Menopause is a natural stage in a woman’s life
And it can be navigated with comfort and confidence through thoughtful preparation, self-care, and the support of healthcare professionals.
Learn more about menopause and ways to care for your health and well-being during this stage of life!
WHAT IS MENOPAUSE
Menopause is a woman’s final natural menstrual period. As a rule, it is diagnosed retrospectively – after 12 consecutive months without menstruation. 1
Types of menopause 1
Spontaneous or natural menopause occurs as a result of age-related hormonal decline and the gradual loss of ovarian reproductive function:
- Premature menopause (before age 40)
- Early menopause (ages 40–44)
- Typical menopause (ages 45–55)
- Late menopause (after age 55)
Iatrogenic or secondary menopause occurs as a result of bilateral oophorectomy (removal of both ovaries), chemotherapy, or radiation therapy.
Natural menopause is preceded by the menopausal transition — a period during which menstrual cycles become irregular in both duration and intensity. It usually begins between the ages of 40 and 45. 1
The menopausal transition together with the 12 months following menopause is called perimenopause, while the period after menopause as a whole is referred to as postmenopause. 1
Menopause and its related stages are natural biological processes. However, women experience them differently: some have little to no symptoms, while for others the symptoms may significantly affect quality of life and, in some cases, persist for several years. 2
Changes associated with menopause
Menopause occurs as a result of the decline in ovarian reproductive function and a significant decrease in estrogen levels. 2 In turn, the deficiency of these hormones can have widespread effects on the body: 1,2
- Heart and blood vessels: after menopause, women gradually lose the protective advantage they previously had over men in terms of cardiovascular disease risk;
- Bones: bone tissue becomes more fragile, increasing the risk of osteoporosis and fractures;
- Pelvic floor: muscles and ligaments weaken, which may lead to discomfort in the pelvic area and, in some cases, pelvic organ prolapse;
- Metabolism: the distribution of body fat changes – fat is more likely to accumulate around the abdomen rather than the hips.
Estrogen deficiency during peri- and postmenopause often leads to the following symptoms: 1,2
- hot flashes and night sweats – a sudden sensation of heat, especially in the face, neck, and chest area, often accompanied by skin flushing, increased sweating, rapid heartbeat, and acute physical discomfort that may last for several minutes;
- changes in the regularity and pattern of the menstrual cycle, eventually leading to the cessation of menstruation;
- vaginal dryness, pain during sexual intercourse, and urinary incontinence;
- sleep disturbances — difficulty falling asleep, frequent awakenings, or insomnia;
- mood changes, depression, and/or feelings of anxiety.
suffer from sleep disturbances 1
The symptoms that occur during peri- and postmenopause due to estrogen deficiency collectively make up the climacteric syndrome 1
However, it is important to remember that modern medicine offers effective ways to manage the discomfort associated with menopause and maintain quality of life. If symptoms are present, a woman should consult a gynecologist-endocrinologist for a medical evaluation and personalized recommendations on therapy, nutrition, and lifestyle. 1
Preparing for menopause
Menopause is not a sudden event, but a gradual process that you can prepare for in advance in order to face these changes with confidence and minimize possible discomfort
- Undergo a comprehensive check-up – assess the condition of your cardiovascular system, bone density, hormone levels, and overall health indicators. This can help identify potential risks and address them before symptoms become more pronounced.
- Establish healthy habits in advance: eat a balanced diet, engage in regular moderate physical activity, maintain a healthy weight, and follow a consistent sleep-wake schedule. 3
- Quit smoking – доказано, что менопауза наступает раньше у курящих женщин. 1
- If you feel anxious about the upcoming changes, consider speaking with a psychologist.
In addition, maintaining quality of life as women approach and move through menopause can be supported by the use of dietary supplements containing ingredients that effectively alleviate symptoms of the menopausal transition.
Since such symptoms are associated with an increased risk of cardiovascular disease, addressing them may also have a positive impact on heart and vascular health. 4 In particular, to prevent severe menopausal symptoms, a doctor may consider prescribing phytoestrogens 3 – non-steroidal plant-derived compounds that have effects similar to estrogens. 5 Phytoestrogens may also be recommended for women over 40 who do not experience hot flashes or menstrual irregularities but report a decline in quality of life. 3
How to Manage Unpleasant Symptoms
During the transitional period associated with the onset of menopause, caring for one's health and well-being becomes especially important for every woman. Timely consultation with a doctor can help not only relieve unpleasant symptoms but also prevent possible complications related to hormonal changes and significantly improve quality of life. 1
There are two main approaches to managing climacteric syndrome 1
Menopausal hormone therapy (MHT)
It helps compensate for estrogen deficiency and effectively relieves its main symptoms, including hot flashes, vaginal dryness, and mood swings. Such therapy is selected individually after medical evaluation, taking into account each woman’s health profile, and is carried out under close medical supervision. 1 A doctor may advise against MHT if a woman has certain contraindications. These may include: 1
- patient age and duration of postmenopause — the older the woman and the longer the time since her last menstrual period, the more cautiously hormone therapy is prescribed;
- obesity;
- insulin resistance, diabetes mellitus;
- history of cholelithiasis, cholecystitis, or cholecystectomy;
- chronic liver disease;
- migraine;
- dyslipidemia;
- uncontrolled hypertension;
- smoking;
- uterine fibroids, endometriosis;
- family history of venous thromboembolism (VTE) in close relatives;
- complications during previous pregnancies (arterial hypertension, preeclampsia, gestational diabetes mellitus);
- increased risk of breast cancer;
- collagen diseases;
- epilepsy.
Non-hormonal treatment
It is prescribed when there are contraindications to MHT or if the patient prefers not to use hormone therapy. 1 It encompasses various alternative therapeutic approaches, including: 1
- weight loss;
- cognitive behavioral therapy;
- cinical hypnosis;
- treatment with non-hormonal medications.
The latter includes products containing phytoestrogens. Studies have shown that they are more effective when taken early, 6,7 and their use may be considered even before hot flashes appear — as soon as a woman enters the menopausal transition period. 3
Lifestyle
The period associated with the onset of menopause is an ideal time to reassess your priorities and lifestyle
Take care of your health and emotional well-being, give yourself more time, and try the things you’ve long dreamed of — whether it’s new hobbies, traveling, or starting a business!
he following recommendations can help maintain well-being and confidence during peri- and postmenopause: 1, 2, 8, 9
- Incorporate regular physical activity into your routine – at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity exercise per week.
- Aim to walk at least 10,000 steps per day.
- Maintain a healthy body weight. If you are overweight, try to reach a healthier weight.
- Follow the principles of a healthy diet. Eat several servings of fruits, vegetables, and whole grains each day, and include fish in your diet twice a week.
- Limit overall consumption of alcohol, salt, and fats, favoring olive oil among the latter.
- Quit smoking.
- Since pregnancy is still possible during perimenopause, use contraception for 12 months after your last menstrual period. If you experience vaginal dryness or discomfort during sex, use vaginal lubricants.
- Stay socially active and engage in leisure activities that stimulate cognitive function.
- If you have symptoms such as dryness, itching, and burning in the vaginal area, pain during intercourse, or urinary issues, talk to your doctor about the possibility of local low-dose estrogen therapy. It helps restore the epithelium of the urinary and genital tracts, supports the growth of lactobacilli and acidic vaginal pH, improves blood flow to the vaginal walls, urethra, and pelvic floor muscles, alleviates urinary symptoms, and reduces vaginal dryness and itching.
- If you have symptoms such as dryness, itching, and burning in the vaginal area, pain during intercourse, or urinary issues, talk to your doctor about the possibility of local low-dose estrogen therapy. It helps restore the epithelium of the urinary and genital tracts, supports the growth of lactobacilli and acidic vaginal pH, improves blood flow to the vaginal walls, urethra, and pelvic floor muscles, alleviates urinary symptoms, and reduces vaginal dryness and itching.
This stage of life can become the beginning of something beautiful.
- Ministry of Health of the Russian Federation. Clinical Guidelines: Menopause and Climacteric Condition in Women. Year of Approval: 2021.
- Menopause. 16.10.2024. // World Health Organization. [Electronic resource]. URL: https://www.who.int/ru/news-room/fact-sheets/detail/menopause (Accessed: 07.05.2025).
- Kuznetsova I. V. Improving quality of life in the early phase of the menopausal transition as a method for preventing age-related diseases. Women’s Clinic. 2020; 2: 7–18.
- Kuznetsova I.V., Voychenko N.A., Kirillova M.Yu. Quality of life and cardiovascular risk in women during the menopausal transition and postmenopause. Medical Alphabet. 2020; (4): 39–45. https://doi.org/10.33667/2078-5631-2020-4-39-45
- Dikke G.B. Phytoestrogens from red clover extract: mechanism of action and clinical effectiveness. Consilium Medicum. 2020; 22 (6): 19–24.
- Mu Y, Kou T, Wei B, et al. Soy Products Ameliorate Obesity-Related Anthropometric Indicators in Overweight or Obese Asian and Non-Menopausal Women: A Meta-Analysis of Randomized Controlled Trials. Nutrients. 2019; 11(11): 2790.
- Hodis HN, Mack WJ, Kono N, et al. Isoflavone Soy Protein Supplementation and Atherosclerosis Progression in Healthy Postmenopausal Women: A Randomized Controlled Trial. Stroke. 2011; 42(11): 3168–3175.
- Balan V.E., Esefidze Z.T., Gadzhieva Z.K. Clinical presentation, diagnosis, and treatment of vaginal atrophy during the climacteric period. Gynecology. 2009; 02: 15–18.
- Instructions for use of the medicinal product Estrokad®, registration certificate LS-001609 dated 29.09.2011. [Electronic resource]. URL: https://grls.minzdrav.gov.ru/Grls_View_v2.aspx?routingGuid=98379652-07cd-4f6d-b65d-0ab0c0e8d54e (Accessed: 07.05.2025).
