Let’s Talk About Menopause
Menopause in our society
Menopause isn’t a moment, it’s a continuum. For many, it begins subtly. Maybe sleep gets a little harder to come by. Maybe moods shifts occur in unexpected ways. For some, there’s a sudden sensitivity to heat, or a brain fog that settles in during meetings. These changes often arrive unannounced and they catch people off guard. Because the transition doesn’t happen all at once, and because of the stigma around menstruation and related life experiences, it can be difficult to recognize, let alone talk about.
The stigmatization of menopause comes at a cost. Even though every person with a uterus will move through some stage of menopause if they live long enough, the topic still remains socially and medically underaddressed. There is a lack of access to clear information, supportive care, and space to ask real questions that leaves many people who are navigating this life stage feeling isolated, frustrated, and unsure of what’s happening in their own bodies.
Too often, the effects of the menopausal transition are chalked up to moodiness, irritability, or “emotional instability”. These shallow stereotypes distract from the complexity of the experience and the reality of physiological changes that impact many parts of the human body. Hormonal fluctuations don’t just influence menstrual cycles; they affect sleep, memory, sexual wellbeing, body temperature, and even cardiovascular and bone health. There are emotional, physical, and mental layers to this shift, and none of them happen in a vacuum.
To move through this transition with dignity, people need systems that treat them as whole. That means clinical care that is informed and proactive, not dismissive. It means providers who understand how symptoms may overlap or manifest differently across race, class, or gender identity. It also means talking about menopause outside of medical rooms and bringing it into community spaces, families, and everyday conversation.
Stages of Menopause
I refer to the full progression of the hormonal changes that signal the transitions through menopause, including perimenopause, menopause, and postmenopause, as the menopausal arc. This framework acknowledges that this isn’t just a phase with a start and end date, but an unfolding with a series of changes that can span years. Here’s a brief look at how that arc is typically defined:
Perimenopause marks the beginning of the transition. During this time, the body’s production of estrogen and progesterone begins to shift. Sometimes this shift can happen gradually and other times, it happens in dramatic spikes or dips. The result is a dynamic range of symptoms that can include hot flashes, insomnia, anxiety, mood swings, and brain fog. Some people notice changes in libido, skin, or periods that suddenly become heavier or more irregular.
Menopause is defined clinically as the moment when someone has gone 12 consecutive months without a menstrual period, with no other medical cause. This phase can also be induced surgically through an oophorectomy (removal of the ovaries), which stops hormone production more abruptly.
Postmenopause begins one year after the final period and continues through the rest of someone’s life. Symptoms may ease, persist, or evolve during this time depending on the individual. This phase is not the “end” of menopause, but rather another chapter in the body’s transformation.
Symptoms of perimenopause and menopause
Because the hormonal changes of menopause affect so many systems, symptoms can vary widely from person to person and even from generation to generation within families. There is no one-size-fits-all experience with menopause. While some people move through the arc with mild symptoms, others may find their daily life significantly disrupted.
Here are a few examples of what someone might experience during this transition (courtesy of Georgetown University, linked in sources):
Symptoms:
decreased libido
pain with intercourse
incontinence
sleep disruption
anxiety
insomnia
difficulty with memory or concentration
Signs:
vaginal dryness
facial hair
thinning hair
weight change
skin changes
higher blood pressure
loss of breast fullness
Transitioning from perimenopause to menopause
Tracking your menstrual cycle is currently the most straightforward way to confirm the shift from perimenopause into menopause, assuming there are no other medical causes. But relying on that marker alone can be limiting. Many experience pronounced changes in mood, cognition, or body before they stop bleeding, and some people may not have regular periods to begin with.
This is why having a strong relationship with a trusted provider matters. When providers have longitudinal knowledge of your health and are trained to recognize the nuances of the menopausal arc, they’re better positioned to offer relevant care. Ideally, this relationship starts early, before symptoms feel unmanageable, but building that kind of connection is not always accessible or even culturally safe.
There’s still stigma around discussing menstruation, sexual health, and mental health. When we add to that the systemic disparities in health literacy, financial hardship, distant proximity to resources, and the daily exhaustion of just trying to survive, we easily see that it’s no wonder so many are left to figure things out alone.
What’s needed isn’t just awareness, it’s access. Access to consistent, informed care. Access to communities where menopause isn’t treated as shameful or invisible. Access to wellness strategies that honor cultural differences and lived experiences. Whether through mutual aid, group education, tech tools, or public policy, we need systems that extend support across the arc, not just at its endpoints.
Menopause is not something to “get through” in silence. It’s a major transformation that deserves our attention in our community conversations, in our clinical settings, and in our technological advancements.
In my next post, I’ll explore these various stages of menopause more in depth and will cover a few interventions from an herbal medicine perspective.
