Between the ages of 40 to 50 when many women have finally figured out their periods, their bodies, and their own life rhythm, everything changes—the reason: Menopause. Menopause is the time that marks the end of a woman’s menstrual cycles. Just like puberty, it’s a massive part of a woman’s life. Yet, it can feel like a taboo subject.

Well, not for us! Here, we look at what is meant by perimenopause,
menopause, and postmenopause, how to know if you’re approaching menopause, and outline the symptoms. We’ll answer some of the most commonly asked questions to help you understand what’s happening to your body and why. If you’re struggling with menopause, there are ways to make it easier. Remember that this is a stage in life that every woman has to go through, and you can – and will – come out on the other side, free of periods and ready to embrace life!


Perimenopause means “around menopause”. It is also referred to as the menopausal transition. It’s a time when your body and hormones begin to change, even though your periods might still be regular. Perimenopause usually starts in a woman’s mid to late 40s.

Symptoms of Perimenopause

During perimenopause you might start to experience changes such as worsening premenstrual symptoms or heavier or irregular periods. Some women skip periods for months at a time while others may get their periods closer together, but bleed fewer days or sometimes all of the above- everyone is unique in their path.

You may notice changes to your body, such as vaginal dryness, a loss of breast fullness, thinning hair, dry skin, or weight gain. Other symptoms caused by hormonal changes include hot flashes, chills, night sweats, and poor sleep quality.

Some women don’t connect their troublesome symptoms to perimenopause, especially if the changes are subtle. Perhaps they are wondering why they have become more forgetful or worry that their mood keeps changing. Some women sail through this transition period without feeling any different.

Perimenopause can last four to five years before your monthly cycle completely stops. Remember that you can still become pregnant during perimenopause. Dr. Karmel can help you decide if birth control is still necessary or if hormone replacement therapy is a good idea.

Menopause and Hormone Replacement

Menopause is the point in time when you haven’t had a period for 12 months. In the USA, the average age for menopause is 51.

In some cases, menopause is surgically induced, such as when a woman has her ovaries removed for cancer prevention or treatment or other medical reasons.

Are hormones right for me?

The answer is, it depends! Due to the changes in hormone levels, many women continue to experience hot flashes, vaginal dryness, decreased libido, insomnia, skin changes, brain fog and more. Hormone replacement therapy can help with most of these symptoms. There are many different formulations including pharmacologic , compounded and herbal. Dr. Karmel can help you come up with the optimal combination to help you feel your best.

However you feel, when you look at your calendar and know you have not had a period for 12 months, you can call yourself menopausal.

When to See Your Doctor

If you experience unpleasant symptoms during menopause, various treatments are available to help you including both hormonal and non hormonal therapies. Talk to your doctor about what is right for you.

Looking After Your Health

During menopause, it’s more important than ever to look after yourself. With the change in hormone levels can come increased risk for osteoporosis (brittle bones), higher cholesterol levels and increased risk for heart disease and stroke. Try to eat a balanced diet that includes fruits, vegetables and whole grains, exercise regularly and make sure to get enough sleep. These things will also help you with weight control since your metabolism can slow down after menopause. Yoga and tai chi can improve strength and coordination and may help prevent falls that could lead to broken bones. It will also help with breathing techniques and relaxation.

Complementary and alternative treatments are available, but results are not generally scientifically proven. Dr. Karmel will work with you towards the optimal health plan using both traditional and complementary methods

The Good News About Menopause

After menopause, you will no longer be able to get pregnant and you will not have periods. This will be a welcome relief if you suffer from PMS symptoms, heavy bleeding, or headaches associated with ovulation and menstruation. Some women are so happy to be free from periods that they feel like they have a new lease on life.

If you’re not sure whether you are perimenopausal or menopausal, speak to your doctor. You’re bound to have plenty of questions. Talk to other women who are going through the same as you and exchange practical hints and tips. Make time for yourself and find ways to relax. This too will pass!