Menopause, the change no one warns about

Menopause is a natural stage of a woman’s life, but its physical and emotional effects often remain misunderstood or unspoken. Disrupted sleep and hormonal changes lead to anxiety, shifting identities and concerns about long-term health. It is a transition that deserves greater understanding, informed care and compassion.

Dr. Tatiana El Hachem, obstetrician and gynecologist, began by dismantling the biggest misconception. “Menopause is not an illness,” she told The Beiruter. “It is the permanent end of ovarian function, confirmed after twelve consecutive months without a period.” The average age is around 51, but the journey starts earlier. Perimenopause, the unpredictable transition, can stretch across four to eight years as estrogen and progesterone fluctuate and then decline.

The consequences reach far beyond hot flashes. Dr. El Hachem described night sweats that fracture sleep, palpitations, joint pain, brain fog, anxiety, and low mood. “Estrogen receptors exist in the brain, the bones, the heart, the bladder, and the skin,” she noted. “When the hormone withdraws, every one of those tissues feels it.” She warned that vaginal dryness and urinary urgency tend to worsen without treatment, while bone density drops sharply in the first years after the final period, and cardiovascular risk climbs afterward.

This explains why many women now choose menopausal hormone therapy, which replaces estrogen, combined with a progestogen for women who still have a uterus. Dr. El Hachem corrected a popular myth. “Hormones do not stop menopause, and they do not keep anyone alive,” she clarified. “They relieve symptoms and protect bone, and they may offer cardiovascular benefit when started early. The ideal window is within ten years of menopause, or before the age of sixty.”

She was equally candid about the risks. Combined therapy carries a small increase in breast cancer risk with prolonged use, and oral estrogen can raise the risk of blood clots. “It is never a blanket prescription,” she stressed. “Women with a history of hormone-sensitive cancers, clots, or unexplained bleeding need other options. Every decision demands a personal risk assessment.” Her final message was that “no woman should suffer in silence when relief exists.”

“My body became a stranger”

The first sign for Yolla, 54, was exhaustion. “I woke at three every morning, drenched, with my heart racing,” she recalled. “I thought I was dying.” Months of confusion followed. Her periods vanished and returned, her patience evaporated, and a woman once known for her calm began snapping at her own family.

The emotional toll cut deeper than the physical one. “I cried over nothing, and then I felt ashamed for crying,” she confessed. “I lost words in the middle of meetings. I wondered whether I was losing my mind.” The turning point came when she finally spoke openly with a doctor and her sister. “The moment I named it, it stopped frightening me,” she reflected. With lifestyle changes and medical guidance, her nights steadied. “I am not the woman I was at forty, and I have stopped mourning her,” she added, smiling. “The woman I am now is braver.”

“I stopped apologizing”

Laudy, 56, met menopause with humor, at least at first. “I joked that my body had installed its own heater,” she laughed. The jokes faded when the insomnia set in, along with aching knees and a creeping sense of invisibility. “Nobody warned me that I would feel unseen,” she admitted. “I had spent my life being useful, and suddenly I felt irrelevant.”

Her recovery was gradual. She walked every morning, strengthened her muscles, and joined a small circle of friends who shared their experiences without embarrassment. “We traded advice continuously,” she remembered. Today, she described an unexpected freedom. “My periods are gone, the worry is gone, and so is the urge to please everyone,” she declared. “I stopped apologizing for taking up space.”

Menopause is neither a defect nor a finish line. It is a biological threshold that demands medical attention, honest conversation, and compassion. The greatest remedy may be the simplest, refusing to treat it as a secret.