed when you haven’t had a period for 12 consecutive months. The next day you are in postmenopause! Congratulations! Celebrate this milestone!
All women go through menopause if they live long enough, and for most women it is a normal and natural event.
Menopause usually happens between 45 and 55 years of age, and the average age of menopause in North America is 51. Some women may experience early menopause, before 40 years old.

Induced menopause/surgical menopause

Induced menopause occurs when a woman undergoes removal of both ovaries and/or chemotherapy and radiation treatments (which damage the ovaries) for certain types of cancer. Women who experience induced menopause at a younger age experience more severe symptoms due to the very sudden drop in estrogen levels and are at higher risk for diseases related to low estrogen levels, like osteoporosis, dementia, and heart disease.

Postmenopause

These are the years after menopause is confirmed and postmenopause lasts for the rest of the woman’s life. Many women will live past their 80s and will spend one-third of their lives in postmenopause. It’s important to understand the protective effect of estrogen against diseases like stroke and heart attack, osteoporosis, and diabetes to help you make healthy lifestyle choices to ensure healthy aging and prevent disease.

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