Let's Keep Talking About Menopause: Understanding Symptoms, Health and Support
October may be recognized as Menopause Awareness Month, but conversations about menopause shouldn't be limited to just 31 days of the year. Menopause is a significant life transition that affects millions of women, yet it's still surrounded by uncertainty, misconceptions and, far too often, silence.
For many people, the changes can begin long before they realize what's happening. Hot flashes that show up unexpectedly, nights spent staring at the ceiling, mood changes, brain fog, achy joints, and a body that suddenly doesn't seem to feel quite like their own. These experiences can be confusing, frustrating and sometimes overwhelming, particularly when you don't know what's causing them or where to turn for support.
The reality is that menopause is much more than the end of menstrual periods. It's a natural biological transition that can influence nearly every system in the body, from bone and cardiovascular health to sleep, mood, metabolism and musculoskeletal function. Yet many people enter perimenopause and menopause without fully understanding what's happening, which symptoms to look out for, or what treatment and support options are available.
At Bright Health Co., we believe everyone deserves access to the information and care they need to navigate this stage of life with confidence. Menopause Awareness Month is an important opportunity to start these conversations, but the need for education, understanding and advocacy continues all year long.
So, let's take a closer look at what's happening in the body, what you might experience, and how the right support can make this transition a little easier.
First, What Exactly Is Menopause?
You may have heard the terms perimenopause, menopause and post-menopause used interchangeably, but they actually describe different stages of the same transition. Understanding the difference can help you make sense of the changes you're experiencing and recognize when it might be helpful to seek support.
Perimenopause: The Transition Leading Up to Menopause
Perimenopause is the stage leading up to menopause. It often begins in your mid-to-late 40s, although the timing varies from person to person.
During this time, the ovaries gradually become less consistent in their production of estrogen and progesterone. Rather than declining in a smooth, predictable way, hormone levels can fluctuate significantly. You might notice changes in the length or regularity of your menstrual cycle, along with symptoms such as:
Hot flashes and night sweats
Difficulty falling or staying asleep
Mood changes, irritability or anxiety
Brain fog and difficulty concentrating
Changes in libido
Joint aches and muscle discomfort
For some, these changes are subtle. For others, they can significantly affect everyday life.
Perimenopause ends when you've gone 12 consecutive months without a menstrual period.
Menopause: The Milestone
Menopause is technically a single point in time: the date marking 12 consecutive months since your final menstrual period, provided there isn't another medical explanation for the absence of periods.
The average age of natural menopause is around 51, although it commonly occurs between 45 and 55. By this stage, ovarian estrogen and progesterone production has declined significantly, and menstrual periods have stopped. For some people, symptoms such as hot flashes, night sweats and sleep disruption may be particularly noticeable around this time. Others may have relatively few symptoms.
Menopause can also occur earlier than expected. When it happens before age 45, it's considered early menopause. Before age 40, it's called premature menopause. It can happen naturally, or be brought on by certain medical treatments, including chemotherapy, pelvic radiation or surgical removal of both ovaries.
Post-Menopause: Life After Menopause
Post-menopause refers to the years following that 12-month milestone.
Although some symptoms gradually improve, others can persist or become more noticeable over time. With estrogen levels remaining lower, vaginal and urinary changes, bone density loss and changes in cardiovascular health become important considerations.
This is also why menopause care shouldn't focus exclusively on managing symptoms in the moment. Understanding how hormonal changes influence long-term health is an important part of supporting your overall well-being.
Why Does Estrogen Matter So Much?
When we think about estrogen, we often associate it with menstrual cycles, pregnancy and fertility. But estrogen does much more than that. It's involved in the function of many different systems throughout the body, including your bones, heart, brain, muscles and reproductive tissues.
So, when estrogen levels fluctuate and eventually decline during menopause, the effects can extend well beyond changes to your menstrual cycle.
Let's look at some of the ways estrogen influences your health.
Bone Health
Estrogen plays an important role in maintaining healthy bones. It helps regulate bone remodelling, the ongoing process of breaking down old bone tissue and building new bone. As estrogen levels decline, bone breakdown can happen faster than new bone is formed. This can lead to a loss of bone density, increasing the risk of osteopenia, osteoporosis and fractures. In fact, a significant amount of bone loss can occur during the years surrounding menopause, making this an important time to think about strength training, adequate nutrition and bone health assessments where appropriate.
Heart and Cardiovascular Health
Estrogen also influences the cardiovascular system. It helps regulate blood vessel function and plays a role in maintaining healthy cholesterol levels. During and after menopause, changes in cholesterol, blood pressure and fat distribution can contribute to an increased risk of cardiovascular disease. This doesn't mean heart disease is inevitable after menopause. It does mean that paying attention to cardiovascular health becomes increasingly important during midlife and beyond.
Metabolism and Body Composition
Have you noticed that your body seems to be responding differently to the same exercise routine or eating habits? You're not imagining that - things can change.
Declining estrogen levels are associated with changes in body composition, including an increased tendency to store fat around the abdomen. Changes in muscle mass, physical activity, sleep and insulin sensitivity can also influence metabolism. This can make weight management feel different than it did in your 20s or 30s. Rather than focusing exclusively on the number on the scale, this is a good time to prioritize muscle strength, metabolic health, balanced nutrition and sustainable movement habits.
Brain Health and Mood
Estrogen also interacts with several processes in the brain. It plays a role in memory, learning, neurotransmitter activity and the regulation of mood. During the menopausal transition, hormonal fluctuations can contribute to brain fog, difficulty concentrating, anxiety and changes in mood. Some people notice that they struggle to find the right words or feel less mentally sharp than they used to.
These experiences can be frustrating, but they're also commonly reported during the menopausal transition. Persistent or concerning cognitive changes should still be discussed with a healthcare provider rather than automatically attributed to menopause.
Temperature Regulation
Ever wonder why a hot flash can seemingly come out of nowhere? Estrogen influences the hypothalamus, the part of your brain responsible for regulating body temperature. As hormone levels fluctuate, the body's temperature-regulating system can become more sensitive to small changes in core temperature.
The result? Your body suddenly thinks it needs to cool down, triggering sweating, flushing and that familiar rush of heat.
Because estrogen influences so many different systems, menopause is truly a whole-body transition. No two people experience it exactly the same way, and there's no single approach that works for everyone.
The Symptoms We Don't Talk About Enough
Hot flashes might be the symptom most commonly associated with menopause, but they're certainly not the only ones worth discussing. Let's take a closer look at a few of the changes that can have a significant impact on everyday life.
Hot Flashes and Night Sweats
Hot flashes and night sweats are collectively known as vasomotor symptoms, and they're among the most recognizable signs of menopause. They can feel like a sudden wave of heat spreading through your face, neck and chest, sometimes accompanied by sweating, flushing, heart palpitations or chills. Night sweats are essentially hot flashes that happen while you're sleeping, and they can make it difficult to get a full night's rest.
A few things worth knowing:
Approximately 60–80% of people experience vasomotor symptoms during the menopausal transition.
They can begin several years before the final menstrual period.
For some people, they last for many years, with an average duration often reported around 7–8 years.
For others, symptoms can be severe enough to interfere with sleep, work, relationships and overall quality of life.
The important thing to remember is that you don't have to simply put up with them. There are treatment options available, and a healthcare provider can help determine which approaches may be appropriate for you.
Genitourinary Syndrome of Menopause (GSM)
This is one of the least discussed aspects of menopause, but it's also one of the most important.
Genitourinary syndrome of menopause (GSM) describes a collection of vaginal, vulvar and urinary symptoms associated with declining estrogen levels.
You might notice:
Vaginal and sexual changes:
Vaginal dryness
Burning, itching or irritation
Reduced natural lubrication
Discomfort or pain during intercourse
Changes in sexual comfort or function
Urinary changes:
Increased urinary urgency or frequency
Discomfort or burning with urination
Recurrent urinary tract infections
Changes in bladder control
Unlike hot flashes, which may gradually improve over time, GSM symptoms often persist or become more noticeable without treatment. And because these symptoms can feel uncomfortable or embarrassing to bring up, many people simply assume they're something they have to live with.
They're not.
There are several ways to manage GSM, including vaginal moisturizers and lubricants along with pelvic floor physiotherapy. These are important conversations to have with your healthcare provider, especially if symptoms are affecting your comfort, intimacy or quality of life.
Sleep, Mood and the Emotional Side of Menopause
Menopause isn't just a physical transition. It can affect how you feel emotionally, mentally and socially, too.
Difficulty falling asleep, waking throughout the night, anxiety, low mood, irritability and trouble concentrating are all commonly reported during perimenopause and menopause. Sometimes these symptoms are directly influenced by hormonal fluctuations. Other times, they're made worse by disrupted sleep, ongoing stress or the physical discomfort of other menopausal symptoms.
And then there's the emotional side of navigating such a significant life change. You might feel frustrated by changes in your body, overwhelmed by symptoms you don't understand, or simply unlike yourself. For some, menopause also coincides with other major life transitions, such as changing family dynamics, caring for aging parents, career pressures or children leaving home. All of these experiences deserve attention.
Your emotional well-being is just as important as your physical health, and support through counselling, lifestyle changes and appropriate healthcare can make a meaningful difference.
The Musculoskeletal Side of Menopause: Why Are My Joints So Achy?
If you've found yourself wondering why your joints suddenly feel stiff and achy, or why your muscles don't seem to respond the way they used to, you're not alone. Musculoskeletal (MSK) symptoms are increasingly recognized as an important part of the menopausal transition.
A 2024 paper published in Climacteric explored what researchers describe as the musculoskeletal syndrome of menopause: a collection of symptoms involving the bones, muscles, joints, tendons and ligaments that may be influenced, in part, by declining estrogen.
These can include:
Joint pain and stiffness
Loss of muscle mass and strength
Reduced bone density
Increased risk of fractures
Tendon and ligament discomfort or injuries
Frozen shoulder
Changes in cartilage and joint health
Research suggests that musculoskeletal symptoms are particularly common during the menopausal transition, with some people experiencing significant pain even when imaging doesn't show obvious structural changes.
So, why does this happen?
Once again, estrogen plays an important role. Estradiol, the most active form of estrogen, influences the health and function of bone, muscle, cartilage, tendons and ligaments. As estrogen levels decline, changes in inflammation, bone remodelling and muscle maintenance can contribute to joint discomfort, reduced muscle strength and declining bone density. Over time, these changes can affect mobility, physical function and the body's ability to recover from everyday physical demands.
The good news? There are proactive steps you can take to support your musculoskeletal health. Strength training, appropriate physical activity, adequate protein and nutrient intake, and targeted care can all play a role in maintaining muscle and bone health.
Something else we think is important: understanding the relationship between menopause and musculoskeletal health can help explain why you're experiencing changes that might otherwise feel confusing or unexpected. Your aches and pains aren't something you have to dismiss as simply getting older. They deserve to be understood, assessed and addressed.
How a Collaborative Healthcare Team Can Help
By now, one thing should be clear: menopause affects much more than one area of the body. From sleep, mood and metabolism to bone health, joint function and pelvic health, there's a lot happening during this transition. That's why we believe a collaborative approach to care can be so valuable.
At Bright Health Co., our multidisciplinary team looks at your health from different perspectives, helping you access support that considers both your individual symptoms and your overall well-being.
Depending on your needs, that support may include:
Naturopathic Medicine
Naturopathic doctors take a whole-person approach to menopause, looking at how hormonal changes may be influencing different aspects of your health. Appointments can include a detailed review of your symptoms and health history, appropriate laboratory investigations, personalized nutrition and lifestyle recommendations, botanical medicine and a review of supplements. Whether you're struggling with sleep, energy, mood, digestion, metabolic changes or bone health, naturopathic care can help you better understand what's happening and explore supportive strategies.
Acupuncture and Traditional Chinese Medicine (TCM)
In Traditional Chinese Medicine, menopause is viewed as a natural transition in which the body's balance changes over time. Rather than taking a one-size-fits-all approach, treatments are tailored to your individual presentation and concerns. Acupuncture may be used as a complementary approach to help manage symptoms such as hot flashes, night sweats, sleep difficulties, stress, anxiety, headaches and musculoskeletal discomfort.
Counselling
There's more to menopause than hormones, and having a space to talk about the emotional side of this transition can be incredibly valuable. Counselling provides an opportunity to work through anxiety, low mood, changes in identity, relationship challenges and the stress that can accompany this stage of life. It can also help you develop practical tools for navigating change, building resilience and prioritizing your emotional well-being.
Chiropractic Care
Menopause-related changes in muscle and joint health can affect how comfortably you move throughout the day. Chiropractic care can help support mobility, joint function and musculoskeletal comfort through individualized hands-on treatment and movement-based strategies. Depending on your needs, care may also incorporate soft tissue techniques, cupping, acupuncture and education around strength training, posture and movement. Our chiropractors can also help you understand how to support your musculoskeletal health as you navigate changes in bone density, strength and mobility.
Physiotherapy & Pelvic Floor Physiotherapy
Movement is one of the most important tools we have for maintaining strength, balance, mobility and bone health as we age. Physiotherapy can help you develop an individualized exercise program that supports muscle strength, joint function, balance and confidence with movement.
Pelvic floor physiotherapy is also particularly important during menopause as changes in estrogen can affect the tissues of the pelvic floor, contributing to symptoms such as urinary leakage, urgency, pelvic discomfort and vaginal changes. A pelvic floor physiotherapist can help assess your individual needs and develop a treatment plan to improve pelvic floor function, manage symptoms and support your quality of life.
Registered Massage Therapy
Sometimes, your body just needs a little extra care and relaxation. Massage therapy can help ease muscle tension and reduce feelings of tightness and discomfort. Whether you're experiencing sore shoulders, tight hips, back discomfort or general muscle tension, massage can be a helpful addition to your overall wellness routine.
The best part of a collaborative approach is that you don't necessarily have to choose just one avenue of support. Different practitioners can work together to address different aspects of your health, with care tailored to what matters most to you - that’s the bright approach!
Menopause Awareness Matters All Year Long
Menopause is a natural part of life, but that doesn't mean navigating it is always easy.
Too many people still enter perimenopause without knowing what to expect. Too many symptoms are dismissed as stress, aging or something they simply have to live with. And too many people don't realize just how much support is available.
We want to help change that.
Continued menopause awareness means creating more opportunities for open conversations, making reliable health information easier to access, and ensuring people know that their symptoms deserve to be taken seriously. It also means recognizing that menopause care isn't one-size-fits-all. Everyone's experience is different, and access to knowledgeable healthcare providers and appropriate treatment options can make a meaningful difference.
Whether you're just beginning to notice changes, navigating more challenging symptoms, or well into post-menopause and looking to prioritize your long-term health, it's never too early or too late to seek support.
At Bright Health Co., our team is here to help you feel heard, informed and supported throughout every stage of life. Because menopause awareness shouldn't be limited to one month of the year, and neither should access to the resources and care that help you feel your best.
Want to learn more about how we can support you? Book an appointment with our team at Bright Health Co. and let's start the conversation.
WRITTEN BY: SHELBY SLY, NATUROPATHIC INTERN
Disclaimer
The advice provided in this article is for educational information purposes only and is intended to complement, not replace consultation with a licensed healthcare provider. Menopause symptoms and treatment options vary from person to person. Please consult with an appropriate healthcare provider to discuss your individual health concerns and determine the care that's right for you.