When Periods End And The Struggle Begins: How Menopause Wrecks Hormones And Daily Life | Explainers News

Last Updated:October 31, 2025, 07:00 IST

At its core, menopause is a story of shifting hormones and how those shifts can feel like a wrecking ball to both body and mind.

Menopause marks a major turning point in a woman’s life, the end of menstrual periods and the close of reproductive years. (Representative image/ AI-generated)

The US Food and Drug Administration (FDA) has approved a new drug, Lynkuet, to help manage hot flashes in menopausal women. This non-hormonal treatment is designed to relieve moderate-to-severe vasomotor symptoms, commonly known as hot flashes, associated with menopause.

The approval highlights an important truth: menopause isn’t merely the end of menstrual periods, but a complex biological transition that deserves medical attention and awareness.

Menopause doesn’t happen overnight. It’s a gradual process that unfolds over years—beginning with perimenopause, which can start 8–10 years earlier, usually in the mid-40s. While the transition can last anywhere from 4 to 8 years, it eventually leads to menopause and then postmenopause, a stage that lasts for life.

Let’s understand why menopause isn’t just freedom from menstrual pain, but a complex transition that calls for both scientific attention and social compassion.

The Hormone Crash That Changes Everything

Menopause marks a major turning point in a woman’s life, the end of menstrual periods and the close of reproductive years. By definition, it is diagnosed after 12 consecutive months without menstruation, spotting, or bleeding.

Most women reach this stage in their 40s or 50s, with the average age being 46.6 years in India, according to a review published in the journal Diabetes and Metabolic Syndrome: Clinical Research and Reviews.

At its core, menopause is a story of shifting hormones and how those shifts can feel like a wrecking ball to both body and mind.

In the late 30s and early 40s, the ovaries gradually produce less estrogen and progesterone, the hormones that regulate menstrual cycles, fertility, and many other functions.

But instead of a smooth decline, hormone levels fluctuate unpredictably during perimenopause, leading to irregular periods; sometimes shorter, longer, or skipped altogether.

By menopause, the ovaries stop releasing eggs and estrogen levels plummet, pushing the body into a permanent low-hormone state. This hormonal drop doesn’t just affect fertility; it also disrupts the immune system, creating what researchers call “inflamm-ageing.”

Studies have linked this to elevated pro-inflammatory cytokines such as TNFα and IL-6, lower CD4 T-cell function, and reduced NK cell cytotoxicity, all of which can increase infection risk. It’s important to note that while this increased risk is real, its impact varies greatly among individuals.

While menopause is a natural biological process, it can also occur prematurely due to medical reasons such as ovary removal (oophorectomy), chemotherapy, radiation therapy, or primary ovarian insufficiency, which affects about 1% of women before 40, as reported by Mayo Clinic.

When The Body And Mind Go Off Balance

These hormonal upheavals trigger a wave of symptoms that can disrupt daily life, often for one to ten years, with an average of about seven years. Common symptoms include hot flashes, night sweats, vaginal dryness and atrophy causing itching, discomfort, or pain during intercourse, sleep problems, and irregular periods during the transition phase.

Menopause also brings urinary issues, like incontinence and recurrent infections. The loss of estrogen leads to thinner vaginal epithelium, reduced acidity, and weaker antimicrobial defences, leaving women more prone to urinary tract infections (affecting 10–15% of women over 60) and even higher HIV replication rates.

A woman’s body also undergoes significant metabolic changes during menopause. As metabolism slows down and muscle mass decreases, it often leads to weight gain.

Bone density also drops sharply in early postmenopause, increasing the risk of osteoporosis, with women losing a significant amount of bone mass after menopause, with up to 10% loss in the first five years, and a cumulative loss that can reach 25% over subsequent decades, according to the Cleveland Clinic.

The hormonal chaos doesn’t stop at physical symptoms — it also deeply affects mental and emotional well-being. Fluctuating hormone levels can alter neurotransmitters, leading to mood swings, irritability, anxiety, and depression. It’s crucial to recognise that sleep disturbances and life stressors during this time are also major contributors to mood changes.

Sleep disturbances, often from night sweats,  fuel fatigue, low energy, and difficulty concentrating, a phenomenon many women describe as “brain fog.” Memory lapses, trouble finding words, and low libido are also common.

Sexual dysfunction and reduced pleasure due to vaginal dryness can strain relationships and intimacy. While some women experience mild effects, others find these symptoms debilitating enough to impact work, relationships, social life, and daily routines.

Managing Menopause And Beyond

The long-term health consequences stretch far beyond the menopausal years. The drop in estrogen increases the risk of cardiovascular disease, the leading cause of death among women, by negatively affecting cholesterol balance and blood vessel health.

Osteoporosis raises the chances of fractures in the spine, hips, and wrists, threatening mobility and independence. Meanwhile, immune changes from hormone loss can weaken vaccine responses and increase infection rates, even contributing to a second peak in HPV infections. These challenges can make routine activities like travel or exercise feel exhausting or even intimidating.

Despite its challenges, menopause doesn’t have to be a constant battle. While it can’t be prevented, its effects can often be managed and mitigated.

Hormone therapy (HT or HRT) — supplementing estrogen, with or without progesterone — remains one of the most effective treatments for hot flashes, night sweats, vaginal dryness, and osteoporosis prevention.

Current medical guidelines recommend it at the lowest effective dose to manage symptoms, with the duration personalised for each woman based on her individual benefits and risks, rather than a universal “shortest possible duration.”

Nonhormonal management also plays a vital role. Lifestyle adjustments, viz, avoiding triggers like caffeine, spicy food, or heat; eating phytoestrogen-rich foods (like soybeans), though evidence for their effectiveness is mixed; regular yoga and exercise; maintaining a healthy weight; and quitting smoking — can make a noticeable difference.

Medications as prescribed by the doctor can ease hot flashes and mood symptoms, while vaginal creams, lubricants, and cognitive behavioural therapy (CBT) address sexual and emotional well-being.

Managing menopause isn’t just about medication and healthy eating. A strong social support system matters just as much. Joining menopause support groups or consulting a healthcare provider for a personalised care plan can help women navigate this transition with confidence.

Empathy and understanding from spouse, children, and family members also play a vital role, helping women move through menopause not just surviving, but truly thriving.

As hormone levels stabilise in postmenopause, most symptoms subside, paving the way for a new phase of life.

Surbhi Pathak

Surbhi Pathak, subeditor, writes on India, world affairs, science, and education. She is currently dabbling with lifestyle content. Follow her on X: @S_Pathak_11.

Surbhi Pathak, subeditor, writes on India, world affairs, science, and education. She is currently dabbling with lifestyle content. Follow her on X: @S_Pathak_11.

Menopause doesn’t happen overnight. It’s a gradual process that unfolds over years—beginning with perimenopause, which can start 8–10 years earlier, usually in the mid-40s. While the transition can last anywhere from 4 to 8 years, it eventually leads to menopause and then postmenopause, a stage that lasts for life.

Let’s understand why menopause isn’t just freedom from menstrual pain, but a complex transition that calls for both scientific attention and social compassion.

The Hormone Crash That Changes Everything

Menopause marks a major turning point in a woman’s life, the end of menstrual periods and the close of reproductive years. By definition, it is diagnosed after 12 consecutive months without menstruation, spotting, or bleeding.

Most women reach this stage in their 40s or 50s, with the average age being 46.6 years in India, according to a review published in the journal Diabetes and Metabolic Syndrome: Clinical Research and Reviews.

At its core, menopause is a story of shifting hormones and how those shifts can feel like a wrecking ball to both body and mind.

In the late 30s and early 40s, the ovaries gradually produce less estrogen and progesterone, the hormones that regulate menstrual cycles, fertility, and many other functions.

But instead of a smooth decline, hormone levels fluctuate unpredictably during perimenopause, leading to irregular periods; sometimes shorter, longer, or skipped altogether.

By menopause, the ovaries stop releasing eggs and estrogen levels plummet, pushing the body into a permanent low-hormone state. This hormonal drop doesn’t just affect fertility; it also disrupts the immune system, creating what researchers call “inflamm-ageing.”

Studies have linked this to elevated pro-inflammatory cytokines such as TNFα and IL-6, lower CD4 T-cell function, and reduced NK cell cytotoxicity, all of which can increase infection risk. It’s important to note that while this increased risk is real, its impact varies greatly among individuals.

While menopause is a natural biological process, it can also occur prematurely due to medical reasons such as ovary removal (oophorectomy), chemotherapy, radiation therapy, or primary ovarian insufficiency, which affects about 1% of women before 40, as reported by Mayo Clinic.

When The Body And Mind Go Off Balance

These hormonal upheavals trigger a wave of symptoms that can disrupt daily life, often for one to ten years, with an average of about seven years. Common symptoms include hot flashes, night sweats, vaginal dryness and atrophy causing itching, discomfort, or pain during intercourse, sleep problems, and irregular periods during the transition phase.

Menopause also brings urinary issues, like incontinence and recurrent infections. The loss of estrogen leads to thinner vaginal epithelium, reduced acidity, and weaker antimicrobial defences, leaving women more prone to urinary tract infections (affecting 10–15% of women over 60) and even higher HIV replication rates.

A woman’s body also undergoes significant metabolic changes during menopause. As metabolism slows down and muscle mass decreases, it often leads to weight gain.

Bone density also drops sharply in early postmenopause, increasing the risk of osteoporosis, with women losing a significant amount of bone mass after menopause, with up to 10% loss in the first five years, and a cumulative loss that can reach 25% over subsequent decades, according to the Cleveland Clinic.

The hormonal chaos doesn’t stop at physical symptoms — it also deeply affects mental and emotional well-being. Fluctuating hormone levels can alter neurotransmitters, leading to mood swings, irritability, anxiety, and depression. It’s crucial to recognise that sleep disturbances and life stressors during this time are also major contributors to mood changes.

Sleep disturbances, often from night sweats,  fuel fatigue, low energy, and difficulty concentrating, a phenomenon many women describe as “brain fog.” Memory lapses, trouble finding words, and low libido are also common.

Sexual dysfunction and reduced pleasure due to vaginal dryness can strain relationships and intimacy. While some women experience mild effects, others find these symptoms debilitating enough to impact work, relationships, social life, and daily routines.

Managing Menopause And Beyond

The long-term health consequences stretch far beyond the menopausal years. The drop in estrogen increases the risk of cardiovascular disease, the leading cause of death among women, by negatively affecting cholesterol balance and blood vessel health.

Osteoporosis raises the chances of fractures in the spine, hips, and wrists, threatening mobility and independence. Meanwhile, immune changes from hormone loss can weaken vaccine responses and increase infection rates, even contributing to a second peak in HPV infections. These challenges can make routine activities like travel or exercise feel exhausting or even intimidating.

Despite its challenges, menopause doesn’t have to be a constant battle. While it can’t be prevented, its effects can often be managed and mitigated.

Hormone therapy (HT or HRT) — supplementing estrogen, with or without progesterone — remains one of the most effective treatments for hot flashes, night sweats, vaginal dryness, and osteoporosis prevention.

Current medical guidelines recommend it at the lowest effective dose to manage symptoms, with the duration personalised for each woman based on her individual benefits and risks, rather than a universal “shortest possible duration.”

Nonhormonal management also plays a vital role. Lifestyle adjustments, viz, avoiding triggers like caffeine, spicy food, or heat; eating phytoestrogen-rich foods (like soybeans), though evidence for their effectiveness is mixed; regular yoga and exercise; maintaining a healthy weight; and quitting smoking — can make a noticeable difference.

Medications as prescribed by the doctor can ease hot flashes and mood symptoms, while vaginal creams, lubricants, and cognitive behavioural therapy (CBT) address sexual and emotional well-being.

Managing menopause isn’t just about medication and healthy eating. A strong social support system matters just as much. Joining menopause support groups or consulting a healthcare provider for a personalised care plan can help women navigate this transition with confidence.

Empathy and understanding from spouse, children, and family members also play a vital role, helping women move through menopause not just surviving, but truly thriving.

As hormone levels stabilise in postmenopause, most symptoms subside, paving the way for a new phase of life.

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