Menopause will affect around half of British Columbians, yet many people don’t know what to expect during this phase of life, or how to access help.
What is menopause?
Like puberty, the menopause transition is a natural phase of life.
“Menopause” is actually only one day in a person’s life. It refers to the date of a person’s last menstrual cycle, and is confirmed once periods have stopped for 12 consecutive months.
The average age of menopause for Canadian women is 51.
What is perimenopause?
Perimenopause is the period of time leading up to menopause. During perimenopause, there is a decline in the ovaries’ production of the hormones estrogen and progesterone. They will eventually stop producing these hormones altogether once menopause has been reached.
Perimenopause typically begins when menstrual cycles vary by seven days or more. Identifying perimenopause can be more difficult in those who do not have regular menstrual periods, such as people who have had a hysterectomy or who may be using hormonal contraceptives.
Perimenopause can start up to 10 years before menopause.
Post-menopause, which is the period of time from menopause for the rest of a person’s life, can last many decades.
Certain symptoms peak during perimenopause (such as hot flashes, night sweats, cognitive changes) and other symptoms can worsen during post-menopause (such as genital and urinary symptoms).
Who does menopause affect?
Menopause will usually affect anyone who is assigned female at birth. This can include cisgender women, transgender men, non-binary people, and others.
If you are not sure whether menopause will affect you, speak to your doctor.
For information and support for trans, two-spirit and non-binary people, visit
Trans Care BC.
What is early menopause?
Sometimes menopause can spontaneously occur at a younger age, although this is uncommon.
1 in 100 women reach menopause before the age of 40.
1 in 1,000 women reach menopause before the age of 30.
What is treatment-induced menopause?
Surgery to remove the ovaries, chemotherapy, radiation to the pelvic, and hormone suppressive
therapy can lead to treatment-induced menopause before a person has gone through the normal
menopause transition.
What are the symptoms of menopause?
There are over 30 symptoms associated with perimenopause and menopause. These include:
- Lack of energy or fatigue
- Low mood
- Anxiety
- Brain fog
- Insomnia
- Hot flashes and night sweats (also known as vasomotor symptoms)
- Muscle and joint pain
- Vaginal dryness
- Bladder control issues
For more information on menopause symptoms, visit
Menopause Foundation of Canada.
What are the longer-term health risks of menopause?
According to
Menopause Foundation of Canada, with the onset of menopause and the significant decline in estrogen, the risk for certain long term health conditions increases.
Osteoporosis causes bones to become weak and brittle. The hormone estrogen improves bone density and decreases fracture risk, so lower estrogen levels during menopause can lead to osteoporosis.
After menopause, the risk of heart disease increases steadily due to a lack of estrogen.
Genitourinary Syndrome of Menopause (GSM) affects up to 70% of postmenopausal women, and is caused by low estrogen levels in the tissues of the urinary tract and genital tract. This leads to urinary problems, issues with sexual function, and vaginal dryness/irritation. Unlike symptoms such as hot flashes, which usually improve over time, GSM will generally continue to worsen if not treated.
How are menopause symptoms treated?
Menopause Hormone Therapy (MHT)
Sometimes menopause symptoms can be managed using Menopause Hormone Therapy, previously known as Hormone Replacement Therapy. This can be prescribed as a tablet, patch, gel, spray, or vaginal pessary, ring or cream.
MHT is the first-line recommended treatment for vasomotor symptoms (hot flashes and night sweats), bone loss prevention, and GSM symptoms.
MHT can include the hormones estrogen, progesterone, and occasionally other hormones such as testosterone and DHEA.
As with any medication, there are risks and side effects associated with MHT use.
MHT may not be suitable for some people with other health conditions. Your doctor will be able to
advise on whether MHT is appropriate for you. HealthLink BC offers more information to
help you understand MHT.
For people who are unable to be prescribed MHT due to contra-indications, you should speak with your doctor about other evidence-based treatments.
Other ways to manage menopause symptoms
Exercise and movement can be used to improve sleep quality, reduce anxiety and low mood, improve fatigue, ease chronic muscle pain, slow the rate of bone loss, and improve heart health.
Changes to diet can also help with menopause health risks
. Eating foods rich in calcium and vitamin D can promote bone health. Eating a heart-healthy diet can also improve long term health: this means choosing foods like vegetables, fruits, nuts, beans, fish, or whole grains, while limiting foods that are high in salt, fat and sugar.
Limiting caffeine and alcohol can also help manage menopause symptoms.
Other measures such as acupuncture, Cognitive Behavioural Therapy (CBT), chiropractic interventions,
and cooling techniques can be used to manage hot flashes, although there is limited data on
their effectiveness.
Vaginal discomfort, issues with sexual function and other GSM symptoms can sometimes be managed using specialized products. The Menopause Society offers more information on
menopause and sexual health
.
Further support and resources
Pacific Blue Cross is British Columbia’s number one health benefits provider.
We offer flexible and comprehensive coverage for massage, physio, registered counsellors
and psychologists, and more.
Design your personal health plan today.
Below is a list of resources to support health and wellbeing during menopause:
