Menopause

What to know about menopause

• Menopause is reached after 12 consecutive months without a menstrual period when there is no other obvious cause. Perimenopause is the time around menopause, and symptoms can start even while you are still having periods.
• Common symptoms include hot flashes, night sweats, trouble sleeping, vaginal or urinary changes, mood changes, and changes in menstrual bleeding. Because hormone levels fluctuate, symptoms may come and go rather than follow a set pattern. Some people have few symptoms, while others may need support for several years.
• No single treatment works for everyone. Options may include lifestyle changes, nonhormonal medicines, local vaginal treatments, or hormone therapy.
• Bleeding after menopause, new severe symptoms, chest pain, sudden neurologic symptoms, or thoughts of self-harm need prompt medical attention.

What is menopause?

Menopause is the point in time when a person has gone 12 months in a row without a menstrual period because the ovaries have stopped releasing eggs. It is a natural biological transition, not a disease. Menopause can start earlier if you have surgery, chemotherapy, radiation, or take certain medications.

Perimenopause

Perimenopause, also known as the menopausal transition, often starts with changes in menstrual timing or flow, although symptoms can sometimes appear before your periods become noticeably irregular. Your cycles might get shorter or longer, and you might skip periods or have heavier or lighter bleeding. You can still get pregnant during this time until you reach menopause.

This transition is different for everyone. Your age, genetics, surgeries, health conditions, medicines, sleep, stress, and overall health can all affect your symptoms. A symptom diary that tracks bleeding, sleep, hot flashes, mood, and possible triggers can help you and your healthcare provider identify patterns that inform diagnosis and treatment options.

Symptoms people experience

Common symptoms are hot flashes, night sweats, trouble sleeping, fatigue, irritability, anxiety, low mood, difficulty concentrating, headaches, and changes in sexual desire. Changes in your period are common during perimenopause, but very heavy or prolonged bleeding should be checked by a healthcare provider.

Lower estrogen levels can lead to vaginal dryness, pain during sex, frequent urination, repeated urinary discomfort, and changes in the pelvic floor. Some people also notice joint pain, changes in their skin or hair, or changes in body shape. These symptoms can have many causes, so your healthcare provider should look at your overall health instead of assuming every concern is hormonal.

How menopause is evaluated

For many people over 45 with common symptoms and changing periods, menopause is diagnosed by your medical history. Estrogen and related hormones change a lot during perimenopause, so a single test may not give clear answers. Your healthcare provider will ask about your periods, symptoms, health conditions, medications, birth control, pregnancy possibility, family history, and your personal goals. Based on this, they can decide whether menopause is likely and what next steps make sense.

Testing can help if your symptoms are unusual, your menopause happens earlier than expected, your periods stop suddenly, or another condition might be involved. Depending on your situation, your healthcare provider may suggest tests like a pregnancy test, blood count, thyroid test, blood sugar or cholesterol test, or other specific studies. Breast, pelvic, bone, and cardiovascular screenings should follow recommendations based on your age and risk factors.

The functional medicine approach

Standard menopause care begins with understanding your symptoms, ruling out other conditions that may mimic them, and discussing proven treatment options.

Functional medicine builds on this approach by focusing on each woman’s unique needs. It shifts menopause care from symptom management to an individualized plan, offering a clear, person-focused way to manage menopause. Combining careful assessment, proven lifestyle changes, supplements, and personalized hormone choices, the functional medicine approach can help reduce symptoms and meaningfully support long-term metabolic, bone, and heart health.

You and your healthcare provider work together to develop a practical plan that best addresses your priorities, health history, and lifestyle. Follow-up appointments are typically recommended every few months, or as your symptoms and needs change, to monitor your progress and adjust your plan as needed. The functional medicine approach complements your regular gynecologic and primary care. It does not replace mammograms or other screenings, evaluation of abnormal bleeding, or urgent care if serious symptoms appear.

Treatment options

Treatment depends on which symptoms matter most to you, your age, when menopause started, your health history, and preferences. Embracing healthy lifestyle practices, cutting back on tobacco and alcohol, and identifying what triggers your hot flashes are good first steps.

Hormone therapy can help some people with bothersome hot flashes or night sweats and may help prevent bone loss while you use it. If you have a uterus, systemic estrogen is usually given with a progestogen to protect the uterine lining.

Nonhormonal prescription medicines, behavioral approaches, pelvic-floor care, vaginal moisturizers or lubricants, and low-dose local vaginal estrogen or other local treatments can help with certain symptoms.

Your healthcare provider can review your risk factors, possible interactions, and the safest options for you, and then help you decide which treatment to try first and when to reassess.

Supporting bone, heart, and whole-body health

Menopause is a good time to focus on your long-term health, not just short-term symptoms. Personalize screening and prevention based on your age, family history, blood pressure, cholesterol, diabetes risk, and bone health.

Healthy, practical lifestyle changes can make a difference. Regular exercise, such as walking or strength training, supports bone and heart health. Managing stress through relaxation techniques, deep breathing, or yoga can improve mood and decrease anxiety. Following a consistent sleep routine, limiting caffeine late in the day, and keeping your bedroom cool and dark can improve sleep quality. Eating plenty of vegetables, whole grains, lean protein, and calcium-rich foods supports overall well-being.

Keep in mind that no single menopause diet or supplement works for everyone. Be cautious of products that claim to balance hormones, reverse aging, or treat every symptom. Supplements can interact with medications and may not be tested like prescription drugs, so review them with a qualified healthcare provider before using them.

When to seek care

Contact your healthcare provider right away if you have bleeding after menopause, very heavy bleeding, bleeding between periods or after sex, a new breast lump, ongoing pelvic pain, or rapidly worsening symptoms.

Seek urgent care if you have chest pain, severe shortness of breath, sudden weakness or trouble speaking, a severe new headache, fainting, or thoughts of harming yourself. Do not ignore new symptoms just because they happen during perimenopause or menopause.

How NaturoMedica can help

NaturoMedica’s physicians can help you make sense of your cycles, hot flashes, sleep problems, mood changes, sexual or urinary symptoms, and long-term health issues.

During your visit, you’ll have a chance to talk about your health and any concerns you have. We’ll go over your symptoms, medical history, and what you hope to achieve with treatment. We’ll also review your current medications and supplements, answer your questions, and do a brief physical exam if needed.

We will explain any recommended lab tests or screenings and work with you to create a plan tailored to your needs. Your plan may include advice on nutrition, exercise, sleep support, nonhormonal options, hormone therapy discussions, or working with your primary care or gynecology team.

Our focus is on making sure you feel comfortable, understood, and informed every step of the way.

Symptoms that need medical attention

Some symptoms need prompt medical evaluation and should not be dismissed as menopause. Contact a clinician promptly, or seek urgent care when symptoms are severe.

• Bleeding after menopause or very heavy, prolonged, or unexpected bleeding
• A new breast lump or persistent, unexplained pelvic pain
• Chest pain, severe shortness of breath, fainting, or sudden weakness
• A severe new headache or trouble speaking
• Rapidly worsening symptoms or symptoms that do not fit your usual pattern
• Thoughts of self-harm or feeling unable to stay safe

Menopause FAQs

What is the difference between perimenopause and menopause?

Perimenopause is the time around menopause when your periods and hormone levels can become irregular. Menopause is when you have not had a period for 12 months in a row, when there is no other obvious cause.

Do I need a hormone test to know if I am in menopause?

Often, providers can evaluate people over 45 with typical symptoms and changing periods by looking at their history. Hormone levels change a lot during perimenopause, so one test may not be helpful. Testing can be useful if symptoms are unusual or if another condition needs to be considered.

Is menopausal hormone therapy safe for everyone?

No treatment is right for everyone. The benefits and risks depend on your age, when menopause started, your symptoms, medical history, type of therapy, and whether you have a uterus. A qualified healthcare provider can help you make a decision that fits your needs.

Can lifestyle changes help menopause symptoms?

Lifestyle changes can help some people, especially with sleep, mood, strength, heart health, and overall well-being. Exercise, good nutrition, cutting back on tobacco and extra alcohol, and a regular sleep routine are good basics, but ongoing or severe symptoms may need more treatment.

Can NaturoMedica help with menopause in the Seattle Eastside?

NaturoMedica’s Issaquah clinic serves patients from Sammamish, Bellevue, Redmond, Renton, Kirkland, and nearby areas. Our doctors can review your symptoms, screenings, medications, supplements, and treatment options, and work with your primary care or gynecology team when needed.

Related services

• Women's Health — Personalized care for hormones, reproductive health, and whole-person wellness.
• Hormone Therapy — Discuss whether hormone therapy may be appropriate and how risks and benefits apply to you.
• Functional Testing — Consider targeted testing when it can answer a specific clinical question.

Medical information sources

This page is for education and does not replace medical advice, diagnosis, or treatment.

• The Menopause Society: 2022 Hormone Therapy Position Statement
• ACOG: The Menopause Years
• NIA: What Is Menopause?
• NICE: Menopause — diagnosis and management