Understanding Menopause: Hot Flashes, Hormones and Hope

Menopause.  It goes by many names – the change; ovarian retirement; reverse puberty.  No matter what you call it, it is a time of significant transition and can be filled with a variety of bodily changes – some well-known, others less so.  In my practice I see many patients who are unsure if their symptoms are related to menopause or not.  As such, I’m here to help break things down, and hopefully provide some explanations and ways to feel better during this process.

Menopause officially arrives when you’ve gone 12 months without a period, signaling that your ovaries are taking a well-deserved retirement from their hormone-producing duties. For most women in the U.S., this happens around age 51-52, but it can show up anywhere from your early 40s to your mid-50s. According to the 2022 Menopause Society Hormone Therapy Position Statement, approximately 1.3 million women in the U.S. hit menopause each year, and by 2025, more than 1 billion women globally will be postmenopausal!

What Exactly is Happening to Me?

Great question! Menopause (and perimenopause) comes with a long list of potential symptoms. The most notorious? Hot flashes and night sweats. These vasomotor symptoms affect up to 75% of menopausal women and can stick around for an average of 7.4 years after menopause.  Then, there’s the genitourinary syndrome of menopause (GSM) — a collective term for symptoms like vaginal dryness, discomfort during sex, and the occasional surprise urinary tract infection.  It’s not something people talk about much, but trust me, you’re not alone in dealing with these symptoms, as GSM affects nearly half of all postmenopausal women.

Menopause also has a way of throwing your sleep schedule out the window. Add in mood changes, cognitive difficulties, joint pain, and even hair loss, and suddenly, you’re juggling a lot. Not to mention, the drop in estrogen levels can put you at greater risk for osteoporosis and cardiovascular disease. Basically, your body is trying to adjust, and it’s not always subtle about it.

So, here’s the thing about menopause: It’s not a one-size-fits-all experience. Some women breeze through it with just a few hot flashes, while others feel like they’ve been hit with an overwhelming array of symptoms. Whatever your experience, it’s valid, and there are more treatment options available today than ever before, including both hormonal therapies and non-hormonal options. 

Hormone Therapy (HT)

In the medical community, the gold standard for managing menopausal symptoms is hormone therapy (HT). According to the Menopause Society, HT is especially effective for women under 60 or within 10 years of menopause onset who are experiencing moderate to severe symptoms. Patients outside of this window may also benefit from HT but need to be informed of some specific risks before they start therapy.  HT can come in many systemic forms: oral tablets, transdermal patches, or topical gels. For GSM, localized (meaning it only affects the vagina) vaginal hormone therapy is the answer, delivered in creams, tablets, suppositories, or rings that get right to the root of the problem.

But before you run to your doctor wanting a prescription for HT, it’s important to know it’s not for everyone. There are risks, especially for women with a history of certain cancers or cardiovascular issues. That’s why personalized care is key — what works for your friend might not be the best option for you. Talk to your healthcare provider about what makes the most sense for your body.

Non-Hormonal Options

Now, if hormone therapy doesn’t sound like your cup of tea (or your doctor advises against it), don’t worry. There are plenty of non-hormonal options available. Medications like SSRIs and SNRIs (usually used for mood disorders) have been shown to reduce hot flashes. A newer medication, Fezolinetant, offers non-hormonal relief for vasomotor symptoms as well.

For those battling GSM, vaginal moisturizers and lubricants can be lifesavers. There’s even Platelet-Rich Plasma (PRP) therapy, a treatment that helps restore and rebuild vaginal tissue.  And, as always, lifestyle changes like staying active, eating a balanced diet, and managing stress through activities like yoga or meditation can go a long way in helping to reduce symptoms.

It’s Your Journey — There’s No One Right Way

Whether you’re opting for hormone therapy, trying non-hormonal treatments, or relying on lifestyle changes, you have the power to manage your symptoms and make this transition as smooth as possible. And with ongoing research and updated guidelines, the medical community is continually working to refine best practices so women everywhere can approach menopause with confidence.

So, while menopause might not be the easiest chapter of life, it’s a natural part of the journey — one that you don’t have to navigate alone. With the right care and support, this can be a time of empowerment, where you focus on your health, your happiness, and what comes next. After all, menopause is just another part of your story — and you’re the one writing it.

To learn more about this complex life transition, watch Dr. Corey Babb go into more detail here!

Dr. Babb has dedicated his life to bringing awareness and acceptance to female sexual health. In addition to being a board-certified gynecologist, he is a fellow of the International Society for the Study of Women’s Sexual Health (ISSWSH), a Menopause Society Certified Practitioner (MSCP), and a member of the International Society for the Study of Vulvovaginal Disorders (ISSVD).
Currently, Dr. Babb serves on the board of directors for ISSWSH, is a reviewer for multiple sexual medicine journals, is a respected lecturer and educator, and has been featured in numerous national and international publications. He welcomes patients from across the world to Haven Center, where he is passionate about illuminating and treating conditions that have been previously neglected or marginalized in modern medicine.