Eight Things You Might Not Know About Menopause

While every woman will go through menopause, education and awareness of its signs and symptoms is still limited

Do you suspect menopause might be on your not-so-distant horizon? Then it’s time to start talking. “Menopause is a natural stage in every woman’s life, yet it remains misunderstood and often surrounded by silence,” says Dr. Ido Sirota, a leading women’s health specialist and gynaecologist focused on increasing awareness and education in the region through public talks and outreach initiatives.

“Cultural taboos and a lack of open discussion can leave many women unprepared for the physical and emotional changes that come with menopause. As a gynaecologist specialising in women’s health in general and menopause specifically, I want to empower women with knowledge so they can navigate menopause with confidence.”

Here are eight crucial things every woman should know to improve protect the mind, body and soul during menopause.

Menopause Is More Than Just Hot Flashes

“Most women associate menopause with hot flashes, but the reality is much more complex,” says Dr. Ido. “Oestrogen, the primary female hormone, plays a role in nearly every system of the body, and as oestrogen levels decline, women may experience myriad issues.” These can include:

Skin and hair changes—Loss of collagen leads to thinner, drier skin and more fragile hair.

Joint pain—Oestrogen has anti-inflammatory properties, so its decline can contribute to joint discomfort.

Heart health risks—Women’s risk of heart disease increases after menopause because oestrogen protects the cardiovascular system.

Cognitive changes—Some women experience brain fog, memory lapses, and difficulty concentrating.

Understanding these changes can help women seek the right medical advice, lifestyle adjustments, and treatments to stay healthy and active.

Menopause Can Start Earlier Than You Think

“Many women believe menopause happens suddenly at 50, but the transition actually begins much earlier. Perimenopause—the phase leading up to menopause—can start in a woman’s late 30s or early 40s and last several years,” says Dr. Ido. Symptoms may be subtle at first, but can include:

Irregular periods—menstrual cycles may become irregular—shorter, longer, heavier, or lighter—and skipped periods or spotting between cycles can also be common.

Increased Premenstrual Syndrome (PMS)-like symptoms—Women may experience more intense PMS-like symptoms such as bloating, breast tenderness, irritability, or cravings often caused by hormonal shifts.

Sleep disturbances—Difficulty falling or staying asleep may be linked to night sweats, increased stress, or reduced melatonin production.

Factors such as genetics, smoking, autoimmune conditions, and even high stress levels can lead to earlier menopause, and recognising these signs early will enable women to be proactive about their health.

Hormone Therapy: Myths vs. Reality

Hormone Replacement Therapy (HRT) has been surrounded by controversy for decades, but it’s time to dispel the rumours. “Many women avoid it due to fears of cancer or other complications, but modern research shows that HRT can be safe and highly effective for most women, especially when started early and monitored carefully by your gynaecologist,” says Dr. Ido. “HRT involves taking oestrogen (sometimes with progesterone) to relieve menopause symptoms, which can reduce hot flashes, improve sleep, prevent osteoporosis, and protect heart health.” For some women, HRT may slightly increase the risk of blood clots or certain cancers, but the risks are lower in younger, healthy women. “Not every woman needs HRT, but those struggling with severe symptoms should consult a gynaecologist specialising in menopause to understand the safest and most beneficial options,” he adds.

Menopause And Weight Gain: What You Can Control

“One of the most common and frustrating aspects of menopause is weight gain, especially around the abdomen,” says Dr. Ido. “This happens because metabolism slows down due to hormonal changes, a loss of muscle mass makes it harder to burn calories, and oestrogen influences how fat is distributed in the body.” Instead of resorting to extreme diets, the best approach is to focus on:

Strength training—Lifting weights preserves muscle and boosts metabolism.

Balanced nutrition—A diet rich in protein, fibre, and healthy fats helps manage weight effectively.

Intermittent fasting—Some women find that time-restricted eating helps regulate insulin and weight.

By making these adjustments, women can maintain a healthy weight and energy levels well into their postmenopausal years.

Intimacy Issues During Menopause Deserve More Attention

Perhaps one of the least talked-about side effects of menopause is the impact that it can have on intimacy in mid-life. Decreased libido due to hormonal changes and emotional barriers such as feeling less desirable, or struggling with body image changes, can cause our intimate relationships to deteriorate. There are, however, plenty of solutions to be sought. “Women should not feel embarrassed to seek medical advice, as sexual health is an important part of overall well-being,” advises Dr. Ido. A gynaecologist can advise on practical solutions and treatments for any discomfort during intimate moments, including localised oestrogen therapy—such as creams, rings, or tablets—to help restore tissue elasticity, along with CO2 laser therapy, radio-frequency therapy, and hyaluronic acid therapy to restore vaginal tissue condition and hydration.

Bone Health: A Silent Concern

While symptoms such as hot flashes may be well known, many women aren’t aware that oestrogen is crucial for maintaining bone density. “After menopause, women are at a higher risk of osteoporosis and fractures, especially in the hip, spine, and wrists,” says Dr. Ido. “Risk factors are even greater in the Middle East due to vitamin D deficiency—many women avoid sun exposure, which limits vitamin D absorption—and low calcium intake, as diets low in dairy or fortified foods can accelerate bone loss.” Preventative steps include:

Bone density scans—Regular screening can detect bone loss early.

Strength training and weight-bearing exercise—Walking, running, and resistance workouts strengthen bones.

Calcium and vitamin D supplementation—Speak with your gynaecologist about the right dosage.

Taking control of your bone health can prevent fractures and mobility issues later in life.

Menopause Isn’t Just Physical

“Menopause can have a profound impact on mental health, and ignoring this can make symptoms worse,” says Dr. Ido. “Women must prioritise their emotional well-being just as much as their physical health.” Issues to look out for? “Hormonal fluctuations can make emotions feel unpredictable, leading to mood swings and irritability, and can even trigger mental health struggles that need professional support, such as anxiety and depression,” he continues. Sleep disturbances such as insomnia and night sweats can also contribute to chronic fatigue and irritability, but there are many steps that can help improve your sleep quality, such as:

Mindfulness and meditation—Studies show these practices reduce anxiety and promote mental clarity.

Regular exercise—Movement boosts mood-regulating hormones like serotonin and dopamine.

Seeking support—Therapy, support groups, or even talking to friends or your partner can make a big difference.

Menopause Is Not the End—It’s a New Beginning

“Many cultures view menopause as a decline in femininity, desirability, and vitality, but in reality, menopause can be a new chapter of freedom and self-discovery,” says Dr. Ido. There are, in fact, several positives to this new phase of life—no more periods, cramps, or PMS, for a start. It is possible to make menopause your era to focus on self-care and personal goals, while prioritising health and well-being. “Rather than fearing menopause, women can embrace it as a time to redefine themselves. With the right knowledge, support, and medical care, menopause can be a powerful transition into a confident and healthy future.”

For more information on women’s health, follow Dr. Ido Sirota on Instagram.

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