Midlife and menopause

Photo of raspberries

The more you know about menopause, the more likely you are to understand the changes in your body and move forward positively.

Each woman experiences midlife and menopause differently, but most women go through the same general phases. At midlife, a healthy lifestyle can help manage menopausal symptoms and reduce your risk of serious health conditions, like breast cancer, heart disease, and osteoporosis (thinning bones).

What is menopause?

Photo of a woman gardeningMenopause, "the change of life," is when you have not had a menstrual period for one year. Some women stop menstruating in their mid-40s, others in their mid-50s, but the average age is about 50. Women who have their ovaries removed surgically or take medications such as chemotherapy may go through menopause early.

What changes and symptoms should you expect — and when?  Here are the usual stages, although your experience may vary from this:

AgeChanges and symptoms
Mid-30s to mid-40s
  • Your chance of getting pregnant goes down, though it's still possible to get pregnant.
  • Your periods could get lighter or heavier, and your cycles could get longer or shorter.
  • You may experience mood swings, premenstrual syndrome (PMS), hot flashes, and sleeplessness.
Mid-40s to late 40s
  • Your menstrual periods may become irregular (missed periods, periods closer together, more or less bleeding).
  • You may have PMS-like symptoms, such as mood swings, irritability, bloating, breast discomfort.
  • You may feel physical symptoms like hot flashes, headaches, muscle and joint pain, heart palpitations, weight gain.
  • You may have trouble sleeping and feel fatigue, anxiety, dizziness, difficulty concentrating or remembering.
  • Your sex life may be affected by vaginal dryness and changes in sexual interest.
Late 40s to mid-50s
  • Your ovaries produce much less estrogen during the 6 to 8 months before menopause.
  • Your menopause symptoms may increase.
  • Your menstrual periods end.
  • You may develop incontinence — leakage of urine during activities such as coughing or sneezing or an "overactive bladder" that makes you have a need/urgency to urinate more frequently.
Mid-50s and beyond
  • Your menopause symptoms begin to decrease, although some women continue to experience some symptoms indefinitely.
  • You may experience mood swings.
  • You may notice more vaginal dryness or pain, especially with intercourse, as the vaginal walls become thinner and less elastic.
  • The final phase, postmenopause, begins after one year of having no menstrual periods.

The whole process of menopause can take several years to complete.

Enjoy a healthy sex life

The changes during menopause may make enjoying a healthy sex life challenging, but they don't mean the end of your sex life. Learn how you can keep your sex life lively.

Menopause and health risks

Along with the changes to your menstrual cycle, there are other changes to your body, too. As you experience menopause:

  • Your metabolism, the rate at which your body burns calories, slows down and your body fat increases. You may gain weight if you don't take steps to prevent it.
  • Your weight may move toward your stomach and midsection. You may also lose muscle, which supports bones and joints and keeps your body looking firm.
  • You may lose strength and density in your bones. Bone loss is greatest within the first 5 to 7 years after menopause and is a major reason for falls and fractures. An injury from falling can make you less active and lead to a lower quality of life.
  • Your risk of serious health conditions — breast and colorectal cancer, heart disease, stroke, high blood pressure, diabetes, and obesity — goes up.

Managing menopause symptoms

You may be one of the lucky women who sail through menopause without much difficulty, but if you have symptoms that aren't helped by the following healthy living routines, you and your practitioner can choose treatments that suit your symptoms, health, and personal attitudes.

Eat a healthy diet. Good nutrition helps you maintain a healthy weight.

Be active and stay active.  Midlife may be the most important time for you to get regular exercise. It:

  • Increases your metabolism
  • Helps keep your bones strong
  • Helps strengthen your muscles
  • Improves your balance
  • Lifts your mood, self-confidence, and self-esteem
  • Helps you feel more energetic and relaxed
  • Improves your sleep

Explore your emotions. Midlife inspires some women to lead a healthier, more reflective life, while it seems to heighten emotional and mental challenges for others. Find mental health services in your area.

Source: Menopause: A Kaiser Permanente Guidebook for Women

Reviewed by: Jean Kayser, MD, December 2018

Reviewed by: Juanita Watts, MD, April 2016

Additional Kaiser Permanente Reviewers

© 2016 Kaiser Permanente