Published on July 28, 2022

A woman talking to her provider.

Your provider can help you navigate the transition to menopause

It can be hard for a woman to know when her transition to menopause begins. There is no universal experience or timeline for this stage of life, commonly known as perimenopause, or "around menopause."

The transition to cessation of menstruation can last several years. Symptoms and their severity vary widely. Most women experience perimenopause in their late 40s to early 50s, with 51 to 52 the average age for menopause. Early menopause may begin as soon as age 40.

About 70% of women experience uncomfortable symptoms along with perimenopause and menopause. Night sweats are often the first sign, followed by changes in menstrual cycles. Hot flashes, disrupted sleep, brain fog, fatigue, mood changes and vaginal dryness are common. Depression and anxiety are also associated with perimenopause and menopause.

"Many women can address mild to moderate perimenopausal symptoms without medical intervention" said Sarit Aschkenazi, MD, a urogynecologist with ProHealth Care. "Staying cool, wearing layered clothing that can be quickly removed, and getting plenty of sleep in a cool, dark and quiet room can help reduce symptoms."

The symptoms of perimenopause and menopause are caused by declining levels of the hormone estrogen. The less estrogen present in your body, the greater likelihood of symptoms.

Hormone therapy is often prescribed to replace estrogen. It is typically delivered through a transdermal patch and is also available in pill form. Typically, progesterone may be prescribed along with estrogen for most women.

There is accumulating evidence that women can attain lifelong health benefits when they receive hormone replacement therapy during their transition and early years of menopause. In general, the window for treatment is between ages 50 and 60, or within 10 years of menopause.

Hormone therapy can improve sleep and the ability to concentrate, and protect bone health. It can also reduce hot flashes, fatigue, mood changes and vaginal dryness that can cause painful sex. Studies have also shown that it can contribute to overall longevity.

Your provider can explain everything you need to know about hormone therapy, and why you should not use compounded products or alternative products purchased over the counter or online. Instead, talk to your provider about an FDA-approved medical prescription tailored for you and your needs.

Your provider will determine when to prescribe therapy for you based on your symptoms and age. The goal is to effectively treat your symptoms with the least amount of hormone necessary. Your medication may need to be adjusted periodically.

Additional tests may be recommended, as symptoms can be related to other issues. If you are diagnosed with depression, anxiety or another health issue, your provider can help you receive treatment for these issues as well.

Your provider is trained to answer all of your questions about perimenopause using evidence-based research, including questions about fertility. The North American Menopause Society also provides fact sheets, videos and other resources about perimenopause and menopause at

"The symptoms you experience may seem overwhelming at times, but they are perfectly natural," Dr. Aschkenazi said. "Eating healthy foods, exercising, maintaining good sleep habits, and keeping up with recommended health screenings are always beneficial for overall health."

When it comes to this stage of life, you are not alone – and you are not going crazy. Most important, know that your symptoms can be successfully treated.