It’s never too early to talk about, well, early menopause—and menopause in general for that matter. Considering that women are estimated to spend a third of their lives in it (😮‍💨), we should all know what to expect sooner rather than later, right? So, for our last Women’s Health Week feature, we chatted with Dr. Sophia Yen, MD, MPH (she/her), co-founder and chief medical officer of Pandia Health—the only doctor-funded and women-led online hormonal health clinic that provides prescription birth control, menopause, and acne services—to explain everything about the end of our menstrual cycle.

What exactly is menopause? Why does it happen?
Menopause is when you stop having periods. We often “diagnose” it when it’s been 12 months since the last day of your last period. So when women ask, “Am I done yet? Are we there yet?”, it’s a period of unknown because we don’t know when an individual person is going to stop bleeding for 12 months and be actually done. We do know that it happens because your body no longer produces eggs, meaning it’s done with reproduction.

What are the different stages of menopause?
The stages are:

  • Premenopause/perimenopause: This is when you start having menopause symptoms, when your estrogen levels start to go down, when you have irregular periods, etc.
  • Menopause: This stage can include 33+ symptoms. Not so fun fact: 70% of women have menopause symptoms and hot flashes on average that last seven years.
  • Postmenopause: The time immediately after menopause until you don’t have any menopause symptoms.

At what age does menopause usually take place? How long does it normally last?
Menopause on average is diagnosed at 51-years-old in the U.S., the perimenopause can be up to 10 years, and symptoms of post-menopause can last 10 years or more.

What are the common symptoms of menopause?
Some common symptoms include:

  • Hot flashes, also called vasomotor symptoms (VMS), which is a sudden feeling of warmth that spreads over your body that can cause sweating mainly in the chest and face.
  • Night sweats.
  • Vaginal dryness that causes pain/discomfort during sex. (I call it sandpaper vagina.)
  • Urinary urgency, or the need to pee more frequently but not because you’re drinking more water.
  • Difficulty sleeping or insomnia that can also be due to the night sweats/hot flashes.
  • Emotional changes (see: irritability, mood swings, or mild depression).
  • Dry skin, dry eyes, or dry mouth.

Some people also have:

  • Racing heartbeat/palpitations.
  • Headaches.
  • Joint and muscle aches and pains.
  • Changes in libido (aka sex drive).
  • Difficulty concentrating or temporary memory lapses.
  • Weight gain where the fat redistributes to the waist.
  • Hair loss or thinning.

Is there a way to prevent or delay it?
There’s no way to prevent or delay it. Often people hope that using the birth control pill, patch, or hormonal IUD to skip monthly periods will conserve eggs, but it doesn’t. You have all the eggs you’re going to have when you’re born, and they go away on their own schedule.

What happens during early/premature menopause? Is this dangerous if it occurs?
Early/premature menopause occurs when your ovaries stop working early. It could be autoimmune (like your body attacking your ovaries) or could happen for an unknown reason. It’s only dangerous for your health if you have early menopause and they don’t replace the hormones. Estrogen is important for your heart health, brain health, and bone health.

Are there different signs or triggers of early menopause we should watch out for?
There’s no triggers of early menopause, but signs include irregular periods when you’re not on hormonal birth control, hot flashes, and night sweats. This could also be a thyroid issue, cancer, or tuberculosis.

What are practices and/or products that can help women going through menopause?
The best treatment for premature menopause and menopause is estrogen. If you’re afraid of estrogen, read this book. It’s important that women know that the Women’s Health Initiative was deeply flawed. The average age of the women in the study was 63, and we now know that you need to start your estrogen treatment within 10 years of menopause. So, 63 was too late. When menopause occurs, your body takes estrogen away, your arteries change, and we are subject to problems like high cholesterol. So, we need to put that estrogen back ASAP to prevent all that.

What’s your last piece of advice for us about menopause?
Make sure you get treated. You don’t get a medal for white knuckling it for five years to see how long you can last before treatment. Make sure your doctor(s) know the latest in menopause education, and if your doctor won’t treat your menopause, get a different doctor.