Menopause is a natural stage of life that can be experienced with comfort
Menopause is a natural stage in a woman’s life. With gentle preparation, self-care, and support from specialists, it can be navigated with comfort and confidence.
Learn more about menopause and ways to take care of your health and well-being during this important stage of life!
WHAT IS MENOPAUSE
Menopause is the last spontaneous menstrual period in a woman’s life. It is usually 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 shutdown of the ovaries’ reproductive function:
- premature (before age 40)
- early (ages 40–44)
- timely (ages 45–55)
- late (after age 55)
Iatrogenic or secondary menopause results from bilateral oophorectomy (removal of both ovaries), chemotherapy, or radiation therapy.
Natural menopause is preceded by the menopausal transition — a period when menstrual cycles become irregular in both duration and intensity. It typically begins between the ages of 40 and 45 1
The menopausal transition period, along with the 12 months following menopause, is referred to as perimenopause. The period after menopause as a whole is called postmenopause. 1
Menopause and its related stages are natural biological processes. However, each woman’s experience can differ: some may have minimal symptoms, while others may face noticeable impacts on their quality of life, with symptoms lasting for several years in some cases. 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 their advantage over men in terms of lower risk for cardiovascular disease
- bones: bone tissue becomes more fragile, increasing the risk of osteoporosis and fractures
- pelvic floor: muscles and ligaments weaken, which may cause discomfort in the pelvic area and even lead to organ prolapse
- metabolism: fat distribution changes — fat tends to accumulate more 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 — sudden sensations of heat, especially in the face, neck, and chest, often accompanied by flushed skin, increased sweating, a racing heartbeat, and intense physical discomfort that can last for several minutes
- changes in the regularity and nature of menstrual cycles, eventually leading to the cessation of menstruation
- vaginal dryness, pain during intercourse, and urinary incontinence
- sleep disturbances — difficulties falling asleep, frequent awakenings, or insomnia
- mood changes, depression, and/or 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 one can prepare for in advance to face the changes fully equipped and minimize potential discomfort
- Undergo a comprehensive check-up — assess the condition of your cardiovascular system, bone density, hormone levels, and overall health. This can help identify potential risks and address them before pronounced symptoms appear.
- 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 — studies have shown that menopause tends to occur earlier in women who smoke. 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-based compounds that have effects similar to those of estrogen. 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 replenishes estrogen deficiency and effectively alleviates its main symptoms — including hot flashes, vaginal dryness, and mood swings. This therapy is selected individually based on a 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
- the patient’s age and the duration of postmenopause — the older the woman and the more time has passed since her last menstruation, the more cautiously hormones are prescribed
- obesity
- insulin resistance, diabetes mellitus
- history of gallstone disease, cholecystitis, or cholecystectomy
- chronic liver disease
- migraine
- dyslipidemia
- uncontrolled hypertension
- smoking
- uterine fibroids, endometriosis
- family history of venous thromboembolism (VTE)
- complications during previous pregnancies (such as hypertension, preeclampsia, or gestational diabetes)
- increased risk of breast cancer
- collagen disorders
- 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
- clinical 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 can be considered even before hot flashes appear — as soon as a woman enters the menopausal transition. 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
- Include regular physical activity in your routine — at least 150 minutes of moderate-intensity aerobic exercise or 75 minutes of vigorous-intensity activity 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 balanced diet. Eat several servings of fruits, vegetables, and whole grains daily, and fish twice a week.
- Limit overall consumption of alcohol, salt, and fats, favoring olive oil among the latter.
- Stay socially active and engage in leisure activities that stimulate cognitive function.
- 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.
- 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.
- Quit smoking.
- 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.
- Quit smoking.
This stage of life can be the beginning of something wonderful. Most importantly, remember that you are not alone: if the symptoms related to these changes affect your comfort, consult a healthcare professional
- 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).
