A Change is Coming: Here’s What Menopause Can Mean for You

Key takeaways:

• Menopause happens when you’ve stopped menstruating for 12 consecutive months. The time leading up to this is called perimenopause. 
• Low levels of female hormones such as estrogen can cause a long list of physical and even mental symptoms, ranging from hot flashes to brain fog. 
• You can get relief from your menopause systems. Talk to your doctor about hormone replacement therapy and other medications that can help with the transition. 

Related products:

• Basis: Boosts NAD+ levels by 40%, which supports ovarian health at the cellular level and is associated with improvements in certain menopausal symptoms in an open-label, survey-based study.* See disclaimer below.
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Gen X women (that’s those who were born between 1965 and 1980) are approaching or already immersed in a very pivotal time in their lives: menopause. If that’s you, you may be experiencing or at least know about some of the possible side effects this hormonal shift brings. We hear a lot about menopause’s more common symptoms, such as hot flashes and weight gain. But there are lesser known or talked about symptoms that menopause can bring. Menopause can affect everything from your mind to your skin and hair. Here’s what you can expect during menopause and what you can do about its more unpleasant side effects.

First, what is menopause?

Simply put, menopause marks the end of menstruation for a woman (assigned female at birth, AFAB). It’s also the last step in ovarian aging. While you’ll commonly hear a woman say she’s going through menopause, she’s not officially considered menopausal until she’s gone a full 12 months without a menstrual cycle. That can happen in your 40s or 50s, but according to the Mayo Clinic, the average age at which menopause occurs in a woman in the U.S. is 51. Premature menopause can occur before age 40 and is often associated with certain medications such as chemotherapy, treatments including radiation, and surgery such as a hysterectomy. The age you are at the onset of menopause has been linked to longevity with those who experience it later living longer. A study in the journal Epidemiology found that the life expectancy of those who experienced menopause after age 55 was two years longer than those who went through menopause before 40.

This news doesn’t just affect women. Another study found that brothers of women who go through menopause later also live longer, suggesting a genetic link between reproductive aging and longevity.    

As you approach menopause (what’s known as perimenopause), your ovaries produce fewer eggs, and your levels of estrogen and progesterone, two female reproductive hormones secreted by the ovaries, start to dwindle, too. The perimenopause phase lasts on average four years but can start as early as 10 years before menopause. Once you’re in menopause, your ovaries produce very little estrogen and progesterone. It’s the lack of hormones that produces the long list of side effects. Menopause also leads to an increased risk of developing osteoporosis and cardiovascular disease. The entire menopause transition is about seven years but can be as long as 14 years, according to the National Institute of Health.

What are the symptoms of menopause?

All women AFAB will experience menopause, but not all women will experience menopause in the same way. Some may notice only mild symptoms, while others may experience every symptom, sometimes severely. The reason why this is remains unclear, but one study in the American Journal of Public Health revealed that lifestyle factors such as a high body mass index and smoking can increase specific symptoms such as hot flashes.

So, what are the most common menopause symptoms? See below. 

• Hot flashes

This is a widely talked-about side effect of menopause, also known as a vasomotor symptom. A review in the Journal of Mid-Life Health found that more than 80 percent of women experience hot flashes during menopause. During a hot flash, you may feel a burst of heat, usually on the chest, neck, and face. Then comes sweating, flushing, anxiety, and chills lasting between one and five minutes. Why does this occur? Low estrogen levels can cause your hypothalamus, which is like the body’s thermostat, to become a bit overzealous. If it perceives heat, it creates a hot flash to cool you down. Ironic, right?

• Vaginal atrophy

This term refers to thinning of the vaginal walls, which also contributes to dryness and inflammation due to the loss of estrogen. A study of women ages 40 to 55 found that vaginal atrophy occurred in over 36 percent of women, and its related symptoms were burning, dryness, itching, pain or burning of the urethra, and pain during intercourse (dyspareunia).

• Heartbeat irregularities

It’s not uncommon for menopausal women to feel palpitations, which is a rapid or irregular heartbeat. In the journal Women’s Health, a review found that 54 percent of postmenopausal women experienced palpitations.

• Skin and hair changes

Estrogen is vital for your skin, too. It’s involved in collagen production, moisture levels, elasticity, and thickness, so when it’s at super low levels, your skin may feel dry, look dull, and you may see an uptick in lines and wrinkles. Hair may also turn drier and coarser, and a loss of estrogen is linked to thinning hair.

• Brain fog

It’s not a medical term, but brain fog is a well-known phenomenon of feeling a bit confused: forgetting why you walked into a room, searching for the right word, and losing track of appointments. The connection between menopause and these cognitive episodes isn’t fully understood, but enough research has shown a link between menopause and brain fog.

• Sleep disturbances

It’s not your imagination; you are losing sleep over menopause. Hot flashes and night sweats can wake you up and keep you up. Another study found that middle-aged women with low serum estrogen levels, as well as low progesterone, are more likely to snore and report obstructive sleep apnea, which can cause micro-wakeups all night long.

• Belly fat

There’s not a lot of evidence to suggest that menopause makes you gain weight (experts say the metabolic slow down that comes with age may play a bigger role) but where you gain weight when you do may have something to do with the hormonal shift. A lack of estrogen may make women more likely to gain weight in the belly than in the hips and thighs.

• Mood changes

Feeling blue, anxious, or easily irritated are all associated with menopause. Research has shown an increased risk of menopausal depression and anxiety, especially when there are vasomotor symptoms (hot flashes) and a history of depression.

So how can you relieve your menopause symptoms?

Many women suffer in silence, believing menopause and all its symptoms are par for the course. A study looking at women’s behaviors and attitudes regarding the treatment of menopausal symptoms in five European countries found that only 54 percent of women seek medical help for menopause despite more than 80 percent experiencing symptoms. But you can get help, in the form of: 

• Hormonal replacement therapy (HRT)

Replacing estrogen and progesterone (also called progestin) around the onset of menopause is one of the most effective methods for treating common symptoms of menopause, including hot flashes, night sweats, and vaginal discomfort. HRT can also help prevent bone loss and fractures in postmenopausal women. Your physician can tell you if you’re a candidate and discuss potential risks.

• Vaginal estrogen

A cream, tablet, or ring that you insert into your vagina can help with dryness that stems from vaginal atrophy.

• Oral drugs to help with hot flashes

For women who can’t or don’t take estrogen, certain medications such as fezolinetant, gabapentin, and clonidine have been shown to reduce hot flashes.

• Antidepressants

Certain antidepressants such as paroxetine will not only boost mood-related changes but can help reduce hot flashes as well.

• Diet and supplements

Incorporate more green leafy vegetables, lean protein, and calcium-rich foods to support bone and heart health. Some studies suggest that taking soy products, which contain phytoestrogens (a chemical that’s similar to estrogen) may help ease menopausal symptoms. You may also want to cut down on caffeine, alcohol, and spicy foods as they may trigger hot flashes and night sweats. Changing your diet, however, can be tricky and supplements can help fill nutritional gaps. For example, if you are lactose intolerant or are vegan, calcium and vitamin D supplements can be a good substitute for dairy products to help support bone health. 

• Cellular support

Supporting ovarian health at the cellular level may also help with menopausal symptoms. Like all other organs and tissues in the body, the ovaries are made of cells, which require NAD+, a critical coenzyme that’s closely linked to cellular health. NAD+ is also necessary for the production of key hormone regulators like estradiol. As we age, NAD+ levels decline, and preclinical studies suggest that this decline contributes to ovarian aging at the cellular level. In a recent open-label, survey-based study, taking Elysium’s Basis, which contains an NAD+ precursor and pterostilbene (a phytoestrogen) and is proven to increase NAD+ levels by 40% on average, was associated with improved symptoms of hot flashes in women experiencing pre/post-menopausal symptoms. 75% of women reported an improvement in the frequency of their hot flashes and 84% reported an improvement in the unpleasantness of their hot flashes after one week of supplementation.*

• Exercise and physical activity

If you’re approaching menopause or already experiencing symptoms, make an appointment with a healthcare professional to discuss your menopause options.

Disclaimer:

*Based on self-reported changes in symptoms before/after Basis supplementation in 32 women experiencing pre/postmenopausal symptoms. Changes in these symptoms can be attributable to other factors unrelated to Basis, such as diet, physical activity, and lifestyle choices.