Expert Advice to Help Symptoms of Menopause

Gynecologist and menopause guru Jen Gunter gives tips for preventing and treating hot flashes, vaginal dryness, painful sex and more

Sex and Your Libido

Elizabeth Agnvall,

AARP

En español

Published December 20, 2022

More than 1 million women experience menopause each year, according to the National Institutes of Health. Although menopause is defined as the point in time 12 months after a woman’s last period, perimenopause (the transition to menopause) most often begins between the ages of 45 and 55. It lasts an average of seven years, but can be as long as 14 years. During perimenopause, production of the hormones estrogen and progesterone decreases. Scientists say the decrease in estrogen likely causes most of the symptoms of menopause. Symptoms can include hot flashes, issues with bladder control, trouble sleeping, mood changes and memory problems. Women can also experience changes in their periods and vaginal dryness, which can make sex uncomfortable.

Although there are treatments and things women can do to ease the symptoms of menopause, one 2021 survey of more than 1,000 women found that 73 percent of respondents who were experience menopause symptoms were not treating them. The survey also found that half of the women said they experienced painful sex after the onset of menopause symptoms.

Yet Jen Gunter, an obstetrician/gynecologist and author of The Menopause Manifesto says that she wants every woman to have the knowledge to help them with their own menopause. In a series of videos, Gunter gives advice and tips to help with common symptoms of menopause, and she clears up a few misconceptions.

Sex and your libido

Gunter says the subject of sex and menopause is not often discussed, but it should be. Shifting hormones during menopause can cause a decrease in sex drive around menopause for some but not all women. Some women experience an increase in sex drive. But about 27 percent to 60 percent of women experience vaginal dryness with menopause and perimenopause. This can cause painful sex, but sex doesn’t have to be painful. After talking to your doctor to rule out other causes of pain, Gunter recommends asking about vaginal estrogen. “The first step is talking about it,” she says, “because you deserve to have the kind of sex you want to have.”

How to tame a hot flash

How to Tame a Hot Flash

Hot flashes can start years before menopause begins and are related to declining estrogen levels. More than 80 percent of women experience hot flashes during menopause. They tend to increase in severity and often become most troublesome during the transition to late menopause. But Gunter says women don’t have to suffer. There are things you can do to manage hot flashes, such as maintaining a healthy diet that’s high in fiber, includes at least two servings of fish a week and is lower in fat and sugar. Caffeine, spicy foods and alcohol can be hot flash triggers, Gunter says. There are prescription medications that can help, and there are some herbal remedies that may help, although more research is needed.

Brain fog

How Menopause Messes With Your Brain (and Why You Shouldn't Worry About It)

About two-thirds of women notice changes with their memory during menopause. One 2021 study published in Scientific Reports found that menopause affects women’s brain structure and connectivity. Scientists speculate that estrogen may help protect women’s brains. The good news, Gunter says, is that mental performance seems to rebound after menopause. “I like to think of menopause as loading a new operating system in your brain,” Gunter says. “It can be a bit glitchy at first, but once it’s up and running, things work great again."

Irregular periods

Why Are My Periods So Irregular?

Gunter says the first sign that a woman is headed into menopause is irregular cycles. Periods will often start getting shorter and come later than expected. Some women have heavier periods. This happens due to changes in hormones during ovulation. As women get closer to menopause, their periods become less frequent. Because irregular periods can be a sign of some problems other than menopause, Gunter recommends talking to your health care provider about any changes to your menstrual cycle.

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Elizabeth Agnvall is the health and healthy living editor at AARP.org. She has worked as editor of Staying Sharp, AARP’s brain health platform and as a health editor at the AARP Bulletin. She also wrote for the Washington Post health section.