what to expect from menopause

Female Menopause, What to Expect?

Female Menopause, What to Expect?

What is Menopause?

Better understanding the big ‘M’ should help ease most of the dread and anxiety that come with entering this phase. Menopause is when menstrual cycles no longer occur. All people with ovaries go through this process—whether it is medically induced or age-related—marking the end of their reproductive years. Menopause typically comes on gradually as hormone levels start to change during the period called perimenopause.

The average age of menopause in the UK is 51, and it’s sometimes called a second puberty. Menopause itself marks the 12 month anniversary of having your last period. Let’s say you’re 50 and you have your last menstrual period – it is 12 months after that – on that one day – that is the menopause.The time which leads up to that single day is called the perimenopause, that describes the phase accompanied by the symptoms we hear so much about, from hot flushes to vaginal dryness. It has to be 12 months, otherwise it’s not the menopause. Perimenopause symptoms commonly start in a woman’s forties, with slight (barely noticeable) hormonal shifts that start the process occurring in the mid to late thirties.

Perimenopause vs. menopause vs. postmenopause

  • During perimenopause, menstrual periods become irregular. Your periods may be late, or you may completely skip one or more periods. Menstrual flow may also become heavier or lighter.
  • Menopause is defined as a lack of menstruation for one full year.
  • Postmenopause refers to the years after menopause has occurred.

What are the symptoms of perimenopause?

  • Irregular periods
  • Periods that are heavier or lighter than normal
  • Worse premenstrual syndrome (PMS) before periods
  • Breast tenderness
  • Weight gain
  • Hair changes
  • Heart palpitations
  • Headaches
  • Loss of sex drive
  • Concentration difficulties
  • Forgetfulness
  • Muscle aches
  • Urinary tract infections (UTIs)
  • Fertility issues in women who are trying to conceive

What are the symptoms of menopause?

Estrogen is used by many parts of a woman’s body. As levels of estrogen decrease, you could have various symptoms. Many women experience mild symptoms that can be treated by lifestyle changes such as avoiding caffeine or carrying a portable fan. Some women don’t require any treatment at all, but for others, symptoms can be more severe. The severity of symptoms varies greatly around the world and by race and ethnicity. 

  • Night sweats
  • Hot flashes
  • Depression
  • Anxiety or irritability
  • Mood swings
  • Insomnia
  • Fatigue
  • Dry skin
  • Vaginal dryness
  • Frequent urination

What are the symptoms of postmenopause?

Much of the menopause symptoms carry through to the postmenopause stage, including vaginal atrophy. As mentioned in our Reasons Your Vagina May Be Numb article, estrogen levels drop significantly, and if you didn’t know, it is this very hormone that keeps your vaginal tissues supple and well-lubricated. When there is less estrogen, the vaginal walls can become thin, and dry, better known as vaginal atrophy. 

What causes postmenopausal bleeding?

Vaginal bleeding during postmenopause isn't a normal side effect of decreasing hormone levels. In some cases, the dryness in your vagina could cause some light bleeding or spotting after sex. In other cases, it could indicate a condition like endometrial hyperplasia or uterine fibroids, infections like endometritis, or cancer. But for about 10% of women, bleeding after menopause is a sign of uterine cancer(endometrial cancer). Uterine cancer is the most common type of reproductive cancer (more common than ovarian or cervical cancers). Do contact your healthcare provider if you experience any vaginal bleeding so you can be evaluated.

How to treat menopause symptoms?

A healthy relationship with sexual wellness can help relieve alot of menopausal symptoms. Who knew pleasure was so good? It builds resilience, supports immunity, and keeps us connected with these amazing bodies that house us through so many phases and changes. 


Arousal brings blood flow to the vaginal tissues that are prone to thinning and atrophy in the absence of estrogen. While clitoral stimulation, sexual fantasy, and penetration keep vaginal skin healthy, improve its elasticity and support natural lubrication. Not to mention it can boost levels of androgens and other hormones.

It is likely that what worked for us in bed pre-menopause may need to be re-examined now. We will probably need to be patient with ourselves, and allow more time to become fully aroused than we used to. Experiment with extending foreplay into full-body sensual massage and gentle oral and manual stimulation, and be sure to take all the time you need. Pelvic floor exercises are great for everyone – consult with a doctor, physical therapist, or sexological bodyworker to develop a pelvic rehabilitation plan. When it comes to tools, a good lubricant is an essential support – anytime, and especially during and after menopause. Plant allies like CBD, are a tremendous menopausal aid when used as a topical tool, help to support that all-important blood flow and diminish the discomfort from vaginal dryness.

While many women dread the perimenopause – and/or have heard their mums moan about it – it can actually be a very positive time and a pivotal moment in life. The point of the menstrual cycle is to have sex and create another human, whether you do that or not, so oestrogen makes us interested in other people, and more social and accommodating. When it goes, we don’t care so much about what other people think – and that is a huge gift. This is a liberating opportunity to prioritize yourself. Your period ends, but your pleasure continues.

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