Menopause is a major life transition, but it affects everyone differently.

Symptoms may come and go, so it’s not always easy to know when you’ve officially started. Plus, all the focus seems to be on hot flashes when there are plenty of other symptoms you might experience.

We asked a gynecologist some of the most common questions about menopause. Here’s what you should know as you prepare for this natural life transition, including information to keep in mind at your next gynecologist appointment.

Is it menopause or something else? Good question!

Menopause typically starts in your late 40s or 50s, but may start earlier or later. Symptoms may differ based on a variety of factors, like lifestyle, environment, and genetics.

According to Linda Goler Blount of the Black Women’s Health Imperative (BWHI), Black women are more likely to experience hot flashes and night sweats, while white women are more likely to experience vaginal dryness.

Here are a few signs that you might be experiencing menopause:

  • Your periods start to become irregular. They may also become heavier or lighter.
  • You experience hot flashes and night sweats.
  • Sex may become painful because of vaginal dryness.
  • It’s harder to get to sleep and stay asleep.
  • You’re more irritable than usual.
  • Your energy stores are low.
  • Your libido changes.
  • You notice hair and nail changes, like thinning or dryness.

All these can be signs of other conditions, too. It can be tricky to pinpoint when you’re actually going through it, though, because menopause takes place over time.

The following can also cause a loss of a period and may be mistaken for menopause:

  • pregnancy
  • thyroid or pituitary gland problems
  • ovarian tumors
  • polycystic ovarian disease (PCOS)

That’s why it’s important to stay connected with a healthcare professional. They can help determine whether menopause or something else is causing your symptoms.

It’s possible for menopause to coincide with changes in libido. Hormone fluctuations can contribute to a decrease in your sex drive, and vaginal dryness can make sex less pleasant.

But it’s complicated. Many factors can influence your interest in sex, and not everyone experiences a dip in libido as they enter menopause.

If these symptoms are bothering you, here’s what to ask at your next gynecologist appointment:

  • Is my loss of libido due to hormonal changes? A doctor can order tests that evaluate your hormone profile.
  • What treatment would you recommend for me? Medications, hormone therapy, and lifestyle changes are all potential options for addressing low libido. Additionally, lubricants can help make up for a loss in natural lubrication, making sex more enjoyable.
  • Can you recommend a lubricant? If you have sensitive skin or just don’t know where to start when it comes to lube, ask your gynecologist. They can provide some recommendations.

At the same time, let the doctor know about any other sexual health concerns you have, like pain during sex or abnormal bleeding.

You’ve spent your whole life getting adequate shut-eye, and now that you’re entering your late 40s and 50s, you’re suddenly experiencing sleep disturbances. What gives?

Menopause can make it harder to fall asleep and stay asleep. One reason is that hormonal shifts can make it tough to regulate your body temperature and keep you up at night.

If insomnia is a new problem, ask your gynecologist about treatment options.

Before recommending hormone replacement therapy, medication, or cognitive behavioral therapy (CBT), they may suggest some lifestyle changes to make it easier to sleep. These changes may include limiting caffeine intake, exercising more, or improving your sleep hygiene.

They may also recommend additional testing to rule out other issues that may be affecting your sleep.

According to Paula Green-Smith of BWHI, sleep issues during menopause can worsen other symptoms, like weight gain and overall physical health.

Yes. Regular pap tests and mammograms are even more important as you enter menopause because the risk for certain cancers increases as you get older.

The American Cancer Society (ACS) recommends people between 25 and 65 get a combined Pap and HPV test every 5 years or a Pap test only every 3 years.

The ACS recommends yearly mammograms starting at 45 for those with an average risk of breast cancer and every 2 years after age 54.

Talk with a healthcare professional about the right screening frequency for you. Depending on your health history, you may need more or less frequent testing.

Other tests to ask about at your next gynecologist appointment include a:

  • Bone density scan: This scan assesses your risk for osteoporosis.
  • Lipid profile: This test is used to check your cholesterol levels. Menopause can negatively affect your cholesterol levels, which can increase your risk for heart disease.
  • Blood glucose (A1C) test: This test assesses your risk for type 2 diabetes.
  • Thyroid tests: These tests assess your thyroid hormone levels. Thyroid problems can be more common in older age.

It’s also a good idea to keep tabs on your blood pressure, which you can do at home with an at-home monitor.

If you’re unsure how to properly use a personal blood pressure monitor, bring yours to your next appointment and ask your healthcare professional to show you how to use it.

Hormone changes during menopause may affect your overall mental well-being.

Menopause-related hormone changes can lead to a host of sleep issues that can affect your mood. Physical symptoms like night sweats and hot flashes can affect your sleep quality and lead to irritability.

Suffice it to say, menopause is a major life transition. The physical changes you experience can influence your well-being and sense of self. Plus, you may be going through other life changes in your late 40s and 50s that affect how you feel about yourself and your role in life.

If menopause is affecting your emotional health, ask your gynecologist about treatments, including therapy or medications. You may also benefit from joining a support group.

Hormone therapy, formerly called hormone replacement therapy (HRT), involves taking estrogen or a combination of estrogen and progesterone in pill, topical, or patch form. Which combination you’ll take depends on whether you’ve had a hysterectomy.

Hormone therapy can help with common menopause symptoms like night sweats, vaginal dryness, and even bone loss.

It’s not for everyone, though. Long-term hormone therapy may increase your risk for certain diseases, including breast cancer and heart disease.

If you’re interested in hormone therapy, ask your gynecologist about the pros and cons and whether it might be right for you.

Supplements that may help alleviate menopause symptoms include:

  • Vitamin D and calcium: These help prevent bone loss that may lead to osteoporosis.
  • Vitamin E: Vitamin E may help reduce episodes of hot flashes.
  • B vitamins: These may help balance your mood.
  • Melatonin: Melatonin may help with sleep.
  • Black cohosh tea: This tea is commonly used in the Black community, says Green-Smith, for a number of symptoms, like hot flashes, night sweats, vaginal dryness, heart palpitations, tinnitus, vertigo, sleep disturbances, nervousness, and irritability.
  • Red clover: Another herb commonly used in the Black community, this herb has also been found to help with hot flashes.
  • Evening primrose oil: A 2021 study found that evening primrose oil effectively decreased the frequency and severity of night sweats.

Before taking any supplements for menopause symptoms, talk with a doctor to find out whether they’re safe, especially if you take any medications.

In addition to regular checkups with your gynecologist and any doctor-prescribed treatments, the following complementary therapies may provide some relief:

  • acupuncture
  • yoga
  • meditation
  • massage therapy

While your gynecologist can be a good resource for menopause-related info, short appointment times can sometimes make it hard to ask everything on your mind.

If you find yourself with lingering questions, the following resources may help fill in the gaps between appointments:

Your next gynecologist appointment is a great opportunity to ask important questions about menopause.

And your gynecologist isn’t the only person available to help.

There are plenty of ways to find connection and encouragement during this transition. Speaking with a friend who has already gone through menopause, talking with an empathetic therapist, or finding a menopause support group can also help provide helpful support.