Menopause: It’s no longer your grandmother or mother’s “change of life.”
Today, women more openly talk about the transition to menopause — and there’s a lot to discuss, from new medications and hormone replacement to a better understanding of the risks and benefits.
This transition is natural, but that doesn’t mean it’s easy or that women have to suffer.
“There are treatments to reduce and relieve symptoms,” says Rush gynecologist and certified menopause specialist, Mary Farhi, MD. “But there also are misconceptions about what is safe, what works and where to turn for information.”
Farhi and Natasha Jenkins Cooper, MD, share the truth about entering menopause.
What is menopause?
Menopause is the point in time when a woman has been without a period for 12 consecutive months — without birth control that pauses menstruation or surgical procedures such as hysterectomy or endometrial ablation. Menopause is a natural part of aging, most often occurring between the ages of 45 and 55, when a woman’s ovaries stop producing eggs and the associated reproductive hormones, including estrogen and progesterone.
But it doesn’t happen overnight. The body transitions over months or years, during which time women experience fluctuating hormone levels that cause an array of symptoms. This time is referred to as the perimenopausal transition.
Perimenopause symptoms differ greatly from person to person, and they can range from mild to severe, last from months to years, and can start or continue after menopause. Some of the most common include:
- Vasomotor symptoms such as hot flashes and night sweats
- Difficulty with concentration and memory
- Vaginal dryness and pain during intercourse
- Decreased sex drive
- Depression, anxiety and mood swings
- Disrupted sleep and fatigue
A better understanding of symptoms, treatments
Approaches to treating menopausal symptoms are changing with greater knowledge of who can safely benefit from hormone therapy, the arrival of new non-hormonal treatments, and medical professionals who better understand symptoms and their effect on quality of life.
Menopause hormone therapy is the most effective treatment for hot flashes, night sweats and other vasomotor symptoms, as well as vaginal dryness, pain during intercourse and low libido, Farhi says. It can also help protect against osteoporosis. The therapy uses estrogen and progesterone delivered in a variety of ways, such as pills, patches and vaginal rings. Women who have had a hysterectomy may not require progesterone therapy.
Some types of hormone replacement therapy may not be prescribed to women with certain health risks, such as those who have had or are at risk of having breast cancer or a history of blood clots in the legs or lungs and those with underlying and current heart disease. For women who need or would prefer a treatment that doesn’t use hormones, two FDA-approved, non-hormonal menopause medications are available and proving to be effective, says Jenkins, who is a Rush gynecologist and certified menopause specialist. Veozah (fezolinetant) entered the market in 2023, and Lynkuet (elinzanetant) in 2025. These once-daily pills are designed to treat moderate to severe hot flashes and night sweats related to menopause.
Reversing long-held fears about HRT
With so many changes and so much information — good and bad — available, it’s more important than ever to get accurate information, and your doctor is the best source.
Farhi and Jenkins are specially trained in menopause care, and every day, they see the questions and confusion women must contend with. For example, some women will say they don’t want HRT because they are getting their hormone supplements and compounds elsewhere. But what is right, and safest, for one woman may not be for another, and a gynecologist can best assess that.
Fortunately, doctors have much clearer information about those individual needs. While in the past, women and some physicians shied away from hormone therapy after a 2002 National Institutes of Health study reported an increase in many types of health risks in women ages 50 to 79, who took estrogen and progesterone supplements.
But further analysis clarified that the health risks were identified in women who began HRT after age 60 or more than 10 years from the menopausal transition. Additional research supported the finding that HRT is safe for most women who start within 10 years of the onset of menopause, Farhi says.
Still, decades later, HRT isn’t used as much as it could be.
While women are talking about menopause more and weighing a greater number of treatment options, others hold back, thinking they should wait and try to tough out the symptoms.
Given all of the options available to women now, if hot flashes, cognitive changes such as brain fog, or other symptoms are affecting your quality of life, there is no need to suffer.
"Hormone replacement therapy helps restore the hormones naturally produced by the ovaries and can be effective in relieving symptoms,” Jenkins said. "Women do not need to wait until their symptoms become severe to seek help.”
