Many people have questions about menopauseWhen will it start? What is normal? Does it feel like this for everyone? What can I do about it? How can I support someone going through it?

In honor of the women who have asked these questions, here’s a blog to get the conversation started! Although the information below won’t answer all of your questions, it could be a great place to start. As you read through the information, I encourage you to make a list of questions for your doctors, counselor, spouse, and trusted friends. You aren’t alone!

Three Stages of Menopause


This time may start years before your final menstrual period and is the result of changing levels of ovarian hormones in your body. Although it is still possible to get pregnant during this stage, it only happens rarely. Estrogen levels decline unevenly, so they are virtually impossible to predict or measure to determine exactly when the second stage will occur.Common symptoms for this stage include: irregular menstrual periods, hot flashes, vaginal dryness, sleep disturbances and mood swings.

Natural Menopause

This is the natural (not caused by any medical intervention) and permanent ending of menstruation. Women often experience menopause around the same age as their mothers and sisters. Smokers may reach menopause about two years earlier than nonsmokers. No clear connection has been found between age at menopause and race, age at first period or use of birth control pills or fertility medications. This stage has occurred as early as in a woman’s 30s and as late as in a woman’s 60s. The average age of onset for the second stage in American women is 51. That leaves a lot of life after menopause! Common symptoms for this stage include symptoms above, sometimes more intense.


Postmenopause is the time after menopause, which is typically about a third of a woman’s life. It is possible to live a sexually-fulfilled, emotionally-stable life after menopause, but some interventions may be needed (counseling, medication, etc.) Some menopause-related symptoms (such as vaginal dryness and hot flashes) may still occur because your body is only making a small amount of estrogen. In this time, your risk increases for diseases associated with low estrogen levels, including osteoporosis.

How might menopause affect a woman?

  • [Depression/Anxiety] Some women will experience sleep disturbances, mood swings, and other symptoms that mimic depression and/or anxiety. There are also hormonal changes which can be addressed with a variety of depression/anxiety treatments.
  • [Sexual Dissatisfaction] Many women will experience vaginal dryness, decreased libido, painful intercourse, and other symptoms which may lead to sexual dissatisfaction. Luckily, there are options you can discuss with your doctors and counselors, including medications, creams, and sex therapy approaches.
  • [Grief] The 5 stages of grief include Denial, Anger, Bargaining, Depression, and Acceptance. In the midst of many physical changes, many women will experience grief associated with their perceived loss of maternal identity and old self. It is normal to experience a variety of emotions, but it is important to deal with them in a way that is healthy for you and your relationships.
  • [Phase of Life Stress] is compounded. Someone going through menopause may also be experiencing retirement, an empty nest, and other life changes that occur around the same time in life. Dealing with all of the fluctuating variables at the same time can feel overwhelming. I encourage you to get support, make time for good friends, and be honest with your doctors.

Even though there are struggles associated with menopause, everyone’s journey will be different. Your physical, psychological, and spiritual resources can help you to develop a plan including things like self-care, medical treatments, and lifestyle changes. Consider tracking your experiences to share information with your doctor. You’ll get through this– you aren’t alone!

Published by Jessica Gage, MA, LPC, NCC

I am a Licensed Professional Counselor in the Commonwealth of Pennsylvania (license #PC007550) and a National Certified Counselor.

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