Our mothers often called it “The Change.” That is, if we heard them speak of it at all. One of my colleagues told me he diagnosed menopause by the number of phone calls the spouse made to him. One morning he received a call from the husband of a long-standing patient saying, “She moved into the basement and turned the thermostat to 50. What is wrong with her?”

Times are a bit different now. Many women going through menopause are refusing to live in misery and are turning to their health-care providers for help. Most women are quite aware that hot flushes and night sweats are a sign that change may be coming. Many are unaware, however, that other subtle changes may accompany the end of a woman’s reproductive cycles. Symptoms include difficulty sleeping, memory loss, irregular bleeding, unwanted hair growth and loss of libido, just to name a few. I often tell my patients that just about any unwanted symptom can be blamed on the imbalance that can occur as the ovaries are checking out.

So what is menopause?

What used to be thought of as a final event is now characterized by a series of changes and symptoms that are often precipitated by hormonal shifts. When adolescent girls begin menstruating, you can think of it as a timer starting. Unfortunately, we don’t know how many years are preset on this time. We only know that women are born with a set number of eggs and when they have gone through all of them, the timer will go off and, hopefully, bleeding will cease. Sounds easy, right? It is not that simple, and many things can cause the transition into menopause to be difficult.

Sometimes the timing is off, and women go through menopause much earlier than they planned. This can cause an abrupt and early end to their ability to become pregnant. Sometimes this can be predicted. If a woman has gone through chemotherapy or if other women in her family had a premature menopause, she should seek advice from a specialist before she reaches the age when her relatives went through menopause.

At other times, it seems the change will never come. Many women in their 50s are frustrated because they continue to have bleeding despite a myriad of bothersome symptoms associated with menopause.

So what causes the hot flushes, night sweats, etc? There is a decline in estrogen production that gradually occurs over time. Each woman is wired differently. Some are much more sensitive to this decline and have severe menopausal symptoms that disrupt life and cause a great degree of anxiety. Other women seem to sail through the change with barely a glance.

If you are feeling the heat, consider discussing things with your doctor. A variety of treatments are available to help alleviate symptoms, including hormonal therapies, certain antidepressants, and some herbal remedies. Each of these treatments has benefits and risks and should be discussed with a health-care provider who knows your medical history and can help you decide which would be the best for your situation.

Perhaps the best advice to keep in mind is that menopause is a natural part of the life cycle. Many women find their early to mid-fifties to be one of the most satisfying times in life, a time when they are finally comfortable in their own skin.

If you have questions about menopause and how best to approach the change it brings, contact your health care provider today.