Guest Blog By: Z. Colette Edwards, MD MBA, Founder and Chief Medical Officer of pausitive health
Let’s be real, menopause is a wild ride. One minute you’re feeling fine, and the next, you’re questioning whether you’re sweating because it’s hot outside or because your body decided to turn up the internal thermostat. And that’s just the beginning. But here’s the good news: menopause isn’t something to fear. With the right information, it can be a time of empowerment, growth, and even relief. So, grab a cup of tea, mocktail, (or a glass of wine—no judgment here), and let’s talk about the top 12 things you really need to know about this journey.
1. The Menopause Journey Is a Process, Not a One-Day Event
The menopause journey isn’t something that happens overnight. It’s a transition that takes years, typically starting with perimenopause (which can begin in your 40s, sometimes earlier) which leads up to the day it’s been one year after your last period, the official definition of menopause. And then you’re in the post-menopause stage for the rest of your life, which includes the many vibrant years that lie ahead.
The menopause journey is more like a marathon than a sprint. The key is to understand where you are on the journey and what your body is telling you.
2. It’s Not Just About Hot Flashes
Yes, hot flashes get all the attention, but the menopause journey is about so much more. Brain fog, mood swings, joint pain, sleep disturbances, and even digestive issues can all be part of the experience. It’s not in your head—it’s your hormones, and they impact nearly every system in your body.
One area that often gets overlooked is pelvic health. As estrogen declines, tissues in the pelvic region can become thinner and less elastic, which can lead to issues like vaginal dryness, urinary incontinence, and discomfort during intimacy. Strengthening pelvic floor muscles with targeted exercises and considering vaginal moisturizers or estrogen therapy can make a big difference.
3. Your Mindset Matters
How you approach the menopause journey makes a difference. Women from cultures and countries that view this stage of life as a natural, even positive transition tend to report fewer severe symptoms. Deciding to view it as a powerful phase of life rather than a loss can help shift your experience from dread to empowerment.
Your pelvic health plays into this as well—when you feel strong and in control of your body, including your pelvic floor, you’re more likely to embrace this stage with confidence. Pelvic floor therapy, mindful movement, and self-care practices can enhance both physical well-being and emotional resilience during this transition.
4. Your Hormones Are Changing, But You’re Not “Losing” Them
Estrogen and progesterone levels fluctuate and eventually decline, but your body is still producing hormones—just in different ways. Other organs, like your adrenal glands, help pick up some of the slack. This is why managing stress and supporting adrenal health (think sleep, nutrition, and stress management with techniques like mindfulness) is crucial.
Your pelvic health is also influenced by these hormonal shifts. Lower estrogen levels can lead to weakening of the pelvic floor muscles, which may contribute to bladder leaks, prolapse, and discomfort. Keeping your pelvic muscles engaged through exercises like Kegels or working with a pelvic health specialist can help maintain strength and function.
5. Lifestyle Changes Can Make a Huge Difference
You don’t have to suffer through symptoms in silence. Small lifestyle tweaks—like prioritizing protein, strength training, improving sleep hygiene, and reducing sugar and alcohol intake—can help regulate hormones and ease symptoms. And let’s not forget the power of pelvic floor exercises!
6. Menopause Affects Heart and Bone Health
Estrogen helps protect your heart and bones, so when levels drop, your risk for osteoporosis and heart disease increases. That means this is the time to be proactive about weight-bearing exercise, a calcium-rich diet with vitamin D and a great focus on plant-based meals, and regular health screenings like checking for osteopenia/osteoporosis. Your future self will thank you.
7. Your Gut Health and Microbiome Play a Role
Surprise! Your gut bacteria influence hormone metabolism, inflammation, and even mental health. Eating fiber-rich, probiotic-packed foods can support digestion and hormone balance, which is why gut health should be a priority during the menopause journey.
Interestingly, your gut health also connects to your pelvic health—certain strains of probiotics can support vaginal and urinary tract health, reducing the risk of infections and irritation. That’s because the gut and vaginal microbiomes are interconnected. The gut is the place where bacteria that can colonize the vagina are found, and changes in the gut microbiome potentially impact vaginal health and vice versa, including hormone levels and susceptibility to infections.
A balanced gut microbiome may also help with inflammation that can affect the pelvic floor, making it another key factor in maintaining overall well-being.
8. Sleep Can Be a Challenge—but It’s Fixable
Hormonal fluctuations can wreak havoc on sleep. If you’re waking up drenched in sweat at 3 am, you’re not alone. Cooling bedding, a consistent bedtime routine, and reducing evening caffeine and alcohol can all help.
Getting enough high-quality sleep is also key to helping maintain a healthy weight, reducing fatigue, counteracting brain fog, and supporting cardiovascular health. That’s why it’s important to talk to a healthcare practitioner about solutions, which might include options like hormone therapy, mind-body practices, acupuncture, herbal medicine, or binaural beats.
9. There Are Many Options for Symptom Management
You don’t have to “just deal with it.” Hormone therapy (HT) is one option, but there are also non-hormonal medications, acupuncture, cognitive behavioral therapy, lifestyle changes, and other holistic approaches (or a combination thereof). The right choice depends on your body, your preferences, and your medical history.
Pelvic health should also be part of this conversation. Vaginal estrogen, pelvic floor therapy, and other interventions can help address issues like pain during sex, bladder urgency, and pelvic organ prolapse. A urogynecologist should be able to guide you through the options that best fit your needs.
Remember, sucking it up is the one option not to entertain!
10. Navigating the Healthcare System Can Be Challenging—but You Have Power
Finding the right support can feel overwhelming. Many doctors receive limited menopause training, which means they may not always recognize or appropriately treat symptoms (69% of GYN residency programs don’t have a menopause curriculum!). This lack of training leaves many women feeling dismissed or misunderstood. That’s why self-advocacy is crucial. Keeping a symptom journal, researching treatment options, and seeking out menopause specialists can make all the difference.
Resources like Navigating Your Healthcare Journey provide valuable guidance on making the most of medical visits, understanding insurance coverage, and ensuring you get the care you deserve. Health literacy is also key—being informed about your options, from hormone therapy to lifestyle interventions, empowers you to make decisions that align with your needs. One good place to start is asking questions and persisting until you have answers and understand them. Here’s more information about navigating the healthcare system during the menopause journey.
And don’t forget pelvic health! Many women benefit from seeing a pelvic health specialist, especially if they’re experiencing bladder leaks, pelvic pain, or changes in sexual function.
Infographic courtesy of Khanh Nguyen.
11. The Menopause Journey Experience Varies for Women of Color and Members of the LGBTQ+ Community
Not all menopause experiences are the same. Research shows that women of color often experience menopause differently. For example, Black women tend to have longer and more intense hot flashes and have more bladder issues and vaginal dryness. Hispanic women/Latinas may experience more anxiety and mood changes as well as painful intercourse. And members of the LGBTQIA+ community may face an even greater challenge when searching for a clinician with both menopause journey training and experience and expertise relative to the unique healthcare needs of this community,
Women+ tend to have a more positive outlook on the menopause journey, but may find it more difficult to find healthcare practitioners who have the training to understand their unique needs.
Pelvic health disparities exist as well. Women of color are more likely to experience conditions like uterine fibroids, which can complicate menopause symptoms. Additionally, studies suggest that racial disparities in medical care can lead to delayed diagnosis and inadequate treatment for pelvic floor disorders. Understanding these differences is crucial for ensuring that all women receive the care and support they need. If you’re a woman of color, seeking out culturally competent healthcare practitioners who understand these unique challenges can make a big difference in your menopause journey.
12. You Are Not Alone
One of the hardest things about the menopause journey can be the feeling like you’re going through it alone. But the reality is, millions of women are experiencing the same ups and downs during this transformative life transition. Finding a community—whether through friends, support groups, or online platforms—can make a world of difference.
Final Thoughts
The menopause journey isn’t the end of something—it’s the beginning of a new book. Yes, there are challenges, but with knowledge, support, and the right tools, you can navigate this phase with confidence and thrive. Remember, you deserve to feel good in your body, at every stage of life.
So, what’s one thing you wish you had known about the menopause journey earlier? Let’s keep the conversation going—because the more we talk, the more empowered we become.
About the Author
Dr. Z. Colette Edwards, MD, MBA Founder & Chief Medical Officer of pausitive health, a holistic menopause platform redefining support for women at midlife. Dr. Edwards brings a background that spans Harvard, Wharton, clinical medicine, and wellness coaching, blending science with soul in her work. She’s also the co-author of Navigating Your Healthcare Journey: Lessons Learned to Get the Care You Need and Deserve
Through her integrative lens, she helps women move beyond symptoms and into a space of vitality, self-awareness, and whole-person healing.
