Helping women navigate menopause and perimenopause with confidence

By Inna Dulkin, NP, certified menopause provider

All women who live past middle age will experience menopause, a natural process that marks the end of the menstrual cycle and the reproductive stage of a woman's life.

Women typically enter menopause after 12 consecutive months without a period. Menopause usually occurs between ages of 40 and 58, with the average range occurring between ages of 45 and 54. Menopause that occurs before the age of 45 is considered early menopause, and menopause that occurs after age 54 is considered late menopause. Women who undergo removal of ovaries experience induced menopause.

Women experience a wide variety of symptoms in their perimenopausal, menopausal and post-menopausal stages of life. The most common symptoms of menopause include:

• Hot flashes and night sweats.
• Increased frequency and urgency of urination, often with burning or recurrent urinary tract infections.
• Vaginal dryness and irritation.
• Decreased or full loss of desire to participate in sexual activity, along with changes in the ability to achieve orgasm.
• Pain or discomfort with intercourse.
• Sleep disturbances.
• Brain fog.
• Memory changes.
• Musculoskeletal pain.
• Weight gain.
• Hair loss.

Perimenopause occurs when the menstrual cycle becomes irregular or a woman starts experiencing menopausal symptoms. The transition to menopause occurs after a final menstrual period and the post-menopause phase can last up to 10 years after a woman’s last period. On average, a woman spends four years in perimenopause, but it can last up to eight years. During that time, many women experience symptoms.

Adopting specific lifestyle changes can help ease menopausal symptoms. Regular physical activity and a healthy, balanced diet rich in calcium and vitamin D can help maintain bone density, cardiac and mental health.

Gaining a better understanding of menopause can also help a woman’s partner offer more effective support during this time. Hormonal changes can be intense, often leading to mood swings, hot flashes, sleep disturbances and changes in sexual health. It is important for partners to be patient and compassionate, not dismissive. Offer empathy, be a good listener and let your partner know you are there for her – when she needs to talk, receive support, or simply needs space. Remember that you are a team navigating this transition together.

For decades, misinformation has led many women to believe they must simply endure menopause symptoms without relief. A 2002 Women’s Health Initiative study, sponsored by the National Heart, Lung and Blood Institute, linked hormone replacement therapy (HRT) to a higher risk of breast cancer, sparking widespread concern. While medical professionals now understand that HRT can be safe and effective when properly prescribed, the initial fears about the treatment have had a lasting impact on women.

Even today, many medical providers lack the training to effectively support women through perimenopause and menopause. It is important for women to seek providers who are well-versed in personalized menopause treatment and can offer the support they need.

Inna Dulkin, NP, is a certified menopause provider. She is part of ProHealth Care’s urogynecology team, a group of providers who specialize in female urinary incontinence, vaginal organ prolapses, recurrent urinary tract infections, sexual dysfunction and menopause. Services are available in Brookfield, Mukwonago, Oconomowoc and Waukesha. Learn more at ProHealthCare.org/Urogynecology.