Cohen Medical Associates is a family medical center and research center located in Delray Beach, FL.
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Living Well Through Menopause

In days past, if the perfectly normal transition from childbearing years to infertility was discussed at all, it was coyly referred to as “the change.” Fortunately, we’ve progressed to the point where the transition of menopause every woman experiences by her mid- to late-50s is now discussed openly.

Still, our family practice doctors at Cohen Medical Associates are aware many misconceptions remain regarding this natural phase of life. We wanted to clear up some of these and offer suggestions on best practices for managing the associated symptoms.


What happens in menopause?

Menopause is generally defined as the cessation of menstrual periods for 12 consecutive months. The hormonal changes can begin any time from the late 30s. The average age for most women, however, is between the ages of 45 and 55. In the U.S., the average age for the onset of menopause is 51. During this time, estrogen and progesterone production lowers or becomes irregular.

While most women don’t enter menopause until their early 50s or even later, most of them don’t realize their bodies begin the actual transition much earlier. Some even begin to notice symptoms in their mid-30s, a lengthy period known as perimenopause.

Some of the early telltale signs may include:

  • unexplained weight gain
  • increased difficulty sleeping
  • unusual irritability, anxiety, or depression
  • heart palpitations
  • hot flashes (a sudden feeling of heat, especially on the face and chest)
  • vaginal dryness
  • acne or allergies
  • changes in breast tissue
  • urinary incontinence
  • itchy or crawly skin
  • memory problems
  • increased facial hair
  • headaches
  • leg cramps
  • panic attacks
  • joint pain
  • urinary infections
  • fatigue
  • reduced/increased sex drive
  • irregular periods

During the period of perimenopause, several of these symptoms may start, stop and start again; or start, stop and be replaced by others. What’s happening is that your body’s production of estrogen and progesterone is fluctuating. Think of it like alternately hitting the gas and then the brakes when driving a car.

Some of the symptoms are driven by excess or deficient estrogen or progesterone, while some by an imbalance between these two critical hormones. And they won’t stop this tug-of-war until well after menopause.

Of course, many of these signs could signal other issues. Let us know about any such changes you’re experiencing to rule out other causes and help set your mind at ease.


Managing symptoms

We resist referring to the changes associated with menopause as “symptoms” because that tends to denote a disease process instead the a normal biological process that it is. But there’s no denying that menopause can be disruptive—even miserable—for many women, although some women sail through it barely noticing what’s happening.

Fortunately, the signs that signal the changes surrounding menopause are manageable through lifestyle adjustments and possibly short periods of hormone therapy.


Although exercise may seem totally unrelated to menopause, it’s the first line of defense in helping to regulate chaotic hormones. Aerobic and strength-training exercises three or more times per week can help calm those hormones. It can also help control weight, insomnia, depression and anxiety.


Dietary changes can also play a role in regulating the symptoms of menopause. Sugar, alcohol and animal fats not only contribute to the hormonal fluctuations, but make it more difficult for your body to throw off their effects. Eating lighter, fresher foods, including nuts, whole grains and vegetables, will help mood swings, ease insomnia and contribute to weight loss.

Keep your cool

Nearly 75 percent of women experiencing menopause report hot flashes as their most bothersome symptom. This is a sudden flushing of heat that suffuses the body, which may last for several minutes. At the peak of menopause, they can occur many times throughout the day. Hot flashes are most often noticeable at night when they can disrupt sleep and even drench sheets in perspiration. They typically recede within a few years, but for some they may last over 10 years.

    • Dress in layers so you can remove various layers as necessary.
    • Know and avoid your triggers: alcohol, hot drinks, spicy food, anger/anxiety, etc.
    • Keep a personal handheld fan available for use when they occur.
    • Try ice packs applied to the neck or chest.
    • Implement stress-relief techniques like meditation and deep breathing, which have been shown to relieve hot flashes, anxiety, depression, and insomnia.

Consider supplements

Supplements that some women have found helpful include black cohosh, evening primrose oil, ginseng and ground flaxseeds or flaxseed oil. Of course, please check with us before beginning any of these.


If you’re having difficulty with perimenopause or menopause, please remember we can help. There’s no need to “tough it out” or to try the myriad unproven remedies available on the internet. There are proven medical interventions, as well as other alternative approaches, that can help alleviate even the worst symptoms.

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