Menopause is having its moment, as more people are talking about the midlife transition all women experience.
Celebrities, influencers and many other women are learning to become more comfortable discussing menopause, which is defined as a woman experiencing 12 consecutive months without a menstrual period.
Perimenopause is the transition phase leading up to that, which could last two-to-four years, or even longer. That’s the time, before menopause, many women experience symptoms like hot flashes, night sweats and mood swings.
“There is no one, hallmark menopausal symptom,” said Dr. Kristi DeSapri. “I will see 10 to 12 different women, and each one of them will have their own constellation of symptoms.”
In menopause, ovaries stop producing significant estrogen and progesterone, and with estrogen receptors from head to toe, the spectrum of symptoms is wide ranging.
Women can experience joint pain, hair loss, acid reflux and bloating, to osteoporosis, and brain fog.
DeSapri, a menopause-certified clinician provider and the founder of Bone & Body Women’s Health on Chicago’s North Shore, says some of the lesser talked about symptoms women experience are changes in the vagina, vulva, bladder and urethra.
“Women complain of things like vaginal dryness, painful intercourse, frequent urinary tract infections, not being able to wear their same clothes,” said DeSapri. “And then there are the silent symptoms of menopause: changes in your blood pressure, changes in vascular resistance, cholesterol changes.”
The average age of menopause in the United States is 52. Premature menopause is defined as happening before age 40, but that’s when symptoms often start. They can also begin in a woman’s 30s.
Hot flashes affect 70 to 80% of women, but significant disparities exist.
“Black women tend to have more intense symptoms, lasting for a longer period of time,” said Dr. Kristen Myhand, an attending physician at Cook County Hospital.
The SWAN Study of Women’s Health Across the Nation, a longitudinal study examining the health of women during their middle years, finds menopause symptoms are more severe for women of color.
Native American and Black women experience the most frequent and bothersome hot flashes, according to SWAN. They’re also half as likely as white women to seek out and receive care. Hispanic women have similar rates of hot flashes than White women, but fewer than Black women, and Chinese and Japanese women have the fewest hot flashes.
“Patients can be ignored, which is nothing new, but they can be ignored and the symptoms can be anxiety or, ‘you’re just feeling a lot of stress’ and not really address the true problem of perimenopause or menopause,” said Myhand, who’s currently in the process of becoming menopause certified through the Menopause Society.
The same study finds hot flashes may last longer if they started early or if a woman is also experiencing anxiety, stress, or depressive symptoms.
Doctors Kristi DeSapri and Kristen Myhand each specialize in women’s health and note most physicians aren’t specifically trained in menopause care.
“Most of the training that we get in perimenopause and menopause is abysmal in this country,” said DeSapri. “Even gynecologists get less than three hours of menopausal training during their curriculum of residency unless they’ve focused on that or they do some specialty care in that.”
“So, the problem is, we have a lot of clinicians, physicians that are not specifically trained in menopause. If they’re not thinking that way, they might say, ‘oh, I don’t know what’s going on with you.’ And, what I often see in my patient practice is some patients have been to eight, nine doctors,” she added.
Myhand concurs, saying the menopausal transition was only a small part of the curriculum in her OBGYN training.
“I think there are so many missed opportunities in our training where we can just talk about it, just a quick lecture about it just to touch on it, and then as we’re always expanding our practice to just get deeper into it and grow our knowledge base ourselves,” she said.
By the end of 2026, according to Myhand, Cook County Health will include a dedicated menopause clinic, with a goal to expand into a full menopause center in the future.
While the conversation is growing, both doctors agree, there are likely many women suffering in silence.
“So many,” said Myhand. “Menopause is by far not the only thing that we feel so much shame as women to talk about. It’s an opportunity for us as female providers to be like, ‘yeah let’s talk about it. Let’s let everyone know about it, and let’s get you some care so you can be back to yourself.'”
“We still have a long way to go. It’s still women’s care, and it still, I think, has an upward battle for a lot of reasons, but I think we are of seeing some great progress,” added DeSapri.
Part two of “The Change We’re Finally Talking About” airs Tuesday at 4 p.m.
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