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The Menopause Survival Guide: Navigating Menopause with Style

Menopause is different for everyone. The average age of menopause is 51 but just as our periods start at various ages, we all enter menopause at different times too. There are three stages of this process: perimenopause, menopause and postmenopause. It’s important to know the difference because education is the first step in self-care. We sat down with Dr. Patti Ischiropoulos, an OB/GYN with Main Line Health to figure out how to manage menopause.


On average, women start to experience perimenopause about five to seven years before menopause. However, keep in mind that not all women will experience perimenopause symptoms. Some women may only notice subtle changes in their menstrual cycle while others will experience hot flashes or have trouble sleeping. If you’re experiencing these symptoms but are still getting your period regularly, this stage is perimenopause.


When you haven’t had your period for one year and you’ve ruled out other causes, you’ve entered menopause. Menopause correlates with when your ovaries stop producing estrogen. For some women, this happens in their late forties, for someone else its mid-fifties. “There’s a range for all things,” Dr. Ischiropoulos says.

Symptoms of menopause include hot flashes, disturbed sleep, night sweats, vaginal dryness or pain during intercourse, which is due to thinning of the vaginal walls.

While these physical changes can be uncomfortable there are many ways to manage your menopausal symptoms. Eat a healthy diet, find ways manage your stress and exercise regularly. There are also many medical options: hormone replacement therapy (HRT), certain antidepressants, vaginal therapies as well as several other options.

Whichever you choose, Dr. Ischiropoulos says it’s always important to talk to your doctor first in order to determine which treatment is best for you. Each option comes with its own risks and benefits, which will be different for everyone. For example, HRT comes with a variety of risk factors that should be taken into account like increased risks for blood clots, stroke, cancer and osteoporosis.

“Despite these risks, there is a place for hormone treatments. It’s true that some women are able to just manage things and won’t need hormone therapy, but listen to yourself and don’t suffer in silence,” Dr. Ischiropoulos says. “If you’re constantly not sleeping and hormones can help, let them help you. As long as your medical history is clear and you understand the risks, they’re okay for short-term use.”

Lastly, this is a vital time to take care of yourself through diet and exercise. Bone loss accelerates during menopause so calcium and vitamin D are extremely important. When estrogen levels become low, your risk for heart disease and attacks also increase. Have an honest discussion with yourself about setting realistic goals for how you’re going to tackle your diet and how you’re going to fit exercise into your routine.


Postmenopause begins once your symptoms end, however, some transitional symptoms can occur during post-menopause.

During menopause our metabolism slows down and the way we lose and gain weight changes. As a result, many women become frustrated with their body image but Dr. Ischiropoulos encourages self-love through self-care: Keep a food diary and stay away from processed foods and foods high in fats and sugar. Eat lean proteins, vegetables, and fruit. Drink water to stay hydrated.

Dr. Ischiropoulos advises that these healthy changes can’t be about the scale – the mental shift needs to be a focus on lifestyle changes.

For more information about women’s reproductive health, visit Main Line Health here.