Pearson Benefits

During midlife, a woman’s menstrual cycle grows further and further apart. At some point, they stop completely, and she can no longer get pregnant. This is because the ovaries aren’t releasing eggs and making hormones like estrogen anymore. After 12 months without a period, a woman can say she’s gone through menopause.

In the years before menopause, women may experience skipped and unpredictable menstrual cycles. This phase is called the midlife transition, perimenopause, or the change of life. Some women go through the transition faster than others. It lasts between 1 and 10 years.

Midlife Transition

Typically, menopause occurs between ages 45 and 55. This means women can expect less frequent menstrual cycles and other symptoms at some point during their 40s. But it’s different for every woman. There’s no lab test to predict when in life it will start or how easy it will be.

Along with unpredictable cycles, a woman may have other symptoms—both physical and emotional. Hot flashes, poor sleep, and mood changes are common. Some women have vaginal dryness, weight gain, and thinning hair. Bone density may also start to decrease.

“Most people don’t have severe symptoms. Most people have mild or less frequent symptoms,” says Dr. Hadine Joffe, a menopause researcher and psychiatrist at Brigham and Women’s Hospital who is supported by the U.S. National Institutes of Health (NIH).

Waves of Heat

Hot flashes are a common symptom during the midlife transition. Many women have these for several years after menopause. Some experience hot flashes for 10 or more years. A mild hot flash feels like being embarrassed, Joffe says. “There’s a wave of heat sensation that rises to your head and chest, and sometimes you look red, feel hot, and then it’s gone.” A not-so-mild hot flash can make your skin appear very red. Your head, neck, and chest may become hot and sweaty.

“It’s particularly disruptive at night,” Joffe says. “People are waking up, feeling very hot and sweaty, and they have weird, disrupted sleep.” The most effective treatment approved by the U.S. Food and Drug Administration (FDA) is low-dose hormone therapy. Some women are given estrogen or estrogen with another hormone, progestin. Women take hormone therapy for the shortest time that they need it.

Below are some other ways to outsmart hot flashes.

Restless Nights

During midlife, women may start having trouble sleeping because of changes in hormone levels. Hot flashes and night sweats can also cause women to wake up.
For women who have a hard time falling asleep, relaxation breathing can help. Slowly breathe in through your nose. With a hand below your ribs, feel your stomach push your hand out. Slowly exhale through your mouth. You can do this for several minutes to relax.

Rollercoaster Moods

During perimenopause, many women become irritable or feel moody. Some may feel sad and anxious and unable to enjoy things as much as they used to.

If a woman has these symptoms day after day for at least two weeks, she may be dealing with a clinical depression. “There is a two- to three-fold risk of depression during perimenopause,” says NIH psychiatrist and researcher, Dr. Peter J. Schmidt.

“If you think you’re at a higher risk of depression, you should proactively touch base with your doctor”, says Schmidt. “Talk about what kind of symptoms you should be looking for and be concerned about as you age.” He advises that you set up a plan for how to look for symptoms of depression. That way, you can enter midlife prepared to act. Schmidt encourages anyone who has a depressed mood to seek help from a primary care doctor or mental health professional.

Midlife Wellbeing

The midlife transition is a phase of life that brings gradual changes. Many women don’t have problems during this transition. You can make midlife your time for optimizing wellbeing by eating well, exercising, and getting quality sleep. The healthier you are at midlife, the more successful you’ll be combating age-related changes and diseases. “We see it almost like a window of opportunity where people want to be entering midlife as healthy as possible,” Joffe says. “It’s really important for people to do the right thing now and protect their health over time.”