Menopause—it’s a term that often conjures up visions of hot flashes, fans, and spritzer bottles. I used to be fascinated by the fact that my mother would transform from looking cool and comfortable to someone with sweat dripping off her nose within a matter of seconds. Yet somehow I sailed through menopause with only two hot flashes. Go figure. Andrea (the Founder of Morphus) had a different experience and definitely had hot flashes.

Basically, menopause is a different experience for every woman. O if you haven’t experienced it yet, don’t panic! If you are in the throes of the phase, the advice is the same. Here are some of the things you should know about this time of life.

What is menopause?

Menopause is the time in a woman’s life when menstruation stops. Specifically, it’s when a woman’s ovaries stop releasing mature eggs and the body makes less estrogen and progesterone.

Typically menopause has probably begun if you haven’t had a period for more than six months, although the “official” word is that 12 full months need to go by without a period.

At what age does menopause begin?

The majority of women experience menopause between ages 40 and 58, with the average age being 51. However, there are certain exceptions that may be the result of genetics (mom had late menopause so you may too!) or medical interventions, such as having had an oophorectomy (removal of both ovaries), a hysterectomy, or having received chemotherapy or pelvic radiation for cancer.

If you are a smoker, you may reach menopause about two years earlier. That’s just a generalization.

Approximately 1 percent of women experience premature menopause, which can start before age 40 but usually occurs between ages 40 and 45. Premature menopause may appear because of thyroid disease, a hysterectomy, chemotherapy or other radiation for cancer, or a chromosomal defect, such as Turner syndrome. If you haven’t had a period in more than three months and you’re younger than 40, you should talk to your doctor and get tested for early menopause or other possible causes.

What are the symptoms of menopause?

The transition from perimenopause to menopause can be gradual or more sudden, depending on the woman. Actually, the symptoms often blend together for a while, but the one symptom most symbolic of menopause is hot flashes. Other symptoms you may experience during menopause include the following. Don’t let the long list scare you!

• Night sweats
• Lower libido
• Spotting
• Thinning hair and hair loss
• Dry skin
• Vaginal dryness (which can cause pain with sex)
• Mood changes
• Weight gain
• Burning mouth
• Breast pain
• Irregular periods
• Muscle tension
• Electrical shocks
• Headaches
• Digestive problems
• Itchy skin
• Gum problems
• Anxiety
• Disrupted sleep
• Tingling in your extremities
• Fatigue
• Hair loss
• Memory and concentration challenges
• Dizzy spells
• Bloating
• Urinary stress incontinence
• Brittle nails and hair
• Allergies
• Irregular heartbeat
• Increase in body odor
• Depression and/or anxiety disorder
• Osteoporosis (loss of bone density and strength)

You can get some symptomatic relief if you eat a clean natural diet, exercise regularly, get sufficient sleep, stay hydrated, avoid alcohol, caffeine, and smoking, and practice stress-reduction techniques, such as yoga, progressive relaxation, visualization, deep breathing, and tai chi.

Is there a menopause test?

Generally, you don’t need a test to confirm you’re in menopause, but some are available. Your doctor can swab your vagina to test pH levels, which can confirm menopause. During your premenopausal years, vaginal pH is about 4.5. During menopause, that number rises to about 6.

If you’re experiencing menopausal symptoms and there’s any reason to suggest you may have a medical condition such as a thyroid problem or ovarian failure, your doctor may order a thyroid function test, a lipid profile (for cholesterol and triglycerides), or tests for kidney and liver function. Hypothyroidism (low functioning thyroid) is not uncommon among women of menopausal age, and it can cause symptoms similar to those of menopause.

Your doctor also may order a blood test to measure follicle-stimulating hormone (FSH) and estrogen levels. During menopause, your FSH levels rise while your estrogen levels decline. The FDA approved a new test in 2018 called the PicoAMH Elisa test, which measures the level of anti-Mullerian hormone in the blood. This level helps doctors identify when you will begin menopause if you haven’t already.

Another way to test hormone levels is using the DUTCH Test which measures hormone levels in dried urine to determine where you may be with the transition to menopause.